Baby likes bottle and not breast - help!

[NatashaB]

*This thread was split off the http://babywhispererforums.com/index.php?topic=170327.0 thread as it pertains more to BFing than to Naps*

Hi There

Thank you so much for following up.  I have my son currently napping and sleeping on his side and he seems sooo much better this way.  He fusses through his naps at times but he settles with just a light touch on his head for a minute or so.  We have a bit of a routine happening the last 3 days....much much better.  The nights are still wonky.  He wakes at 11pm, 2:30am, 5am and sometimes a fuss somewhere in between all this.  He eats in the night but not very much so I am worried a bad habit has started now.  

I am pumping breast milk and serving it to him in a bottle.  I was hoping not to have to continue this for very long but he seems to feed much more relaxed this way.  I try offering my breast to him before the bottle feed and he does accept it but because I am almost empty from pumping he takes the bottle preferably. If he takes from me when I am full, it is a gulping fast let down mess.  Hoping I can correct this somehow so primarily am breast feeding again.  Perhaps when his digestion and the reflux are corrected in a month or so??

That's where we are at right now.  Hope this continues and only gets better,
Thanks again
Natasha

[Shiv52]

GLad things are looking  up.  I was with my best friend the other day and was reminded of you.  She has a 6 week old and a really overactive let down and it was causing lots of choking and spluttering etc.  Her midwife got a bfing woman from the hospital to come out and see her last week and they recommendd pumping for the first first minute of the feed (just to get the letdown started) as the flow slowed alot after the initial let down.  Have you tried something like that.  Just pump for first few minutes then offer the baby the feed from the breast and top up with the pumped milk at the end.  Rather than pump the whole feed and offer the nearly empty breast.  She did the pumping until just after letdown for last 4 weeks and has now went back to just bfing as the LO has gotten used to the faster flow and can manage it better.   Would that help do you think?


Glad he is settling more easily and you've found a way to help him sleep more comfortably.  Really pleased to hear you are finding a routine to suit you all.  Slow and steady and you'll get there.

Keep me posted how things are going xx

[NatashaB]

I just woke this morning and read your post "after" I decided to pump a short amount out and offer him my breast.  It totally worked! He fed from me for about 8 minutes and then played a bit and then I topped him up with whatever he wanted from the pumped bottle...which wasn't much because I think he fed well from bfding!!  You're advice here is great and worked wonderfully for over active let downs!!

He is waking for one feed at night and sometimes wakes only to be soothed back with the soother...perhaps this happens twice.  Is there anyway I can get him to resoothe himself or is this just going to take time on his part to stay to sleep??

Much appreciated,
Natasha oxox

[Shiv52]

Great news on the feeding!!!  Excellent news!!

To be honest at 2-3 months if your LO is only wakening once to be fed and for his dummy a couple of times I'd say you're doing great.  My LO was still waking twice to feed at this age!!   I think once you get the reflux sorted and a few more days of him sleeping comfortably and taking good feeds he'll extend his sleep on his own. 

Keep an eye he doesn't start wakening loads more for the dummy and you shouldn't have a problem.  To be fair I think though dummies can help babies with reflux and I used a dummy with my DD with no ill effects or prop issues.  She was a really sucky baby and needed the dummy otherwise she was attached to my breast all the time!  I'd read in the BW book that some babies just need to suck for comfort so that put my mind at ease.  I think if it becomes a prop issue its recommended to wean at 4-5 months but it wasn't a big issue here and she learned to replug fairly early on so it never bothered me.  I always saw its as a soothing item as opposed to a prop! 

Lots of {{{hugs}}} to you, you're doing great!!  You're LO is lucky to have such a dedicated mummy! 

[NatashaB]

Still working on the feeding but getting better. He seems to accept breast feeding during the night feeds but not so much during the day?  It's very hard to gauge if he has had enough from breast feeding, as when he gets in too much air he becomes frustrated and and disintered very quickly.  I will offer him the breast and he screams only to accept the bottle if I give it to him.  It's a tough one with this over active let down, but we're working on it.

Still NWing too much.  He feeds only once at night which is great...but...he wakes so often and so frequently with fusses and discomforts or bowel movements and gas.  I don't think there is much I can do for this other than time I guess??

Thanks so much for following up with me, makes me feel that I'm not completely alone,
Natasha

[Shiv52]

I'd say once his feeds settle and the reflux is under control the nights will get better.   Is your LO medicated for reflux? 

In addition to the side sleeping etc, is his crib/cot raised slightly at one end.  That can help LOs settle at night a bit better, sorry if you are already doing that.  The NWs do sound like he is dealing with his reflux as opposed to just waking IYKWIM? 

With the bfing I'd keep pumping until letdown for a bit and offering the breast and see will he take it from you.  I think the HV warned the friend I was telling you about before that if you offer the bottle too often it can make them less keen to actually bf off the mum as the bottle is much less effort to suck from.  So hopefully you can get the reflux sorted and settled and then he'll be happier just to bf if that is your  plan.  I admire you for all the pumping, I found it hard work but you're doing the very best by your LO so you should be really proud of yourself xx

Lots of {{{hugs}}}

Keep me posted on how you're both getting on xx

[NatashaB]

If my LO is already much happier with the bottle than bfing from me now...is there a way to correct this?  Will it correct itself hopefully!!?

