9.5 month old refusing breast, seems to be impacting naps

[BstnMelody]

Hi everyone,

I'm going to attempt to explain my problem, but it's a very long explanation. Sorry!

I have a 9.5 month old who I breastfed exclusively until 6 weeks ago. The only time I gave her a bottle was in the evenings before bed. I could never seem to get my supply in the evenings high enough for her to fall asleep, so I pump after the first feed and give her that after breastfeeding in the evenings. Occasionally when I've been away for the day, she'd also get a bottle. She did go through two small boughts of refusing a particular breast, which I think was oversupply once, and the other time I have no idea, but it ended after a few days. But that last time was when she was 5 months. Other than that, it's been pretty smooth sailing with both breastfeeding and the bottle.

She has been a snacker since around 5 months, eating every 2-2.5 hours. Around that time, she started refusing her naps and I discovered that she won't go down for her nap without a really full tummy, so we got into the habit of breastfeeding before her nap. Maybe that was AP, but I don't think so. I never let her fall asleep during those feedings. I breastfed 20 minutes before the nap, burp her, maybe a little play time, and then put her down for her nap fully awake. Except for a pacifier and some lovies, she has no other sleep associations and puts herself to sleep alone in a dark room with a sound machine going. The only exceptions are when she's over-tired, I might have to shush her, caress her head, or hold the lovies against her face for her to calm down. As soon as I see she is getting sleepy, I leave.

So when the nanny started 6 weeks ago, I had her follow the same routine I did, but with a bottle (slow-flow nipple). Here is how a typical day went:

6:30am WU (this has consistently become 5:20am the last 4 mornings, and was inconsistent even a few days before that)
7:00am Breastfeed (takes 45 minutes, breastfeeding for only 15-20 minutes of that, the rest is a break in-between, as she won't eat from the 2nd boob immediately)
8:00am Breakfast 4oz of some kind of fruit & cereal
9:00am Bottle 2-4oz
9:30am Nap 1hr
11:45pm - Bottle 3-4oz
12:30pm - Lunch 4-5oz
1:15pm - Bottle 3-4oz
1:45/2:00pm - Nap 30-40 minutes (this used to be 1hr 20min, but has shortened, tried moving it later, and we get nap refusal and have to hold her)
3:00pm - Bottle 4-5oz
5:00pm - Breastfeed or Bottle 2-4oz
6:00pm - Dinner 4-5oz
6:45pm - Bath
7:10pm - Bottle 6-8oz
7:30pm - Asleep

Generally, we had no problems with this routine, even when using a bottle. But as you can see, she is basically eating all day long. I really wanted to change this, as I want to continue breastfeeding in the mornings during the week, and on the weekends, but between all her breastfeeding (which she gets really distracted when we're in public) and needing to be home for her naps, it pretty much means we can't get to very many places on the weekends without skipping a feeding and getting a cranky baby.

So we've been slowly stretching her both with the bottle during the week, and with breastfeeding on the weekends. We stretched her to 3 hours between bottles with relative success. Then I got the idea to switch the nipple to a medium flow from a slow-flow hoping she would take more during a feed and stretch out to 4 hours or longer We did that on Thursday or Friday, can't remember.

Then this weekend, I had the hardest time breastfeeding her. In the mornings for the first feed, she breastfed for a fraction of her normal time (I don't keep track of time, just using perception, but it was only a few minutes on each side, as opposed to what I think was probably 10 minutes on each side before). And then for every other feed, I stretched her to 3.5 hours, but she only ate willingly from the first side, popped off when there was still tons of milk in there, and then threw a tantrum on the other side refusing to eat from that side. So the entire weekend, except for the mornings, she only ever ate from one side, making my breasts really full and painful. Also, we only got 30 minute naps, which she took forever to fall asleep for, so she was overtired by the time she fell asleep. So I *think* she's been hungry this entire weekend and not getting enough to fill her belly and fall asleep. Nighttime sleep doesn't seem to be impacted. She sleeps through the night with maybe one waking, gives a few cries, then falls back asleep. She *has* been waking for the day around 5:20am (almost exactly by the clock every day), but that started happening early last week before we switched the nipple and tried to stretch her longer, so I think that's more an issue of either needing more awake time or a later bed-time. I'm not overly concerned about that one.

