Author Topic: Is this a breast feeding issue or a sleep issue?  (Read 1857 times)

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Offline NatashaB

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Is this a breast feeding issue or a sleep issue?
« on: April 30, 2010, 18:26:40 pm »
Hi

Our LO is now 2 months.  He has not taken to EASY well since day one.  His naps are always short, he depends on being picked up to sleep and to settle to sleep, he was gassy in his early weeks and has always had NWings at roughly the same hours each night...3-5:30am. 

I believe our problems start at the early hours of the morning when he has his NWing and won't settle back to sleep. He feeds at 2am...by the time I am done feeding/burping he is down at 3am.  In an hour he is usually up and won't settle until 5:30am, when he is completely exhausted.  He couldn't possibly be hungry after a 5oz pumped bottle at 2am!  At 6am he is hungry but OT from the NWing and usually only has a 1/2 feed.  At 7am I put him down and at 8am he is hungry again but for only 1/2 a feed...his naps are max. 1 hour...usually wakes at 45 minutes.  His activity time is about an hour sometimes more....don't think it's UT?? 

I'm very depressed about all this and am wondering if my milk content is not sufficient enough for him even though I have an abundance of milk.  I am going to try topping off with formula a some point today because I just can't see where the problem is coming from other than not enough satisifaction at his feeds.  I have now, unfortunately resorted to letting him CIO after his 45 minute waking if I know all his needs have been met.  This is all killing me.

Here's our EASY:

6am Wake/Feed
7am Sleep
8am Wake...attempt more feed??
9am Sleep
10am  Feed
11am Wake
etc...etc...
By 6pm he is exhausted and sleeps until 12am...feeds at 12am and then again at 2am..

Offline NatashaB

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Re: Is this a breast feeding issue or a sleep issue?
« Reply #1 on: April 30, 2010, 19:21:10 pm »
Hi

I would like to correct our EASY.  There really is no EASY at this point.  I try however to feed every 3 hours...sometimes has to be sooner because his awake time is too long from his naps being too short.

Thanks
Natasha

Offline ~ Vik ~

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Re: Is this a breast feeding issue or a sleep issue?
« Reply #2 on: May 01, 2010, 02:19:28 am »
Hi and (((hugs)))  I'm so sorry that you're having a rough go right now.  We will definitely do our best to help you get this sorted, and hopefully some other moms will jump on with thoughts too :)

Could you pop onto this link:  http://babywhispererforums.com/index.php?topic=54625.0 and check out the questions there?  If you can answer them that will help give the whole picture and get a better idea of where your troubles might be.

Also, any reflux issues (http://babywhispererforums.com/index.php?topic=654.0) ?  How is his behaviour during his day A time?  Happy/fussy/colicky, etc?  You mentioned that gas was a problem in the early weeks, is that still going on?  Have you tried using shh/pat with him?

'm very depressed about all this and am wondering if my milk content is not sufficient enough for him even though I have an abundance of milk.  I am going to try topping off with formula a some point today because I just can't see where the problem is coming from other than not enough satisifaction at his feeds.
TBH, what you're describing in your post does not sound like a breastfeeding problem to me.  Especially if you clearly have an abundance of milk, supplementing with formula is not likely to help.  In fact, it may actually cause your supply to decrease :-\ 
If it is a breastfeeding problem, it sounds like it might be oversupply or overactive letdown, based only on the bit of information you've given.  Here's a couple links to look through if you think that that might be the case:
http://babywhispererforums.com/index.php?topic=63604.0
http://babywhispererforums.com/index.php?topic=96501.0


I have now, unfortunately resorted to letting him CIO after his 45 minute waking if I know all his needs have been met.
Please, please don't leave your little man to CIO.  Even proponents of CIO and CC do NOT recommend it as a sleep training tool until after 6mo.  And Tracy was very against CIO, as she felt that there is always a gentler way to do sleep training.  At this age, your ds is not crying to manipulate.  Crying is the only way that he has to express a need.  When he's crying he needs *something* - even if he's been fed, changed, what have you.  Maybe he's having gas pains, or is thirsty, or lonely, or scared.  Even the need to be held is still a need.  He needs to know that you are there for him - even at 4am when you've already been up for 2 hours.  Please, please put an end to that tonight.  We can help you find methods that will work and you don't have to leave your little guy alone to cry in the dark :'( 
Here are some links too:
http://babywhispererforums.com/index.php?topic=163042.0
http://babywhispererforums.com/index.php?topic=63839.0

Some of your problems may actually be due to you leaving him to CIO - he may have developed a crib phobia.  Have you read either of Tracy's books - secrets of the baby whisperer or baby whisperer solves all your problems?  She does have a detailed plan to help overcome this and regain your baby's trust.

