Author Topic: Struggling with feeding and getting to a 3 hour easy with 3.5 week old  (Read 5124 times)

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Offline Clairehv

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Hi
am posting for some help/advice as I feel I am in a complete pickle with DD2.
Ayda is 3 weeks and 4 days old. Was a section delivery but a good birth weight 8lb 7oz and a lovely healthy baby. I am doing combination feeding, had started off positively with BF (after a dreadful experience with DD1) and had thought it was going well initially. Then was demoralised as after her weigh in a 4 days where she had lost the expected 7% by day 7 had not gained weight and in fact had lost. By two weeks she was back at birth weight.
So no health issues with her now.

However I had hoped by week 4 to have been moving towards the 3 hour EASY but my issue is the feeding.
Regardless of whether I offer a breast feed or bottle each feed time seems to take at least 1.5 hours with her being very sleepy and taking gaps but then not settling at all after a feed. I do think she is windy but is also displaying some symptoms of silent reflux which our oldest daughter had.
I spend ages trying to wind but then if I lay her down on her back she just makes these repeated coughing/barking type noises and won't settle then will start crying and I pick up will head bob so I offer her breast or bottle again.

My concerns are how to identify true hunger/ vs her trying to comfort pain. She is a good weight and also a month old so should be able to stretch between feeds.
Our whole A time is spent feeding so essentially I always feed to sleep.
Some examples of how the last days are

Wednesday
7.30am E 90 ml expressed,
Not settled 40 ml formula, + another 30 ml formula. Tried to settle from 9am
9.30 really crying 30ml formula
S- 10.10-11am woke fussing/crying tried to settle
E- 11.30-12.15 60 ml formula
     12.45.        30 ml formula
S. 1.15-1.45
E  1.45 50 ml. Then really unsettled couldn't get a burp for ages
S 3.15-3.40 then crying
E  3.45 bf LB 10/12 mins then crying/pulling on/off but then head bobbing, offered RB and was head bobbing wanting to be on but then screaming, stopped and just walked around rocked until 5pm
E offered RB 3-4 mins
S 5.10-5.45
Bath around 6pm to fit with DD1
6.10 offered bottle bedtime feed. Realised after 30 mins was only chewing teat.
6.45-7.30pm took 60 ml, kept seeming asleep then crying
8pm 30ml
S 8.30pm-

E 12.15 am RB: only 15 mins then fast asleep couldn't interest
E 4.15am lB 15 mins then really fussy on/off both LB and RB asleep on me from 5am into Moses at 5.30 then asleep but doing the funny cough throat/hacks type noise
Woke 6am

Thursday
6.30am: offered bottle. Just chewed teat for 20 mins
7am E 60 ml
7.45 E 30 ml
S 8.10- 9am woke really crying
E BF 9-10am
S 10am-10.15 then really crying/screaming
10.30 E offered bottle sucked for 20 mins but only had 10 ml
S 11-11.40 then red face, crying knees pulled up
Asleep in arms for 10 mins then crying again
E 12.00 90ml
S 12.40-1.45 in Moses then managed to settle in arms upright 1.50pm-3.15pm
3.30 E crying. Offered bottle took until 5pm to have 90ml in small bits, fussy I winded several times.
No sleep
Bath
6.05 BF RB 20 mins LB 20 mins (fussed on/off)
7pm screaming/crying, tried to offer bf but just got worse
Projectile vomit
8pm 30 ml bottle then asleep.
2am sucked teat for 20 mins - about 20 ml. Vomit then asleep
S 2.45am-5am
E 5.15 am 40 ml asleep on me 5.45

Friday woke up 7.15

So my concerns: I was just feeding as and when as could it be a 3 week growth spurt? However I am concerned about her being in discomfort or genuinely hungry before trying to stretch.

Dd1 fell quite easily into the 3 hour easy ( we had to wake to feed) so I am just feeling confused.
We did have gaviscon prescribed by GP at 11 days old but I have held off using just in case it wasn't reflux. Happy to try it.

Any advice greatly appreciated. I don't think a feed should be taking this long and particularly given she doesn't seem satisfied afterwards

Friday Saturday haven't seen much improvement.
I can post today's info if needed


Thank you
Claire x
Claire




Offline Clairehv

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Please help...
Following my above post.
Yesterday was really difficult and today hasn't started out well.
It has taken DD2 from 7.15-9.15 to get through 90 ml in small amounts. Every time I thought she was settled and tried to put down then she fussed cried and if I picked up then she rooted.
I really don't know if I am mis reading the cues. She has now been awake for over two hours.

