Won't go to sleep without breast feeding

[LLLena]

My 5 month old is happy, healthy and on the small side.  He is 12 pounds and has gained just over 3 lbs since birth.  However, he is still on the 50-75 percentile for head circumference and length.  Since about 10 wks old, he has been bf and given formula supplement when at the sitter, which was mixed 50% with breastmilk.  The doctor is concerned about poor weight gain and put him on Similac Alimentum (liquid gold with expense) to supplement breastfeeding.  We had been experience the bobbing on and off routine during breast feeding and he didn't seem satisfied, but I know that there was still breast milk available as I could hand express.  I have tried just about everything and I am about to give up on breast feeding, but want to problem solve a bit more if I can.  It almost seems that my lo is just being particular, but he cries a lot for just being picky.  Lately, I have tried to bf and he will take for about 10 minutes total (both breasts) and still doesn't seem satisfied so I have tried repeatedly to get him back on and it ends up with frustration and I have given him a bottle of about 2-4 oz depending.  Worse yet, he seems really upset when I take the bottle.  Am I starving the boy? I don't know what else to do.  We were doing great with BF and for about the last 2 mos it is more frustration than it seems worth.  Any ideas are really appreciated.

I suppose that I should also mention that he is developmentally on target and bright and alert all the time.  There is no sign of dehydration and he is not emaciated. 
Thanks for any help!

[LLLena]

Oh, I forgot to mention that I have tried EASY 3 hr and then it all went down the tubes when he started wanting to be fed before going to sleep too.  Ugh!  With his slow weight gain, I don't want to refuse him, but really don't want to whip out the boob everytime I turn around either. 

Thanks for any help!

[First Time Mom]

First, I'm surprised your doc put him on formula to supplement! My dd is very petite (at 8 months was 13.5 pounds), my first doctor was always concerned about her weight so told me to stop bfing, give formula and start solids at 3 months . Instead of following this, I found a new ped. She wants me to continue bfing, NOT add formula, and to continue the df for now and will check dd's weight monthly. She's not worried as dh and I are slim but just wants to monitor the weight. My dd started solids at 6 mths as well.

If your ds is on target developmentally and alert I wouldn't worry too much. I'm thinking that perhaps your supply has been impacted by the formula supplements. As your ds has grown your body hasn't made more milk to keep up with demands because of the supplements. Also, formula flows feely from a bottle, he may be frustrated that he has to work for the breast milk. 10 minutes could be long enough, many los become efficient feeders, my lo nurses for 10-15, 20 if she's very sleepy. Temporarily, I would nurse more often to increase the supply, especially with the big 6 mth gs around the corner then stretch out the feeds to be on 4 hour EASY, especially for when you introduce solids.

As for feeding before sleep- I've always offered a top up before bed for my dd and she takes it (even though it's less time than the EASY). She pretty much 1/2 falls asleep at the end of the feed but then she wakes when I take her to her room and put her in her crib so technically, she's not 100% asleep from the feed.

[Peek-a-boo]

Have you considered contacting a lactation consultant?  If breastfeeding is a priority for you, I would seek professional help.  Although they are very knowledable about many things, pediatricians can lack the specialized training that a lactation consultant should have.  I've been told you should look for one who has the credential of International Board Certified Lactation Consultant (IBCLC). 

I'm new to BW, but from other sources that I've read, supplementation can contribute to milk supply problems (if that is indeed the source of the problem).  For me, breastfeeding is too important to gamble with--I'd seek out a lactation consultant. 

Increasing feedings and allowing baby to fall asleep at the breast are two separate matters, however.  If you are worried about breastfeeding becoming a prop that causes future sleep issues, baby shouldn't fall asleep during the feeding.

[LLLena]

I am going to call the US Breastfeeding helpline in the morning and try to get a referral to a lactation consultant as well. I have tried doing this before and ran into a brick wall.  This is more important to me than I had originally expected before ds was born.  I had really hoped to bf for at least a year, but am now starting to reconsider a bit. 

