On breast strike? But will drink XBM from bottle...

[Emma-Rose's mom]

My lo is 6 mo, and I don't know what's going on with her in regards to bfing. For the past 6 months, DD usually nursed at home and took bottles of XBM at daycare. But, lately, she's been refusing breast and will only take XBM in bottle.

When I try to nurse, she seems either:
1) impatient that let-down is slow and will not stay latched. Will start screaming until she gets bottle of XBM.

2) will bob off the breast as soon as let-down happens. (really frustrating, since then I spray everywhere) then she won't go back on

3) if I get her to nurse, she only nurses on one side (instead of both), and for only a couple of minutes. Then she detaches and starts arching her back and refuses to go back on. I have considered if she's "done" and is just more efficient, but when I offer bottle afterwards, she always takes a full feeding.

I'm not really sure how to get her back on breast. It's double the work to pump and give her bottle, plus we all know the pump isn't as efficient, and she's starting to use up all my spare milk in the freezer, which I need for work... Plus, when I go out, I can't pump in public for her!

She has never been on formula, and I really don't want to supplement with that. Any suggestions or ideas? Would really appreciate it!

[mum101]

HUGS, I don't have much to offer, but I found that DD did the same, as we'd began to offer her a bottle of EBM at night because she was so hard to feed.  IMO mixing bottle and breast is tough!

[Emma-Rose's mom]

Thanks, mum101, for your hugs.

Since last I posted, I have not had any progress. I offer breast first before feeding, but DD is now completely refusing breast and won't latch at all. I fight with her as she squirms for about 20 minutes, then I give in and have to pump and put bm in bottle, which she always takes.

Is there anyone out there that can help me?

Or is this a sign that she is already weaning herself? I'm not ready yet! She's not even 7 months yet, and I hate the idea of going to formula. Blah!!

Mika

[Emma-Rose's mom]

Stacy, IKWYM. But, I don't have a choice.  I have to give bottles at least 2x per day, sometimes 3x per day because I work and DD goes to daycare. It would be so much easier if I was a SAHM; then, I could only offer breast and she would probably go back onto breast if left no other choice, even if it were a struggle at first.

I hate pumping, and it's definitely extra work. Currently, I am like you, pumping 4x per day. Yuck!  But, I'm most concerned with days when I go on outings on weekends with family or something. I can't pump while I'm out to give her a bottle, unless I pack bm in a cooler. I worry about bm going bad if left out too long. My DH is not supportive about supplementing with formula, either...

Should I be hardball, and just offer breast when I'm home? even if it means she skips a meal and goes hungry???

Mika

[clh]

Well, I haven't been in your position, beyond the usual distracted-ness.  I agree that this probably is not self-weaning at this age.  I also like the idea of talking with a LC.  They've seen/heard it all before.  Do you have one?  I think there's something in the FAQs about finding one.

What bottles do you use?  What flow nipple?  If you don't want to move to something like a haberman (medela special needs nurser, now, I've heard recently) I'd at least suggest moving to the slowest flow you can.  Can you talk to daycare about how they give her bottles?  Do they hold her/the bottle for her?  My LC suggested giving the bottle for a few swallows, removing it for a few moments (like putting your fork down between bites as an adult), then giving again for a few swallows.  Would they be willing to try something like that?  My boys go to daycare, too, and I understand about that being different/difficult to manage.

Where do you feed her?  Dark, secluded (boring) room?  Is she trying to spread out her feedings?  How often was she feeding before this?  Is she cutting teeth?  Ear infection?  other physical ailment?

Maybe when you're with her try for 10 minutes & then let it go for 10-15, then try again for 10, then relax again, etc?  Will she feed when she's sleepy?  Can you keep her close (sling, etc)?  Skin-to-skin?  Offer often.  What if you pumped to get let-down, let it spray in a towel & then tried to latch her?  The flow would be there, but she wouldn't get flooded.  I really don't know, hun.  I'm just throwing ideas out there.

