No appetite to fit into EASY

[LJCsmom]

I am new to this site and have a million questions. My son Liam is 4 months old and I am trying to start EASY - it's been one day.

I have exclusively breastfed him up until about a week ago. He has now more than doubled his birthweight and he has no appetite in the day.

This is our typical day

Wake 6 am eat
6:30-7:00 Sleep
Wake 10 am -  at this point I try to get him to eat again, he might for a minute or two. He has bitten me once and grunted in frustration to tell me he doesn't want to eat. Anything he might have taken down is spitup.

Then I try to get him to eat at 11. He usually won't. Then at 12 and by this time he might eat. But it's usually only a couple of ozs.

I'll feed him again anywhere from 3-4. And usually its a couple of ozs.

By 6pm he's starving and can put back 6/7 ozs, we have a bath then another 6/7ozs.
Sleeping around 8/8:30pm
Dreamfeed 10/11pm 5-7 ozs.

My question is how do I implement EASY when he eats so irratically? I've been pumping my breasts and supplementing him with formula thinking maybe I'm not producing enough milk and/or he might have reflux.  My doctor has not concerns about how much he is eating or that he has reflux. I'm totally lost.

[Samuel's mum]

Hi there. Welcome. Your post contains more than one issue - Can I start with a few questions?

I'm just wondering about Liam's routine. Does he have another sleep later or is he awake from 10am to 8pm? If you started EASY yesterday how did things go?

I'm also wondering what led you to feel you had supply issues and whether you received any support at the time. Did you read this FAQ?

https://babywhispererforums.com/index.php?topic=65905.0

I'm hoping you've been told that supplementing with formula will reduce your supply further and it's important if you are supplementing to ensure you offer the breast first and give the 'minimum' (unless of course you are trying to wean to formula). I'm always a bit nervous when I hear of mums around the 2-4 month mark with supply worries because it's such a common unfounded fear as breasts stop becoming engorged/ pumping gets harder/ leaking stops/ babies feed quicker/ poos become infrequent. All these completely normal desirable steps as breasts/babies settle into nursing can be misinterpreted as supply problem when they are not. You are perhaps in the small minority who has had a problem but I just want to mention that.

Are you always using a bottle? Is this how you know all the oz? Otherwise when you are bfing there isn't a way to judge quantities especially as babies get a lot faster as they get older and a 4 month old could easily get 6oz in around 5 minutes.

Is he feeding at night? He may not be hungry in the day because he could be 'reverse cycling' i.e. swapping day for night in his feeding patterns. If this has happened you would need to try to cut back on nightime calories to increase daytime ones and if this is the case we can talk more about how to do that. If he is having 2 or more night feeds then his daytime pattern is completely understandable. It's surprising that he's not hungry again at 10am but not if he's feeding at night.

Why do you feel reflux might be an issue? It's possible to spit up a LOT (Sam did) and not be bothered by it and not have reflux. Have you checked out the descriptions on the reflux board? https://babywhispererforums.com/index.php?board=13.0

Tell me a bit more about his 24 hr schedule and your low supply fears....

[Wei]

Samuel's mom:

Hmmm.... I'm kinda curious about what you mean by cutting down the nighttime feeds to implement them in the daytime.  I have a 9 week old DD and am wondering how you do that?

Wei

[Samuel's mum]

It's not super easy to be honest and at 9 weeks you may not be able to eliminate all the night feeds as some young babies genuinely do need them.

The basic premise would be to try and settle using other methods e.g. pat/shush perhaps using another adult. If your baby is giving clear hungry signals and you feel they need a feed then still feed but try and give smaller amounts e.g. one breast or restricted time at the breast. For an older baby you might offer use of a paci/dummy/bink to try and resettle.

My advice for a 4 month old might be different for a 9 week old. At 9 weeks Sam was still feeding every 3 hours at night and that was what he needed. He was feeding every 2-2.5 hours in the day.
I think at 9 weeks your main focus is trying to get longer intervals at night and avoiding a nursing to sleep association. Some babies manage without night feeds at that age - some really need them.

[LJCsmom]

Thanks for replying Samuel's mom,

a few answers:

We've been having problems with napping and that's another issue I'm working on with Liam. Today he had 3 naps and was woken up on two of them and was just miserable. He is using a pacifier in the day(just broke the middle of the night habit) and when I can figure out when he naps and for how long I will work on getting rid of the pacifier. nap times today 10:30 (45mins, we also got up and hour earlier than usual), then 1:14 (slept an hour was woken up and tried to go back for half but didn't work), and then 5(slept 20 mins and was woken up).