I don't believe that he is dependent on bf before naptime as a prop, but I am just getting frustrated with having to whip out the boob almost everytime I turn around.  At least, it sometimes feels that way.  I think he is genuinely hungry, and will sometimes fall asleep at the end. However, I will wake him and make sure he doesn't go straight away to naptime from the breast.  He is always alert to the point that everyone comments on how he is so alert and taking it all in.  He started rolling at 10 wks and has the other developmental milestones down.  It is just that he is on the skinny side.  Since we started supplementing a bit, he does have more meat on him, but hasn't gained excessively and are due back this week for another weight check.  I would rather not do any supplementing for all of the obvious reasons: healthier for him to bf, and now financial due to the tremendous expense of Alimentum. 

The pediatrician wanted me to start solids at 4 mos and I did reluctantly on and off until last week.  DS has had MAJOR constipation issues and I have finally had enough and decided his belly isn't ready for it.  There isn't any real good reason to start them so darn soon anyway.  I didn't want to, but my mom and  pediatrician talked me into it.  DS has had a tender belly even with the little bit of mixed formula that he has received, hence the Alimentum. 

This is just a bit frustrating on so many levels.  I would like to get a full night's sleep and he doesn't seem to want to do that for me.  We will cluster feed in the evening while prepping for bed and he will still only sleep about 4 hours.  He was doing really well for a while with some 5-6 hour stints at night, but that has gone by the wayside.  I hope that this issue can be worked out soon.

Thanks for any help.   

[First Time Mom]

Post your routine for us.

You mention that he has a sensitive belly- I wonder if he has a cow's milk intolerance (or allergy), some cereals have formula added (with cow's milk). My dd can't take any- I've had to eliminate all cow's milk since she was 6 weeks old.

If he seems always hungry after bfing and you've been supplementing since 10 weeks, could be supply related (due to supplementing) and you'd need to get your supply up by increasing feeds and possibly pumping. Let us know what the helpline says. It's a shame you ran into a brick wall in the past! No wonder so many mothers get frustrated and give up bfing.

The fussing/crying and nws may possibly not be related to feeds, could be related to naps, teething, or anything, that's why a look at the routine may help.

[LLLena]

Ok.... sorry to have taken so long in responding.  We just moved out of state waiting for DH to come home from Iraq.  Like we needed more stress!

The schedule that I have been trying to follow is:

E: 7-730am for about 15 min total
A: 730-930/945
E: 9:30-9:45
S: 945-1045/11am
Y: 945-1045ish

E: 11am
A: 11:20ish-130/2pm
E: ~1:30-2pm
S: 2-3:30/4pm
Y: 2-3:30/4pm

E: 4pm
A: 4:20-6pm
E: 6pm
A: 6-630pm/bathtime
E: 6:45p
S: 7pm

Dream feeds at 9 & 11pm with wake ups at 3am and 5-6am.

I would really like to get rid of the second E in the routine, but don't know how to get him to stop.  He falls asleep on breast and doesn't seem to be able to relax enought to fall asleep otherwise.  This was a very poor habit that we found ourselves in and I really want this to stop.  HELP!  Any suggestions are appreciated.

[First Time Mom]

That is a lot of feeds with having to feed prior to every nap. I checked back in my "baby daytimer" to when my dd was 5 mths and she was down to 5 feeds (sometimes 6). The first thing I also noticed was your lo's nap time- I wonder if his first nap is too late from his wake time, making him too tired and thus napping shorter. This would accumulate throughout the day and could cause nws. At that age my dd woke at 7 and was asleep for her first nap at 9, her first nap was always 1.5 hours. I remember many of the moms on my birth thread had shorter A times in the morning as well. Have you tried to put him down earlier? The total A time should include the time it takes to E. Also, at that age many los need a 3rd catnap (45 minutes is even fine).