{{hugs}}

[Emma-Rose's mom]

I use Dr. Brown Bottles, which work just like a haberman bottle. On top of that I use the lowest flow teat, possible. She's still using the newborn teats. So, I don't think switching bottles is really the thing... but thank you, ladies, for the idea.

I always try to nurse in my rocker and close the blinds so there are minimal distractions. I even tried to wear a toy necklace around my neck to see if that would help her stay focused on me, but alas, that didn't work either.

Yesterday I got her to nurse once, and it was only when I woke her early from a nap and put her on breast immediately while she was still groggy (sort of like a df). She did nurse on one side, but when she started to wake up and be more alert, she started smiling and let go. I tried to relatch, but she wasn't interested. So, she didn't get a full feed. I tried to offer breast again 30 minutes later, but still not interested. I was worried about encouraging snacking, but it looks like I don't have to worry about that since she didn't go back on anyway.

At night for df, she will usually nurse one side but won't switch sides, so she, again, doesn't get a full feed. I think this may be the reason for my recent NW at 3:00 AM in the morning. I don't feed in the middle of the night, though. I don't want to create yet another bad habit due to this feeding blip. She will usually resettle, and hopefully a hungry tummy in the morning is more motivation to nurse...

Today, I'm 4 for 0. (4 attempts and 0 successes). Two times, she tried to nurse and got frustrated that let-down wasn't happening fast enough and let go. Then it was cry, cry, cry and would not relatch. So, I had to get her bottle. I like the idea of pumping first to get let-down going, then try to latch her. Maybe if she's rewarded immediately with milk, she'll continue? Will try that and let you ladies know how its going. Thank you for the suggestions.

Am about to go in and do a df now. Wish me luck.

[Emma-Rose's mom]

Okay, so I'm frustrated now. 

She nursed last night for df on one side to start  but wouldn't switch sides because she was fast asleep and I didn't have a bottle to wiggle the tip of the teat in her mouth.    But, at least she nursed.

Then AM came, and she actually slept through until 7:00 AM for the first time this week. Since I had to wake HER, she was quite groggy when I started to nurse and miraculously she did both sides.

But then, it was all down hill from there...

The rest of her feedings, she would latch for a minute, then go off and would not go back on. Then its cry, squirm, cry, squirm, arch back, kick... Obviously she was hungry but would not go back on breast. So I always had to go get her bottle to top off her feeding. Then I had to pump afterwards, but I was so anxious that I was having trouble with let-down from the pump... Agghh! So frustrating. Even though I was somewhat successful in getting her to start on breast, it didn't last longer than a minute and I ended up having to pump anyway, and sometimes w/o success due to anxiety.

I'm also worried about my milk supply now, since this whole breast strike started, I've noticed quite a reduction in my supply. Don't get as much yield when I manage to pump, so I have to pump more than once to get enough for 1 full feeding... (I know that's normal, but I used to be able to pump a full bottle in one sitting). It seriously stinks having to pump 5 or 6  or more times for 4 feedings.  Okay I'm venting now....

It's summer here, and DH wanted to go to the beach, so we went. Tried to nurse, and of course, she didn't want it. Just cried at the beach. Then had to give her a bottle. Since we were at the beach all day, I had to try to pump at the beach, at least once. (very discretely under a nursing cover) But, talk about anxiety and not getting let-down! I'm sure lack of let-down and not getting a drop is not helping when in comes to trying to maintain my supply... That's the kind of problem I have all the time now since DD went on breast strike... I can't go out w/o having days like this, so I really just end up trapped at home...

AGGGHH!!! Sorry for venting, just need to let out some steam now.

You ladies have been very helpful and encouraging. I know I just need to keep working on it a little at a time, but I can't help thinking that weaning to formula may be coming around the corner soon, even though I don't really want to go that route...

[clh]

{{hugs}} Mika.  I agree that sleeping till 7 is a good sign.  Hungry babies wake up.    Other than that, all I know is to keep trying & pumping if she won't take it. 

Non-prescription hers are fenugreek & blessed thistle, both at herb supply shops.  I also liked Mother's Milk tea by Traditional Medicinals.  That's at herb shops, too, but I also found it in the organic section of my regular grocery store. 