Let me know what you think.  And more huge (((hugs))).  Sleeplessness makes everything seem so much harder, but we can help you find a way :-* :-*

D ~ dairy, egg, peanut/nut and mustard allergies
Proud to have breastfed for over 24 months!


Offline NatashaB

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Re: Is this a breast feeding issue or a sleep issue?
« Reply #3 on: May 01, 2010, 04:24:15 am »
Hi

Thank you soo so much for your reply.  Firstly, I want to start by saying that the CIO method has already stopped.  Only have 3 naps of trying that, I went in to pick him up with tears running down my face and his. No thank you...it just doesn't feel right or natural.  Thank you for the extra support on this issue.  I feel terrible that I even attempted that method and only hope he hasn't lost his trust in me just yet!

To answer some questions:
He is 2 months today

His daily routine is approx. like this:
E 6am wake/feed and continue to feed every 3 hours from here on until his bedtime.
A times are about 1 hour before he starts his first yawn.  Sometimes earlier when he naps short..which is usually the case lately.  Sometimes about 10 minutes longer.
S 45 minute naps and then starts to stir and fuss...finally cry.  I go in and replace pacifier...may work occassionally after 3 tries.  He often fights his way out of the swaddle and his hands interfere and he starts sucking them and keeping himself awake.
6pm Cat Nap..sometimes attempt this to be bedtime if he has had no sleep during the day.
7pm  Bedtime
Diaper, PJs, just started yesterday to read him a book, bath/massage occassionally right now.
8pm  Feed to sleep, burp
12am NF 1
2am  NF 2
3:30/4am NWing...won't resettle until 5/5:30am

Nap routine is about after an hour of activity or a bit more, swaddle and bring to nursery. Craddle in my arms and cover his eyes with soother in his mouth.  Drowsy, put down in crib.

After 45 minutes usually wakes. If lucky, will resettle after a few times of replacing soother and continues nap for 1-2hrs total.

His bedtime routine is basically the same and naps except I add in PJ's and occassional bath/massage and now 1 book.

I am breast feeding.  I have an abundance of supply.  My let down is very active/fast.  He gulps throughout his feeds from me unless he is very relaxed.  I have read the posts on this issue and am trying to help him with it.  I find pumping in a bottle makes for a better feed....which I do in the evenings and night feeds.

He takes 5-6oz in 10-15 minutes for one breast per feed.
5 oz bottle of pumped milk in night feeds.

His NWings are midnight, 2am, 4am, 6am

He is usually tired at his midnight waking
He is usually hungry and then resettles at his 2am waking
He is stimulated and fussy at his 4am waking and will not resettle. Appears OT as his arms are flaying and his eyes are wide awake and he is fussy.

He starts his NWings with fussying and then continues to crying.  Never a Mantra Cry at night except for the 4am waking when he has been up too long...around 4:30am this starts.

I have tried the following to soothe him:  pacifier, cover face lightly and whisper shhh in playpen, hold and rock to sleep covering his face.

Our A time is about 1 hour - 1 hour 10 minutes.  We usually feed, diaper, lay him on his play matt, sit him in a bouncy chair and allow him to observe his surroundings with his older sister playing around him, sing some songs, laugh and converse with him.

No developmental issues.

His prop is a pacifier.

No lovie...yet! :)

He had wind/gas issues that seemed to have passed.  This started at about 3 weeks and lasted for 3 weeks.  He may have some minor reflux issues as he spits up lightly when burping at times. 

His behaviour during his A time, is usually content and observant.  He will start fussing and whining when he is getting tired. Sometimes fussy and OT so crying crying.