Have you received any help from the bfing helpline? You're obviously busy, I would think a move would totally mess up a lo's routine not to mention stress you out! Are you still suplimenting w/ formula? I remember when I thought my supply was low (and I never pumped) I would feed both sides then return dd to the first side for a few extra minutes. This seemed to help me.

Watch for the 6 mth growth spurt as well! This one's a big one! My dd nursed every 2 hours around the clock for days. Oh yeah, I checked my dd's weight at that age- she was 11 pounds 9 oz!

[LLLena]

Yes, I know it is a lot of feeds.  The problem is that he seems hungry (or my mind is just telling me that out of the weight paranoia), but is also a bit flighty with his arms and legs.  So, I am not 100% sure that it is hunger or being tired or both.  I think this whole thing started with the dr pressing about his weight and slow gain which, in turn, caused me to think he wasn't getting enough even with the full diapers. 

So, I think I might be accidental parenting and am going to try something my mom recommended that worked for her when she had him for a few hours.  She did the normal E,A, and then for naptime or bedtime she would swaddle him (even at almost 6 months old).  I feel so stupid that this has happened, but at least I recognize that there is a problem. 

I also know that the stress of this move has totally knocked us off kilter.  But we are finally starting to get back into some semblance of a schedule.  Thank GOD!  When DH comes home in the next week, that'll bring a whole new set of issues teaching him about EASY and the BW way. 

Thanks for your help and anything else you might be able to add.

[First Time Mom]

Arms and legs flighty sounds like overtired to me!

[First Time Mom]

Oops, typed to fast!

[LLLena]

I would agree, however even if I lay him down at 1.5-2 hrs after E, he still gets all flgihty.  I had stopped swaddling for a while, but will watch him closer to lay him down sooner so maybe I won't have to.  UGH! 

Believe it or not, I actually had the 3 hrEASY down until we got thrush and it all went down the tubes.  It works so well and I miss it so much!  Tomorrow is a new day and I will try again. 

Thanks for all your suggestions.

[First Time Mom]

OMG, I did it again .

Don't get too worked up about the doctor and your ds's weight as long as you ds is content, alert, and reaching milestones. I totally hear where you're coming from and have been there. My dd is 9 mths and FINALLY gained over a pound this past month so, for the first time, we don't have to go back to the ped until she is 12 mths. Up until this, we have had to go EVERY MONTH! Often, I would come home crying, thinking I was underfeeding her, thinking I should give up bfing, worrying if her small gains were my fault. My first doctor told me to quit bfing and start formula and solids at 3 months . I never listened to her, after every visit I would call the bfing clinic the next day and they would reasure me that bfing was best. I would take her to the clinic for extra weight checks and they always told me that my dd was small because my dh and I are both slim and small boned even though we're tall and that she appeared to be totally fine. I regularly doubted what I was doing so I would go on this crazy kick to tank up my dd, trying to feed her every 2 hours or so but this resulted in her often crying and getting cranky. I finally changed peds and my new one took one look at dd and at us and said "look at yourselves, do you really expect to have a chunky baby?! She's totally healthy, don't worry about it, continue bfing". She did tell me to continue the df as she said it couldn't hurt.

[LLLena]

Thanks again for your help.  Since you have had the same weight problem, it helps to know that I am not alone.  You are so right about the crying and self-doubt.  This hasn't been easy and I hope the new pediatrician will have a different mindset.  The old one wanted us to starts solids at 4 mos and I reluctantly did it for a few weeks, but he wasn't able to have BMs without "help."  So I decided on my own that his system was too immature to have solids.  Now that he is a bit older and definitely interested in my plate, I think I'll be trying them again soon. 

Being a parent isn't easy!  I am glad that I found this site and the BW book.  It has been a God-send.  And thank you so much for your input, FirstTimeMOM.  It has really helped. 

[First Time Mom]

You're welcome. Let me know if changing the naps helps and what the LC says (if you get any info from them).