I am not able to spend any time with dd1 as these feeds are so long and feel constant regardless if I breast or bottle feed. I don't know whether to try a pacifier but don't want to if she is genuinely hungry.
The same as trying a sling. She doesn't settle until she has fed more and more even if only for 1 more minute.
At the moment at 9.30 she has just taken another 30 ml after crying and rooting.

So it is almost 9.45 and I am still in my pjs. Due to my section I am not really going anywhere and DH has an agreement with work that he can do childcare drop off and pick up for dd1 but in a week I am going to have to be able to leave the house by 8am.
How can I sort this feeding length out?

Feeling really low about this as just not sure what's wrong. We had 3 vomiting episodes yesterday as well.
Let me know if I post yesterday's routine to be helpful.
Thank you
Claire




Offline Lindsay27

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Hi hun!! First off congratulations on your DD2!  It is important to remember that these are still the early days, so as hard as it is don't worry too much if things don't quite fall into place quite yet, I found that with both of mine it was easily 8-9 weeks before they were beginning to really establish EASY.

I am going to get some BF and reflux eyes on this for you, but it sounds like reflux could definitely be an issue, and my advice would be if the doctor gave you a prescription I would absolutely try it...it won't hurt and if anything it might help identify if there really is something else going on yk? When you first offer her feed is she draining the bottle?  If so that is an indication that she needs more right from the get-go.  If not and she wants to feed again/is rooting 30mins later it does sound like it might be comfort feeding.  I personally am pro-paci, both my kids used them, so it is an option that I would consider trying.  I'm not super knowledgeable with reflux but I do believe it helps comfort any pain and helps to settle.



Offline trimbler

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Hi there, sorry I don't have long now but just wanted to offer (((hugs))) and say what I've read from your post sounds so much like my DD was - we struggled through with her struggling to feed and gain weight etc, until she was almost three months and then was diagnosed with silent reflux and tongue tie - I'd definitely try to get her seen (can you get someone to come to you?) for both of those and have a go with the gaviscon, although tbh I've heard that it can be tricky to get down and for this reason my LC recommended ranitidine, which our GP was happy to prescribe straight off - we were so glad we did! Oh and feeding improved loads once she had the tongue tie snipped :)



Offline Lolly

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I would also start the gaviscon and get her checked for tongue tie if she hasn't already. The coughing is typical of reflux - my DD did it from the day she was born until we got it controlled - never when anyone medical could hear her though ::) That's a long time to take to drink from a bottle, they should be done in about 20 mins.

Are you offering formula in the bottle? If you are make sure you discard the bottle by an hour after she has started drinking from it.

Have you tried her with a dummy? I would to see if she actually just needs to suck and it does help with reflux too.

Laura


Offline Clairehv

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Hi
Thanks for the responses.
We started with gaviscon yesterday and I also have moved onto size 2 teats.
DD1 had definite silent reflux with some similar but also different traits. She screamed the place down and didn't lie on her back for 24 hrs straight and there was a marked improvement as soon as we were prescribed gaviscon.

I feel like a first time mum with DD2. Very confused by her cues and crying.
Positive she doesn't have a tongue tie as it was checked several times but will ask HV again. She also latched on very well and seems to BF well.

Don't feel yesterday or today has gone particularly well.

Saturday
6.00 am WU crying / rooting
6.15am E 30 ml then just awake
7am 60 ml (assume as less than an hour this is classed as 1 feed).
S 7.40 -10 (resettled at 9am)
e 10.10am  60 ml ( then burped and vomited)
10.45 30ml
s 11.10-11.50am then crying / rooting
12.00 90ml expressed.
12.45 into sling
S 1.15pm- 2.00 pm
E 2.15 60 ml
S in arms 3pm ( tried to put in Moses - crying after 10 mins
E 3.15 60 ml
E 3.30-4.15 BF
S 5pm-5.20pm
E 6.10pm -6.45 120ml, 7.15 crying. Offered BF - 30 mins then real fussing / crying on/off
7.45 30ml top up then just awake. 8.40pm vomit. Then rooting again
9pm 60 ml
S 9.30pm - 2am.
E 2am 60 ml then sick. Not interested
S 3am, crying 4am. Slept unpright on me until 5.30am
E 5.30am BF
S 6.15am-7.15am

Sunday (today)