I am hoping it's not a breast feeding problem as it doesn't make sense to have to supplement if the lactation consultant said I have a lot of milk.  She said he takes a lot from me quickly. 

Something I noticed, while feeding him today....I fed him my breast for about 8 minutes.  He appeared finished with feeding.  I offered him formula a little bit after that and he drank 2.5 ounces on top of my feed.  Perhaps I am cutting his feeds too short from me, when he appears finished.  The lactation doc said he takes 5 oz from one breast in 8 minutes.  At that time...a few days ago, he appeared not to want anymore..but perhaps he does need a bit more??  He has a tough time feeding from me with my fast let down.  I spend a bit more time with him when I pump in a bottle and he takes it much happier and a bit longer.

Again...with CIO...NEVER AGAIN!  Promise...already have lifetime guilt for doing that only 3 times. :(

Thank you again so much,
After this long novel of a reply, I hope we can find a solution,
Natasha 




Offline ~ Vik ~

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Re: Is this a breast feeding issue or a sleep issue?
« Reply #4 on: May 02, 2010, 17:46:55 pm »
Hi again Natasha, and no worries about the long reply!  The more information the better we can help :)

You're so right about CIO not feeling natural!  I've had family tell me that they let their lo's CIO while sitting in the hallway crying themselves :(  Yet while they were telling me these stories about how heartbreaking it was, they were encouraging me to do it!  :'(  Don't beat yourself up for trying it though - you've decided against it, and loads of moms have been where you are and come out the other side.  There's tons of information here to help you teach independent sleep.  And though bw isn't always a 'no-cry' sleep method, you are always there to comfort and support your lo while they learn.

I feel terrible that I even attempted that method and only hope he hasn't lost his trust in me just yet!
TBH, it is possible to lose trust after a few times of trying this method unsuccessfully.  I don't know if that's contributing to your nw difficulties, but I found this FAQ for you:  http://babywhispererforums.com/index.php?topic=126141.0  Have a read and see if you think that any of that might be helpful.

Average A time at 2mo old is 1h15-20m - so at 1h10 you're not too far off.  Especially since A time is eyes open to eyes shut, when you calculated did you include the time it takes for him to actually fall asleep?  Re: the 45m naps, do you have a thread going on the naps forum at all?  It's actually a relatively common problem and you might be able to get some great support and ideas for extending them.  When you can't extend them, do you shorten A times at all?  After a short nap, your ds won't be able to handle as long an A time and may get OT.  This could be contributing to your unsettled nights.  What do you think?

You mentioned the pacifier as a prop.  How is he falling asleep for naps/nights?  You mentioned holding to sleep in your first post.  Have you ever tried shh/pat?  Here are some more links for you to look through when you have some time:
http://babywhispererforums.com/index.php?topic=85500.0
http://babywhispererforums.com/index.php?topic=26672.0
http://babywhispererforums.com/index.php?topic=64275.0
http://babywhispererforums.com/index.php?topic=64168.0

I am hoping it's not a breast feeding problem as it doesn't make sense to have to supplement if the lactation consultant said I have a lot of milk.  She said he takes a lot from me quickly.

Something I noticed, while feeding him today....I fed him my breast for about 8 minutes.  He appeared finished with feeding.  I offered him formula a little bit after that and he drank 2.5 ounces on top of my feed.  Perhaps I am cutting his feeds too short from me, when he appears finished.  The lactation doc said he takes 5 oz from one breast in 8 minutes.  At that time...a few days ago, he appeared not to want anymore..but perhaps he does need a bit more??  He has a tough time feeding from me with my fast let down.  I spend a bit more time with him when I pump in a bottle and he takes it much happier and a bit longer.
Breastfed babies will often drink from the bottle even when they are finished because it is so easy for them to get milk out of it.  They have to *work* at the breast, but with the bottle it just flows into their mouths.  So you can't really say that he hasn't had enough at the breast just because he also took from the bottle, kwim?
Having said that, how do you end feeds?  Do you take him off after the 8min? Or does he come off on his own? Do you offer the second breast?  How did the lactation dr determine that he took 5oz in 8min - did she weigh him?
Here's a link too with some ways that you can help your ds deal with the fast let down:  http://www.kellymom.com/bf/supply/fast-letdown.html

Let me know what you think?  Hope things are going well :-* :-*
D ~ dairy, egg, peanut/nut and mustard allergies
Proud to have breastfed for over 24 months!