Thank you
Natasha

[Shiv52]

I'd keep offering the breast every after letdown and give it a few minutes before offering the bottle and help him settle back into it.  And offer after bottle feed too.  How much milk is he taking in the bottle?

[~ Vik ~]

Hi Natasha   Just wanted to jump in with some bottle/breast thoughts for you, as I've gone through the bottle preference problem and come out the other side - so it is possible!  I pumped and bottle fed very early due to severely cracked nipples. It was only for about 3 days, but it led to a little over 3 months of breast refusal before I coaxed Dylan back to bfing.  It's actually very easy for a breastfed baby to develop a bottle preference:  Milk flows much faster from a bottle, so babies don't really have to work for it, and there's instant gratification, rather than having to wait for a letdown.

Here is a page from Kellymom.com with some tips you might find helpful (I did!):  http://www.kellymom.com/bf/concerns/baby/back-to-breast.html

Here's a couple of important points from the page (I just copied and pasted) but check out the whole thing when you have time

The two primary rules when you have a baby who is having problems nursing are:

   1. Feed the baby. A baby who is getting the right amount of calories and nutrition is best able to learn how to nurse. First choice for what to feed a non-nursing baby is mom's own milk, second choice is banked milk from another mom, third choice is infant formula.
   2. Maintain milk supply. If mom's milk supply is being maintained with an appropriate frequency and amount of milk expression, more time is available for baby to learn to nurse, and baby's efforts will be better rewarded (with more milk).

General tips

Your goal is to coax baby to the breast. Do not attempt to force your baby to breastfeed. Forcing baby to the breast does not work, stresses baby, and can result in baby forming an aversion to the breast. As baby gets better at nursing and is able to get more milk via nursing, he will grow to trust that breastfeeding works and will have more patience when latching.

    * Wear clothing that allows very easy access to the breasts. Baby may get very impatient in the split-second it takes for mom to lift the blouse and undo the bra. Spend time, if possible, in a warm place that allows both mom and baby to be naked from the waist up.
    * Lots of skin-to-skin contact can help your baby nurse better and even gain weight faster. Keep your baby with you as much as possible, and give him lots of opportunities to nurse (even if you're not successful). Get skin-to-skin with him, first when he is sleepy, right after a bottle feed (or however you're supplementing). This way baby has the opportunity to sleep and wake up happily, skin to skin at mom's chest, and mom is right there to catch the earliest hunger cues. If baby moves toward the breast and then falls asleep before even mouthing the nipple, or after sucking twice, then these are positive baby steps, not failures. (Read more about kangaroo care or take a look at the book.)
    * Offer the breast often. Try breastfeeding in baby's favorite place, in his favorite position, in the bath, while walking around, while lying down, with baby upright, baby flat on his back, in his sleep, just as he is waking, any time baby looks as if he might be interested, or any other way you can think of, i.e. any time, anywhere.
    * Avoid pressuring baby to nurse. Offer in an ultra-casual way and pretend you don't mind if he refuses (easier said than done, but try not to show any frustration - your aim is to avoid pressuring baby to nurse). Don't hold the back of baby's head or push or hold baby to the breast. If baby pulls off the breast, then don't try to make him go back onto the breast at that time - simply try again later. If baby seems frustrated with your offering the breast, then turn the pressure down and simply make the breast available (lots of skin-to-skin!) without offering. It can be helpful to have lots of skin-to-skin time with baby where he is cuddled at the breast with no pressure to nurse - give control over to your baby, so that baby decides if and when to nurse and when to stop nursing.
    * Carry your baby close to you (a sling or other baby carrier can help with this). "Wear," carry, hold and cuddle your baby as much as possible; carry baby on your hip while doing other things, play with baby, and give baby lots of focused attention.
    * Sleep near your baby. If baby sleeps with you, you'll get more skin-to-skin contact, plus baby has more access to the breast (see this information on safe co-sleeping). If baby is not in the same bed, have baby's bed beside your bed or in the same room so that you can catch early feeding cues, breastfeed easier at night, and get more sleep.
    * Nipple shields can be helpful at times for transitioning baby to the breast. Talk to your lactation consultant about using this tool.
    * Comfort nursing is often the first to come, followed by nutritive nursing. Offer the breast for comfort any time you see a chance- at the end of a feeding when baby is not hungry, when baby is going to sleep or just waking up, when baby is asleep, and whenever he needs to comfort suck If your baby is actively resisting nursing, then try encouraging comfort nursing after baby is comfortable with skin-to-skin contact. After baby is willing to nurse for comfort, you can then proceed to working on nursing for "meals" as well.

You are working to seduce your baby back to breast. Again, coax, don't force!