The reason I started worrying about supply issues was because Liam would not eat much in the day and then eat a ton at night and I never seemed to have enough so I started pumping throughout the day to up my supply and be able to have enough milk for him at night. I started the formula cause desperately one night I had one bottle with 2 ounzes in it and had to give him something. He took it really well and I started mixing it with my milk thinking he would might like it better and would eat better in the day but still no change in the day feed.

I can understand if he does not each as much anymore as he has doubled his birthweight and passed the 3 month growthspurt but him playing catch up at night makes me feel he's not getting enough. I've tried to force him to eat and he either gets frustrated or eats and spitups up everything he takes down. Believe me I was looking forward to feeding times getting shorter. Liam has always been a slow eater but I never worried that he wasn't latched properly or not getting enought because he grew so fast and was/is big for his age.

The thing that burns me is that Liam started sleeping through the night at 2 months everything was soo easy. He would eat every 3 hours and then fill up at night, sometimes feeding for up to 2 hours before bedtime. So he's been doing this for a while. As soon as we switched him from his basinett to his crib everything went downhill. My biggest issue up until now has been sleeping through the night and him filling up at night has worked for us. Do you think I should try and switch this around like you suggested?

I feel like there are so many issues to work on with Liam I don't know where to start, I feel very depressed today.
 
-I don't feel he has a reflux problem after speaking with my doctor-





 

[Samuel's mum]

Hi again

The reason I started worrying about supply issues was because Liam would not eat much in the day and then eat a ton at night and I never seemed to have enough so I started pumping throughout the day to up my supply and be able to have enough milk for him at night. I started the formula cause desperately one night I had one bottle with 2 ounzes in it and had to give him something. He took it really well and I started mixing it with my milk thinking he would might like it better and would eat better in the day but still no change in the day feed.

If he was 'eating a ton at night' as you describe he was 'reverse cycling'. It didn't mean there was anything at all wrong with your supply necessarily. It would only get more difficult if you were offering bottles at night and you were not able to pump the required amounts. It might have been a thought to breastfeed at night if that was when he was demanding the most. Is there a reason why you prefer to use bottles at night?

My biggest issue up until now has been sleeping through the night and him filling up at night has worked for us. Do you think I should try and switch this around like you suggested?

Only try and change the reverse cycling if it's what you want.

There are lots of reasons why babies wake up unhappy from naps. Could be discomfort if it's only his first week of formula as it can make babies more windy? Could be he didn't sleep enough? Could be there's nothing wrong at all.

Listen - you sound mixed up and a bit low. Big HUG.

It's not an uncommon time to feel a bit low once that first flush of new baby excitement has gone and real life sets in. I can imagine it must be a bit annoying to say the least to have a baby who was sleeping through now changing the rules. However if you are really feeling low is it something you might need to talk to someone about?

If he's doubled his birth weight already I really don't think feeding is your problem! I think you need some help from sleep folks. I'm going to ask some of the other moderators to look in on you if that's OK.

Can I just check first because I know other mods might ask:
Can you outline what yesterday's day looked like (24 hours)? - I know you have already done this in places but I'm a bit hazy about nights. Just set it all out - really simply like:
e.g.
E 6.30 (breast or bottle 4oz or whatever)
A
S 10.00
Doesn't have to be complicated
And what would you like to achieve first? Think of just one thing.

[rebecaq]

Hi there,

I agree with Emma on all counts. If he has doubled his weight then your supply doesn't seem to be an issue. I also agree that he has reversed his cycle and taking in his calories at night. And I especially agree on the {{{HUGS}}}, we all know how hard it is    Breastfeeding is so fullfilling but also so emotional that it takes us mommies on rollercoaster rides!  Add the fact that it's harder to "see" how much our babies are eating and it can throw us mommies into a headspin!

Regarding his EASY routine.  I want to ask why you are putting him back down for a sleep at 6:30.  Do you start the day with him at 10?  I think this is a big part on why his cycle isn't in place.  That nap is more like an extension of his nighttime sleep, so his natural sleep cycle is being thrown off.  So since he's not "burning" up those calories per se he may not be as hungry at his next feed.

At 4 months he should be sleep through the night, as he was before. So those night feedings need to start slowly dissapearing.  How about offering the breast for less time in a few day increments to slowly start switching his need for calories to the daytime?

HTH

- Beca 

[LJCsmom]

Hello,

First off the reason I started pumping at night was because Liam is not a very active eater he would take for ever, literally hours filling up. It became very taxing as you said Beca, very emotional. I just deperately needed a break when he started waking up at night, I was exhausted. I've never had problems with pumping and Liam would finish a bottle of a lot quicker than nursing for hours.

