screaming at just the bedtime feed

[deckchariot]

DD2 is 8 weeks today and ebf.  She has reflux and a milk protein allergy.  She's on zantac for the reflux and we've seen a tremendous improvement, and we're 2 weeks dairy free, so still working on that.  I realize that our issues could just be related to the reflux and the allergy, but since it's really just at bedtime, I'm wondering if something else is going on.

We're on a 3 hr EASY with feeds at 7/8 (when she wakes up), 10/11, 1/2, 4/4:30 (5:30 - cluster feed), 7.  She wakes up 1-2x per night for a feed as well.  She takes both breasts at each feed and takes a full feed.  When we cluster feed, I only offer one breast.  She gets zantac upon waking in the am and then around 6:45 at night (before we start the bedtime routine).  At bedtime, she seems hungry and takes the breast quickly, but after about 5 min, the screaming begins.  I burp her, still screaming, walk around with her, she'll calm down and start rooting again or sucking on my shirt, so we try feeding again, immediate screaming.  And that scenario repeats until 8ish when she magically calms down, eats on both sides and falls asleep.  I know she's getting milk - I can feel the letdown and see it when she pulls off.  Here's what we've tried:

- cluster feeding (in case my supply is low and she's too hungry at the bedtime feed)
 - not cluster feeding (in case she's not hungry enough at the bedtime feed)
 - breast compressions (in case the flow is too slow and/or not enough)
 - expressing into a cloth diaper (in case the flow is too fast/I'm too full)
 - multiple different nursing positions
 - doing a bottle for the feed of ebm (in case my stress in anticipation of the screaming is too much)
 - doing the feed earlier/later
 - giving zantac earlier (in case it is wearing off)

we've not seen any improvement at all in the bedtime disaster.  We start bedtime about 6:45 (6:15 when she has a bath) and the earliest she's made it to bed has been 8:30, most of the time it's not til 9 because it just takes me that long to either be satisfied that she's full or to give up

The screaming seems like pain to me, but honestly, I don't know.  She gets very red (sometimes even almost purple), closes her eyes and screams a high pitched scream, and usually her arms and legs are flailing about.  Unless she's swaddled in which case her whole body is writhing.

Every once in awhile we get similar behavior at another feed (like last night at the 3am NW), but it is every night at bedtime.  Any ideas?

[firsttimemummy]

Murray used to scream like that and not settle until 10 or 11pm.  We get Oliver into his bed around 7pm and he doesn't scream - I think the difference is that Oliver will have a short nap after his feed around 5pm or so, then when he wakens we get him into his pj's and he has a feed 6.30/7pm immediately before going to bed.  He now goes up to his cot (we found that being downstairs with the tv on etc was too stimulating and he settles well in the quiet bedroom).  Over the next few days I will try to write down my EASY and see if I can explain better!! Actually, will be busy next few days, so next week I will!

I think the secret is a short A time then feed right before going to bed!

And of course, Oliver will be unsettled ALL evening now I have written this!

[Vicku]

OT did slip my mind too. How long is her last A time? Also I read something a while back that indicated that this evening fussiness (that is very common during the first few months) is partly developmental but I don't know if it's true or not... I suppose it could be loads of different reasons.
Also, have a read through this link about evening fussiness  http://www.kellymom.com/babyconcerns/fussy-evening.html There are a few ideas on why it can happen in there. Something may pop out at you.

[deckchariot]

thanks for the kelly mom link!!  OT is definitely a possibility.  Her A time before bed has been quite varied, so I'll keep a closer eye on that....and she's up crying now, so I'm off to get the sling   I'll let you know how tonight goes!

[EloysH]

I would be blaming it on the reflux pain.  For both my refluxer boys bedtime was usually the disaster from about (2 weeks to 4 months old) and maybe the last afternoon nap. The reflux pain meant that napping is never optimal during the day and there is some OT by the end of the day.  Then the reflux hurts more by the end of the day as they have been feeding and feeding thus more acid in the stomach to reflux up and wear on the oespohagus. 

So by the end of the day they are a bit messy and and annoyed they can't sleep because they are just too darn uncomfortable.     It is always a guessing game and you never quite know "what is the cause of what" because with reflux there is always a bit of pain thrown in the mix 


I'm glad you mentioned the sling, it was a life saver for us 

[Roseii]

Evenings were a disaster for us, both babies and only 1 a refluxer In the UK it's always blamed on "colic" whatever that really is

Sorry this isn't much help but it did get better around 3m. xxx

[deckchariot]

turns out it is indeed reflux pain - as yesterday she did it for all but 1 feed, and she did it at the night feed and again this morning, so I called the ped, and we went in and have a med change.....I was really hoping it was something else   But at least I know it's not me   I love my sling and it gets a lot of use in the afternoons especially here!

[Vicku]

Oh poor baby! Good that you saw the ped though, hopefully a med change will help!

[Lewa]

Thanks for that Kelly Mom link - it is very helpful!

My 3 week old is doing the same thing - nurses and fusses from about 4 to 8pm (or later like tonight!).  She doesn't have reflux, although she seems quite windy at this time of day (her poos have always been at this time of night too).  My DS was the same although I had supply issues with him so he was on the formula by the afternoons to add to the confusion!  But DS was sleeping 10+ hours by 3 months so there is hope

Good luck