E 7.15 - 8.45am (1.5 hr) took 60 ml in several small amounts
Would seem settled then start rooting again
9.15-9.45am 60 ml,
S seemed asleep 9.50-10.10am then crying /rooting
10.15 60 ml, managed to wind successfully
11am 60ml!!
11.40am into pram to try and stretch out between feeds
S whilst walking /rocking pram 12-1pm
E 13.30 60ml
S 2pm-2.30 in arms. Into Moses but woke crying at 2.45pm. Burp then crying
Couldn't settle
E 3.30pm BF
S in arms 4.15pm - 4.30 woke when put in Moses. Put in sling. Crying rooting from 5pm on and off
E 5.30 30ml to get through bath
E 6pm 30ml then fast asleep
S 6.15-7pm woke crying
E 7pm-7.40 90ml - drained bottle
Then 20 ml then 10ml. Very fussy crying red face/pain?
S 8.30pm

Fingers crossed that's it until 11pm.

I am so aware that she isn't sleeping enough and we are just all over the place with the feeds.

I am breast feeding when j feel I can (I.e no visitors etc, I just don't find it that easy so there isn't a fixed feed every day. Tbh I had such a horrendous experience first time round that any breast milk she gets is a bonus.

I am aware these are really long emails so I appreciate any input. Good night for now x
Claire




Offline *Ali*

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Do you think your supply is established yet? If you're offering lots of bottles at varying times then it will be sending confusing signals to your body unless you are pumping each time you offer the bottle. It's probably best in the long run if you can offer the bottle for the same or similar feeds each day or if you offer the breast every feed and top up with the bottle afterwards. I understand that may be hard if you don't feel comfortable feeding with company or in certain situations just now. As you say every ounce of breast milk is very worthwhile though ☺

Another thing to consider is that LO might be getting frustrated with the breastfeeding if she is getting used to getting the formula quickly through a size 2 teat already. It's usually recommended to stick to the slowest teat possible if you want to mix feed and avoid bottle preference.

Cadan Dec 2009 and Colby Aug 2011


Offline Lolly

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Another thing to consider is that LO might be getting frustrated with the breastfeeding if she is getting used to getting the formula quickly through a size 2 teat already. It's usually recommended to stick to the slowest teat possible if you want to mix feed and avoid bottle preferenc.

Good point for feeds that are just milk - however if there is gaviscon in the feed you will need the no 2 as although it is designed to work in the stomach, it does thicken the feed too and it's very hard to get out of a no1 teat - been there, done that ::)

Laura


Offline Clairehv

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Hi,

Re the bottle feeding.
I always had wanted to ensure DD2 would take a bottle and then I suppose I have been finding the breast feeding tricky and time consuming I have become more reliant on the bottle.
I moved to size 2 teats due to the length of time a bottle feed was taking and also that she seems to fall asleep after 20-30 ml or sometimes isn't even drinking just has teat in her mouth. My thought was if she struggles or chokes then the flow is too fast and I will stay on teat size 1. She doesn't seem to have a problem with it.

She seems a very sleepy feeder with a breast feed or bottle and to be honest neither of them seem to have sorted out this feeding over an extended period of time issue.

Due to the time spent feeding, then no I haven't been expressing after every bottle feed.

I appreciate my milk supply will be affected. I am happy with going to full bottle feeds. Had hoped to do some BF for 6 weeks.
If she was not getting milk when I am BF would she not fuss/cry at the breast?

Maybe there isn't a solution to getting the feeds shorter.
Or maybe I should just go fully to bottles now to stop confusion.

We do seem to be getting less of the weird Throat clearing coughing noise now she has had the gaviscon for two days.
Just need to work on filling her up more efficiently.

X
Claire




Offline becj86

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I think given she's having issues transferring milk both with bottle and breast, I'd get her mouth checked really thoroughly for tongue tie, and anything else that might affect the suck and swallow motions.

Glad the gaviscon is starting to help, those first posts definitely sound like reflux too.

Is she taking more milk any faster now she's had the gaviscon? She's young I'd have thought for being averse to feeding due to pain from reflux but its possible...

Offline *Ali*

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I'm sure she is getting milk at the breast. One of the signs of having to work too hard to get the milk is falling asleep while feeding so no it doesn't necessarily follow that she would be crying if she was struggling to get milk.

I'd definitely get her checked for tongue tie as pp says.
Cadan Dec 2009 and Colby Aug 2011


Offline Clairehv

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Hi thank you for the support so far.

So I had thought Monday had started more positively but then things deteriorated during the day.
Sunday night she had only fed once- from 1.30am to 3 am breast feed.