I admit the reason we go back to bed after he wakes at 6 is so I can catch up on my sleep as I'm staying up to dreamfeed, don't get to sleep until midnight. So perhaps I should cut this out then? I just hate napping in the day cause I feel like my whole day is shot. But I am willing to do this to get Liam to take the 10 am feeding, then maybe he won't need as much to eat at night?

I haven't tried to cut back on the nightime feeding as I want him to sleep through the night. I try to feed him then bath him and lay him down for bed but if he's still hungry he cries and I give in cause I'm too tired at the end of the day and also figure he will wake up early. But if I have a gameplan I am willing to do whatever to get Liam on track.

This is how last 24hrs went:

S 8:30pm
E 11:00pm df
S 11:30 pm
E 6:30am bf
S 7:00am - 9:30am
E 10:00am bf (offered but didn't take)
A 10:30 -11:15am
S 11:30 - 1:00pm
E 1:00pm bottle
A 1:15 - 2:40 pm
S 3:00pm - 3:45pm
E 4:00 pm bottle
A 4:15 - 5:00pm
S 5:20pm - 5:50pm
E 6:00pm bottle (usually do this around 7, trying EASY)
A 6:30pm (I usually give him another bottle after his bath but tonight he didn't finish the 6:00 one)
S 9:30

Usually he falls asleep around 8/8:30 but perhaps he slept too much today. I am trying to figure out when to give him naps. It's so hard to pick one goal right now. My first goal I picked was to get him to get rid of his pacifier through the night and it worked the first two night and last night it didn't after 1.5 hours of trying he ended up in my bed. I am going to try the sleep forum regarding the pacifier. I am also really concerned about him napping in the day. So I really do need to check out the sleep forum.

Regarding his eating:
If I do cut back on his calories at night should I pat and shush him to go to sleep without it? How long can I go if he really starts freaking out? If he wakes up early can I use the pacifier to get him through without a feed? Should I really change Liam and is it too late? I mean is this bad the way he eats? Or is it just more an inconvenience to me? I just would like to be able to follow the EASY routine and that 10Am feed is missing and he's not eating at regular 4 hour intervals.

I'm hoping that I can figure out what will be best for Liam then I can start with one thing at a time. Thank you soo much for helping me to figure this all out. It really gets my head spinning! 
 

[Samuel's mum]

Aja
I've had a chat on the moderator board and we're going to move you over to the EASY board. The very lovely rebecaq is a moderator there as you can see and hopefully you'll find other people like her there too! That way you'll have support on starting up EASY and from people with an 'overview' on things (as it doesn't seem feeding isn't specifically your problem).

People from the bf board can still reach your thread through this link.

Good Luck. I'll check in on you and come back to the bf board if you'd like to any time. (and on the bottle feeding board you'll find a support thread for people doing mixed feeding.)
It will get better I promise!

[rebecaq]

Aja,

I know you feel like you're in such a spin, but I think Liam's routine will not be that hard to change around.  Just go slowly through the motions.  It's easier to taackle one problem at a time and I'm partial to fixing the big issues first.  With Liam I would say it's his reversed cycle that needs most attention. Not only for him but for you    A rested and calmed momma is the best thing a baby can have.

  Liam is not a very active eater he would take for ever, literally hours filling up. It became very taxing as you said Beca, very emotional.

I think that you are so tired and wound up that maybe your let down has slowed and it's becomes harder for him to nurse.  The same thing happened to me when Santiago was 3 months old and he was nursing for 2 hours on one breast!! I went to a lactation consultant and she gave me an earful on the rest that the mommy needs. And she also "commanded" that I drink a beer 30 mins prior to his last feed at night, not the dreamfeed. Can you imagine my  shock. I asked her if she was insane wanting me to pass alcohol to my baby! She explained that by the time he nursed after my drinking only one beer he wouldn't get any of it, but that the phycological factor it had on ME was what was going to change things around. The idea of drinking a beer, to unwind, as something that was only mine would help me relax and would improve my letdown.  After 3 days the difference was amazing!  I had my daily beer until I weaned him at 9 months.  Now, I'm not saying for you to go and drink beer, but that you need something to help YOU relax.  To help you not to feel that bf is taxing anymore.

I admit the reason we go back to bed after he wakes at 6 is so I can catch up on my sleep as I'm staying up to dreamfeed, don't get to sleep until midnigh

Go to sleep while waiting for the dreamfeed. Set your alarm clock to 11pm, go nurse him and then go back to bed.  You need your sleep, like I was saying above.  Can dh give him the dreamfeed with some ebm?  Let you have an early night and caych up on some sleep?