You're so committed to Emma-Rose!  I hope she cooperates soon. 

[Samuel's mum]

You've had great advice so far. But I wanted to just pop on and say 'HUGS'

That's great she did nurse last night.

I would second the suggestion to consider galactalogues to increase your pumping output - either domperidone on prescription or blessed thistle/ fenugreek.
It seems clear that this is related to bottle use as has been mentioned and as you have identified but as you say you may not have much choice in the matter. I want to just question one thing though - you say the Dr Brown bottles you use work similarly to a haberman feeder (now known as the medela special needs feeder). That sounds odd to me. I have a haberman feeder upstairs and have a couple of friends who use Dr Brown's. The 'anti-colic' device in a Dr Brown's bottle bears no relation to the way a haberman feeder works. Is there a new brand of Dr Browns that I'm not aware of? And if so would you mind posting a link?
The only 2 bottles I'm aware of that really do mimic breast flow (as best they can) are the haberman feeder on zero flow and a bottle in the UK 'breastflow'.
I've just had a look at the Dr Brown's site and all I'm seeing is reference to the anti-colic/ internal vent thing. That won't minimize flow confusion.

In cases like these some mums have luck using a nipple shield as it feels more like a bottle. It can be removed part way through a feed quite often.
I would have a go at persevering with the breast when you are at home. But only you can know how far to take that.

This is an age where babies can sometimes throw us for a loop. They can get distractible and seem reluctant at the breast generally. Your dedication is inspiring and I hope you can get through this. But I do wonder whether rethinking the bottles might help. I don't want to tell you to fork out buying a medela special needs feeder and then find it makes no difference but they do have a history of helping with this problem.

[Samuel's mum]

Yes - Dr Brown does control the airflow and prevents a vacc um building. However this doesn't work to slow down the flow - it actually can make it faster as the baby doesn't have to suck against the negative pressure of the vacc um. It makes it more free-flowing. The baby doesn't 'milk' as they do at the haberman.

[Emma-Rose's mom]

Ladies, this is so wonderful! I feel very supported, even though I'm still not sure of what I'm doing at the moment or what DD is going through... Thank you also for the suggestions on what to take to increase my yield. That will definitely help! Hopefully I can pump enough to have extras frozen again. Lately, I've been using up all of my extras, since DD is taking more in bottle than I can pump. 

I think you are right, in that Dr. Brown's bottles work differently than a habermen. My mistake... I was under the impression when I purchased the bottles that they worked similarly... I wonder how I got that idea? Hmm... Well, anyway, I remember being told by the sales person that they work much in the same way as nursing and that babies would have to work for their milk... but maybe I was misinformed. I'm open to trying habermen bottles, but not sure how DH would feel about having to buy new bottles  He's very much a minimalist and already thinks babies these days have more than they need and DH constantly complains of everything DD already has... I'll have to run it by him before making any new purchases.

Today has been quite the difficult day.

Like previously days, when groggy, at least she is more receptive to breast and she is more patient with let-down and would start nursing. I managed to get her started at 7:00 AM. But, she still would come off breast after a minute.  So forget trying both sides.  I'm not sure what's going on with that, because I actually have a fairly strong let-down, and she doesn't have to work that hard for milk once letdown happens. So, why does she come off? Then, of course, I have to pump a bottle so she can finish a full feed instead of snacking. She would normally take an extra 4 ounces when I top off w/ bottle.

Then I had a girlfriend who came to visit me from out of town. So, DD and I went out with her, and she refused to nurse the entire time we were out. I didn't have a pump with me and wouldn't have been able to even if I wanted. It's not like I could just plug in the pump wherever we were and give her a bottle... So, DD went hungry all day. Poor thing...  I was ready to burst when I got home! I'm sure going all day w/o pumping was probably not good for increasing yield... Even once at home, I tried to nurse, and she STILL refused. She must have been starving. But, she managed to down 2x the amount of her regular feed when I offered bottle...

So the battle wages on...