Offline Canwi

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Re: Is this a breast feeding issue or a sleep issue?
« Reply #5 on: May 02, 2010, 19:21:57 pm »
Natasha, you are right about the content of the breastmilk your LO is getting.  Not that it is insufficient, but that he is getting too much of the "foremilk" (lower in fat content) and not enough "hindmilk" (higher in fat content). 
Ironically my neighbour is having the same issue and I was talking with the LC at work about it.  She said to block feed LO on the same side for an entire feed for 2 feeds.  Do that for a week and then see if there is any difference in his satisfaction with feeding.
 
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Offline NatashaB

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Re: Is this a breast feeding issue or a sleep issue?
« Reply #6 on: May 04, 2010, 03:56:28 am »
Thanks,

I've tried this and it did seem to help.  Then he started the 45 minute naps and things started getting a bit wonky.  I'm finding he feeds best from a bottle. I am pumping my milk in a bottle so that he feeds more upright.

Thanks again
Natasha

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Re: Is this a breast feeding issue or a sleep issue?
« Reply #7 on: May 04, 2010, 19:41:42 pm »
After re-reading your thread, and the ones you have on Naps and EASY, I'm actually wondering if your LO has acid reflux (aka silent reflux).  :-\

The "spit-up" kind of reflux is easy to see, and easy to fix - feed 'em more upright, keep 'em upright for 20-30 mins after a feed and do lots of laundry.
Acid reflux is where the spit-up comes up from the stomach to the food pipe (oesophagus) but not up into the mouth.  Stomach contents are acidic, and the oesophagus gets irritated by the constant exposure to acidic contents.  You need to neutralise the acid so any 'backwash' no longer irritates the oesophagus, and sometimes help speed the progress of the food through the stomach.  Both of these can only be achieved by some kind of intervention. 

So why do I think your LO has acid reflux:
- Trouble staying asleep at night and during naps (when LO's sleep gets lighter as they transition from one sleep cycle to another at they get woken by pain from acidic 'backwash')
- inconsistent feeding times (LO is now making the connection between his oesophagus pain and BFing.  But also has hunger pain.  Unenviable decision for LO to make: Feed to fix hunger pain and get reflux pain OR don't feed and fix reflux pain but get hunger pain)
- LO has made a connection between the breast and reflux pain and is now starting to develop a preference for the bottle.  This potentially has 2 motivators.  Firstly there is not yet a correlation between the bottle and the reflux pain.  Secondly LO doesn't have to work as hard for milk from a bottle.  Pumping is good for keeping a supply, but nowhere near as good as a LO BFing.

It might be worth going to a doctor and asking them to trial LO on some sort of medication to see if that helps things out.  I know that medicating LO's is the last thing anyone (myself included) wants to do.  But, as Tracy said, you will spend many fruitless hours trying to sleep train or feed a LO who is in pain.  :(
HTH
 
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Offline NatashaB

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Re: Is this a breast feeding issue or a sleep issue?
« Reply #8 on: May 04, 2010, 19:51:53 pm »
Thank you so much for the reply.  I was starting to put the pieces together myself and thinking he may have reflux.  I am now placing him to nap on his side with a wedge on the front and back of him and he is miraculously sleeping throughout his naps all day today!!!
By chance or not...hope this will help!!  Also, breast feeding is just impossible as he is always fussy and spitting up as he is lying flat to feed.  I am now pumping in a bottle and sitting him upright to feed....also a 100 x better!!
Much appreciated, keep in touch
Natasha

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Re: Is this a breast feeding issue or a sleep issue?
« Reply #9 on: May 05, 2010, 03:00:27 am »
Natasha, you've been getting some good advice on your naps thread, so will put a link to there.  Keep us updated via that thread.

http://babywhispererforums.com/index.php?topic=170327.msg1909866#msg1909866
 
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