I admit the reason we go back to bed after he wakes at 6 is so I can catch up on my sleep as I'm staying up to dreamfeed, don't get to sleep until midnight. So perhaps I should cut this out then? I just hate napping in the day cause I feel like my whole day is shot. But I am willing to do this to get Liam to take the 10 am feeding, then maybe he won't need as much to eat at night?

I do think that early morning nap has to go.  It will help him to get his sleep/wake cycles back on track and will hopefully get him hungrier during the day.

I am going to try the sleep forum regarding the pacifier. I am also really concerned about him napping in the day. So I really do need to check out the sleep forum.

Don't even worry about the paci right now  We can take care of the later    We don't want to overwhelm our sweet boy 

Regarding his eating:
If I do cut back on his calories at night should I pat and shush him to go to sleep without it? How long can I go if he really starts freaking out? If he wakes up early can I use the pacifier to get him through without a feed? Should I really change Liam and is it too late? I mean is this bad the way he eats? Or is it just more an inconvenience to me? I just would like to be able to follow the EASY routine and that 10Am feed is missing and he's not eating at regular 4 hour intervals.

We're not cutting out his calories. We're just changing the time he gets them.  By slowly shortening the night feed and lengthening the day feeds he won't "freak out" at night.  Not for the need of calories anyway.  He will miss the cuddling he has with you at night and yes, he will need comfort to resettle.  Have you tried PU/PD? He's 4 months old and may be able to handle it.  My concern with Liam is that his natural sleep cycle is a bit askew.  You may think that it's not so bad now that he's 4 months old, but when he's 18 months and waking at night you will probably mind a lot.


I hope you don't feel overwhelmed, this isn't as big a problem as you may think.  Shoot for shortening his feeds at night and giving him a proper A time in the morning to help him get back on track.

We're here for you every step of the way

- Beca 

[* Paula *]

Aja,

Beca has given you some really good advice, and although the next few days are going to be really hectic, it is all going to be worth it in the end.  You will see.

Wishing you the best of luck - keep us posted and let us know how you are getting on.   

[LJCsmom]

Hi all!

Was a good day today, after a bad night.
We woke at 8 today and didn't go back to bed, ate then had some activity and Liam had a nap and low and behold Liam ate 3.5 hours later and so on all day long!
Our evenings have been a little mixed up the last couple of nights, but I think combined with the change in our daily routine, Liam may be having some trouble teething.
Besides that I have given a lot of thought to the reverse cycling. Getting up right away got things started in the right way.

I also decided today that I would just bf all day today thinking that if I am drying up a bit Liam eating will get me going but perhaps he really is getting enough.

So I agree the reverse cycling is what I'm going to work on right now as well as figuring out Liam's napping process. It was surprisingly easy today and the smiles I got from Liam looking up at me made it worth it.

The only thing I'm thinking about is now Liam's new bedtime, dreamfeed time and wake up time. I will see what he does tonight and tomorrow morn.

Will be off now, and update tomorrow.

[rebecaq]

Aja,

I'm so happy to hear that, I was thinknig about you yersterday.  Glad to hear all is well.

Please keep us updated

- Beca 

[* Paula *]

That is fantastic news - keep it up and look forward to hearing from you tomorrow   

[Samuel's mum]

That's great! Good Luck for tomorrow.

[LJCsmom]

O, what a day!
We started off on the right foot again. Last night Liam woke quite a bit and at one point I heard his stomach growl, but kind of pushed it aside since it was 3:30 am.
Bf all day again and he was sucking furiously, I was feeling like he wasn't getting enough so I put him on the other breast and he seemed satisfied after.
I also stuck to the same routine as the last couple of days.
At one nap I heard his stomach growl again. But he seemed happy and everything seemed to be going well.
Then I changed his diaper, around 3 and in his diaper was brick staining, or uric acid crystals.
I remembered reading before that this was perfectly natural for a newborn but couldn't find any info for a 4 month old. I called the health nurse and I explained everything that has been happening lately and she said the uric acid comes from concentrated urine and that Liam was not getting enough fluids.
So she said to me to stick to bf, for the next 4,5 days: eat well, drink lots of water, rest 3x day and have Liam nurse every 2 hours and if he doesn't then pump. If that doesn't work then I can ask my doc for some meds. Hopefully we don't have to resort to that. So that's where we are today. Had a meltdown after I got off the phone with the nurse thinking o my god I'm starving my baby. But I'm focused on the task at hand now.
EASY is going to get a bit mixed up but that's ok cause once I get my supply re-established(cross your fingers) I will get back on track. And like you all said, the nurse agrees he's got his feedings mixed up and I need to cut down his night feedings to increase the daytime cals. So will also work on that after my supply gets better.
Will update in a few days.