Me again now   Just wondering if your lo's reflux is under control? Is he on medication?  The reason that I ask is that it is relatively common for babies with uncontrolled reflux to develop breast and/or bottle aversion.  Because feeding causes the stomach contents to reflux, thus causing pain, babies can associate that pain with the breast and/or bottle.  That may be another reason that your ds is preferring the bottle - he associates his reflux pain with the breast, but not yet with the bottle.  If everything is under control, then that will definitely help you in coaxing him back to breastfeeding.  If not, you may find it much more difficult

Let us know what you think?  Hope things are well

[NatashaB]

Thank you for the replies.  To answer your question on how much I feed our little guy in the bottle, he takes an estimated 5 1/2 ounces per feed.

I will read Kelly Mom's info on this now.

I am trying my best to offer him the breast first, after I pump the let down, but he cries and screams near my breast and takes the bottle immediately.  I am successful at the 3am feed for some reason?  Also, if I hold the pacifier in his mouth near my breast and quickly slide the pacifier out of his mouth and move him to me he does latch on.  He doesn't stay very long, max. 5 minutes per breast but then takes the bottle afterwards.  My let down frustrated the both of us through feeds for some time and this is why the bottle feeding happened.  His reflux is silent and is more so effected with the fast let down and over supply drowning him.
I really hope this can be corrected as we have some time still ahead of us to breast feed.

I have one more question.  Since I am pumping to feed.  Should I only be pumping the estimated amount needed for that particular feed or can I pump to drain and reserve/freeze my supply...since I have a lot?

[~ Vik ~]

I am trying my best to offer him the breast first, after I pump the let down, but he cries and screams near my breast and takes the bottle immediately.  I am successful at the 3am feed for some reason?

Honestly, this really does sound like the breast aversion I described earlier It sounds like he's got a negative association with the breast (Feeding laying down uncomfortable? Pain after feeding?) but is comfortable with the bottle. That would even explain your success with the 3am feed - babies with breast/bottle aversion often feed better in the middle of the night when they are calm and sleepy. I could be way off (my only reflux knowledge is what I've read on the boards), but I would consider the possibility. Maybe check out the colic, reflux, and crying board? Even silent reflux can cause problems.

As for the pumping, I pumped to empty to help build a stash. I don't know if that's the *right* answer, but that's what we did and it worked for us. If you pump just the amount needed for the feed that's fine too - it's enough to maintain your supply to meet his needs, so whatever works best for you! In fact, if oversupply is a problem, that might even be better to get your supply in line

[*Ali*]

Just wanted to say, before you spend time and effort pumping lots for the freezer you may wish to check if your LO actually like frozen milk if you don't already know. I recently gave LO frozen milk for the first time and he refused it as soon as he tasted it. When I tasted it myself (to check the temp) it tasted metalic, which is apparently common. I thought it was disgusting and DS seemed to agree. Now I have a freezer full of milk and nothing to do with it.

[NatashaB]

Hi Vikki..I will check out the reflux boards on breast feeding aversions.  It's a tough one, but he definitely is happier with the bottle right now.  Hopefully can correct this...may need to visit our lactation doc.

Cadie, interesting on the freezer milk.  Our daughter didn't mind freezer milk. I read somewhere that freezer milk may not be sufficient for your baby in, say 3 months from now, as their needs are different and our bodies naturally meet those needs at the time??

Thanks again
Natasha

[*Ali*]

Cadie, interesting on the freezer milk.  Our daughter didn't mind freezer milk. I read somewhere that freezer milk may not be sufficient for your baby in, say 3 months from now, as their needs are different and our bodies naturally meet those needs at the time??

Yes I believe that is true. Probably OK for the odd bottle now and then though.

[Canwi]

Once LO gets over a year, the whole 'sufficiency' of frozen milk becomes a moot point.  I wanted to donate a whole stash of milk to a human milk bank, and when they found out that my LO was over 1 yr they said no thanks. Once LO gets that old the composition of the breastmilk changes enough that the 'goodies' in it aren't sufficient for preemies/NICU babies who are prime recipients.
Keep in mind that your freezer stash suffiency is really only a big deal if breastmilk is the only source of nutrition.  And if it's only a bottle every now and then when you go out I wouldn't get too hung up on it.  The most important thing is that you use the oldest milk first.

Just wanted to say, before you spend time and effort pumping lots for the freezer you may wish to check if your LO actually like frozen milk if you don't already know. I recently gave LO frozen milk for the first time and he refused it as soon as he tasted it. When I tasted it myself (to check the temp) it tasted metalic, which is apparently common. I thought it was disgusting and DS seemed to agree.

Have a taste of your breastmilk freshly pumped, and then once it's been cooled (not frozen).  It may not be a different taste.
You also may have a lipase issue, and need to scald your milk befor freezing to prevent that funny flavour happening.  Some tips here http://www.kellymom.com/bf/pumping/lipase-expressedmilk.html, http://www.workandpump.com/storage.htm

Another thought to keep in mind is that what we think is gross and what our LO's think is gross can be two different things.  Personally I think that any baby formula tastes gross.  Yet how many babies chug-a-lug it by the ounce day in and day out.

Now I have a freezer full of milk and nothing to do with it.

Keep your freezer stash and use it to mix cereals or into fruit purees when LO is on solids.