Thank you all for listening and reading my rants. I feel understood and supported. 

[Emma-Rose's mom]

Stacey, I totally understand everything you've posted. Thank you for all of your suggestions. I think I will try to feed while sleepy, but I have a question.  DDs naps aren't consistent, and sometimes she naps 2 hours and stays on "schedule" and other times only 45 minutes. Should I offer a feed early if she wakes early from naps so I can take advantage of her being sleepy? If so, do I need to go off my 4-hr EASY and do more feeds during the day?

She's sttn again, thank goodness! So I know she's getting enough. But she does go to daycare 3X per week, and she takes bottles all day when she's there. Plus, when she's at home, I've been topping off with bottle. So, I think that's been helping and keeping her from NWs.  I wouldn't mind not topping off if DD would at least stay on breast for 5 minutes, but many times she was coming off pretty much about 10 swallows after letdown, and I was thinking that physically it's impossible for her to have gotten enough?  I guess I'm hesitant about not topping off during those circumstances for fear of the NWs returning. On the flip side, she did nurse for 5 minutes this morning at 7:00, and I noticed my breast on that side was empty when she was finished. So I did not top off, and felt okay with that.

I'm sure going to daycare part-time and staying home part-time adds to the problem.

I will talk w/ DH about habermen bottles and see what he thinks...

[Samuel's mum]

That makes sense to me Stacy!
Sorry I haven't long to post as FIL is visiting. I think mentioning the haberman feeders is a plan. Good Luck with that.

[Samuel's mum]

Do you know that there is some funky reason that night feeds actually are GOOD for supply.  Emma can explain it but something about your prolactin levels are highest at night.  The fear of night wakings coming back i can understand but please dont underestimate that IF these bottles are inhibiting your supply from establishing itself to your babies needs you will need to let her sort out your supply off bottles, or atleast less of them.  If she needs to night feed, feed more often in days for a week thats gonna be life. Its a small price to pay and may just be necessay. 

Completely true. That's right about night feeds being more valuable in terms of your supply. Higher levels of prolactin mean that night feeds count more.

At this point the focus isnt the sleep, its the bfing and getting her back on it.  I can tell you really want it so for me i would commit a week to it, not supplement after bfing, try feeds after naps, if she night wakes and is hungry feed.  See where you get w ith her willingness to bfeed.

I am obviously a bf mod and not a sleep mod so not exactly neutral here. BUT I would be prepared to make some real sacrifices with sleep if it meant I could preserve breastfeeding. Some significant sacrifices.

[Emma-Rose's mom]

Maybe it was a fluke, but I had a breakthrough today.   

I decided that I would not top off with bottle unless I felt it was absolutely and critically necessary, and that I would as much as possible stick to bfing.

I concentrated most of my efforts in reconnecting w/ my lo and recreating that positive association w/ nursing. The last couple of weeks have been such a wrestling match, with me wanting her to nurse and with her refusing, crying, and arching her back. Overtime, it wasn't a pleasant experience for either one of us. So, whenever it was time for her to nurse today, I offered. If she didn't want to nurse, I stopped trying to fight her, and I offered the feed again 30 minutes later. Sometimes she latched and nursed only a minute before coming off breast. Instead of fighting her when she did, I just stopped and played with her, and tried again 30 minutes later. Whenever she would spend at least a couple of minutes at the breast, I ran my fingers through her hair, rubbed her back. Like I said, I just wanted to spend time reconnecting with her and not focus so much on whether or not she was getting enough. I wanted her to enjoy the experience again.

I know this encouraged snacking, but I decided that I wasn't going to worry about that for now. And, although she wasn't feeding as long as I would have liked, at least she was doing so much better than she had been. She even did both sides before bedtime today.  And I only had to pump once today to give me some relief, since she was snacking pretty much all day but never nursed enough for me to be comfortable. Maybe she will have a NW tonight, but like you ladies said, perhaps it's a small price to pay if I can get this re-established.

I'll post my progress as I go along. Hopefully today was a turn in the right direction. 
Mika