We're on the 3rd day of this problem. I really really want to keep breastfeeding on the weekends. I hate pumping, and I enjoy breastfeeding. We're going to switch back to a slow-flow nipple, hoping maybe that is the problem (maybe it's making her realize she doesn't have to work for her milk), but I'm anxious to hear if anyone has any other ideas about how to solve the breastfeeding issue?

[*Ali*]

Check out this FAQ on nursing strikes and see what you think might work for you. Is my baby weaning or is it a nursing strike?
It does sound as though she has worked out it is much quicker and easier to get the milk from a bottle with the faster teat.
WRT her routine I would try pushing that first nap later. I always found an early nap encouraged early waking and 2.5hrs is really very short for a 9.5mo. Most LOs this age are doing 3-4hrs of A time. Average A times- BOOKMARK ME! I expect she is not doing a full nap as she is UT but then ends up OT after the huge 5hr A time at the end if the day.

[BstnMelody]

Thanks so much Ali.

Since writing my original post, I can positively say the faster nipple is part of the problem. For her first bottle of the day, she still had the medium flow. But then for the 2nd bottle, we switched it to the slow flow. She only took 1 ounce (3 hours after the previous bottle), and fought it the entire way. After no milk OR food for 3 hours, she should be hungry for more than 1 oz I would think.

The nanny tried later after lunch (4oz), and she refused the bottle completely. So she put her down for a nap. After letting her roll around for over an hour, she finally took the bottle, but only 3oz, refusing more. Then she rolled around for 20 more minutes, and then took another 3oz. So she's being very stubborn. But I think if we stick with it, she'll eventually give in and take the bottle again more consistently. So I think I'll let the bottle thing work itself out for a few days and then try breastfeeding again to see what happens.

Re: her awake time. She's actually awake ~3 hours before that first nap, sometimes up to 3 hours 20 minutes. And yes, I agree, she needs more awake time, but it's hard to get her to take a proper nap when the food issue is in the way. So I think I have to work that out first, and then work on the awake time.

I read through the weaning page. I don't think baby is weaning either, especially since she is happy to take milk from the faster flow nipple. But I really wonder if I can successfully nurse in the mornings and weekends only or if she will continue to refuse and prefer the bottle. Do you know anyone that has successfully combined the two with an older baby? She's getting to be so smart, I can't fool her anymore!

[*Ali*]

What bottles are you using! Could you try a vary flow teat so she controls the flow herself?

[BstnMelody]

I've been using the Medela bottles with slow flow nipples since day 1. I never considered using a variable flow nipple - to be honest, I had never heard of them until you just suggested it.

As a quick update, I breastfed DD this morning. As usual, the last time she had milk was at 7pm in the evening. She took the first breast just fine, and drank a fair amount. But it was almost 25 minutes after she finished on the first breast that I got her to take from the 2nd. And that was with a lot of fighting. She probably had half the amount from that 2nd breast that she took from the 1st. I won't BF her for any other feedings until the weekend when I'm home all day again, so I'm not sure how they'll all go.

In speaking with the nanny today, it seems DD has taken enough milk from the bottle, but she has really needed to be coaxed to get enough. She seems to only take 1-2 ounces willingly, and the rest she needs a lot of time to get through (she ultimately takes ~4-5oz). She definitely took more with less effort on the nanny's part from the medium flow nipple for the few days we used it. But of course that seemed to really negatively affect breastfeeding. I'm nervous to try the variable flow, as it sounds like it might be faster than me in some cases. Thoughts?

[*Ali*]

I think it can be faster but she has to work to get it so it isn't the easy alternative a fast flow teat would be. I don't have any btdt experience with one, it was actually a suggestion the bottle feeding mid gave me.