So when she woke at 7.15am on Monday i think she was definitely hungry as we had (based on prior days ) a good first feed

E 7.30am 90ml drank quite quickly, took 15 mins to wind and then 30ml more at 8.10am
Tried to settle in Moses from 8.20am, crying 8.40am- I offered the rest of the feed. She drank 30ml and then fell asleep. (Was this a misread of the cue, just I have just worked to settle without feeding to sleep.
S 8.55am- 10.30am (woke her self after best day sleep for a while. As 3 hrs since start of last feed I assumed hunger )
E 10.40am only took 20 ml then fell asleep - I think this is odd?
S 10.55-12 ( woke herself) - now the rest of the day goes wrong

E 12.00 90ml then 30 + 30 expressed with burps in between.  Finished 12.55pm. Then fussing until another burp at 1.15 - then really crying/ rooting on my neck
Drank another 20 ml expressed (emptied bottle) so I offered 30 ml formula, drank 10ml. Seemed tired
Into Moses, crying picked up, asleep in arms, into Moses - crying after 3-4 mins
S 2.30-3pm by rocking in pram. Woke crying , tried to settle, I felt she was rooting again ( does she do this due to discomfort?
E 3.20pm-4.40pm: worked through 120ml with burps and crying whenever she came off the bottle
4.45 put in pram and took for a walk. Escalating crying until 5.20pm. She stopped when I picked up
S 5.20pm in arms until 5.55pm
Bath
6.20pm E drained 50 ml of expressed then hysterical crying, pushing bottle away, red face calmed byb6.45pm
6.45-7.45 pm drank 120 ml in small amounts with burps and crying.
Then seemed settled but crying again at 8.10pm
8.15 30ml then settled and sleep
S 8.30pm -11.30pm
11.45pm : 60 ml not interested in any more
S 12.30am- 2.30am
E 2.45am 30 ml : couldn't interest in any more
S 3.15am- 6.30 am

Today
6.30am BF LB 20 mins RB 20 mins, quiet and awake until 8am, crying offered top up, only took 10 ml ( missed OT cue and feel she needs to suck to go to sleep.
S 8.20am-

So she is clearly not getting enough sleep yesterday afternoon which probably led to the crying and fussing at the bedtime feed but any opinions on yesterday's afternoon behaviour?

I am going to see the hv tomorrow and will get her weighed and tongue checked and then maybe I can be more confident she is getting what she needs and be tougher on the sleep, or restricting the feeds to time limit.
Gosh I feel so unconfident.

Xx
Claire




Offline Lindsay27

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Have you tried a paci at all hun? I am thinking if you do you might be able to determine hunger vs other crying/something else more easily with a paci.

When she woke on Monday morning and took the 90mls did she drain the bottle? If she did I would offer more right from the get-go.  At this age I don't think my DD wasn't really doing more than 90-120mls per feed so I'm thinking all the extra top ups are either comfort feeding because of the reflux or because she tired. 

I think her small feed at 10:40 was simply because she wasn't hungry...if you think, she took 90mls at 7:30, then 30mls at 8:10, then 30mls at 8:40, that's a total of 150mls in about an hour, so at 10:40 I don't expect she would be hungry ya know?  Those small feeds I would instead try to offer paci and see what happens, she just may need comfort sucking. 



Offline Clairehv

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Hi
One of my mummy friends has suggested a paci/dummy.
When would I offer ?

Re the bottle: I am making up 150ml bottles so no she is often not draining. When she drains the smaller amounts I do try and then make up a small amount of fresh and offer again.

What kind of WU time is typical for a 4 week old? 1-1.5 hours?
I think I am missing the tired cues or have got her used to sucking/feeding to sleep.
At least she is young enough for me to change things.
The gaviscon does seem to enable her to be more settled when lying down. The throat clearing/coughing noise seems to have reduced.

Thanks for the help x
Claire




Offline Lindsay27

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I think what I would do is offer her feed, say she takes 90mls then burp and offer some more.  If she doesn't take any more but then a little while later seems unsettled, crying, rooting, fussing etc then offer the paci.  If the paci doesn't change her behaviour then it is possible she is still hungry (or experiencing the effects of reflux), but if it calms her and helps her settle it probably means she just wanted to suck.

I'm not super versed with reflux but my DD does have a mild case, and she is on raniditine.  Great news that the gaviscon appears to be working but if you think she is still experiencing symptoms there are other options :)