screaming while nursing - nursing strike? Reflux?

[deckchariot]

My dd is almost 10 weeks old and has been an ok nurser....she was gaining weight slowly, and was having a lot of trouble with gas and spitting up.  My pediatrician suggested I switch from single side feeding (previously recommended not just by BW but because I also have overactive letdown) to 15 min on each side.  I've been doing that for a week now, and yesterday, she started to scream while nursing - she starts just fine, and seems to manage the overactive letdown (she actually tries to "catch" the milk when it sprays on her face - very cute!), but after 5 minutes, she pulls off and begins to scream.  The today, she'd just pull off after 5 minutes and seem content (though I know she's not that efficient of a nurser).  I ended up pumping and feeding her a bottle, but I don't want to get into the habit of doing that every time.  DH does do a bottle for the df of ebm, but that's usually the only bottle she gets.  I'm wondering if the screaming is possibly reflux (she also gets hiccups A LOT, and will occasionally spit up hours after eating), but then today she doesn't seem interested in nursing at all, so then I thought maybe it was a nursing strike - any suggestions???

[Erin (redstarfalling)]

Did you check out the reflux 101 on the reflux board? https://babywhispererforums.com/index.php?topic=654.0

It could be reflux - any other symptoms of it?  She'd have the same symptoms with a bottle as by nursing....does she?  Have you tried keeping her upright for a while after eating to see if it helps at all? How long are you doing between feeds?

[RachelC]

Here are some tips to deal with over active let down:

https://babywhispererforums.com/index.php?topic=63604.0

Babies do become more efficient as they get older, so she may have improved her nursing skills.

She may also be used to the overactive let down, so when it slows down, she may get frustrated.  I would suggest keeping her on one side to avoid a foremilk imbalance.  You can use breast compressions to help keep the milk flowing:

https://babywhispererforums.com/index.php?topic=88759.0

As Erin asked, what is your daily routine?  How long between feeds?  Naps?  A time?

[deckchariot]

We're on a 3 hour EASY...we were doing cluster feeds at 7 and 9, but have been working to phase those out, then a df at 11 or so.  Her total A time (including time for feeding) is about an hour (1 hr 15 max usually).  She is a HORRIBLE napper, and most of the S time during the day is spent with me by her crib doing shh/pat.  She does sleep well at night, usually from the df until 6 or 7 in the morning (sometimes that's all that gets me through the day!)


We did talk to our pediatrician about reflux, which is why he wanted me to switch to 15 min each side, he thinks by keeping her on one side for 30 min that she's spending a lot of energy sucking for very little pay off after the first 10 -15 min, and that could be causing her to take in more air and thus spit up more.  We've elevated her mattress and do keep her upright for 20ish min after feeding.  I checked out the reflux board, that's why I thought it might be reflux.

She will take a bottle, although today she has been significantly less eager to do so.  And about half the time, if I just give her an ounce or so in a bottle, she will go back to the breast and finish the feed.

I'll check out the breast compression idea - I'm wondering if that's what's going on, that she grows impatient after the initial burst of milk.  Thanks for the link.

[RachelC]

You may want to scale back her A time a bit... maybe 45 minutes.  1 hour seems to be a lot for this age.  She may overtired which would cause short naps.

[Erin (redstarfalling)]

Great idea - I know my first couldn't manage more than 45 min at that age...

[deckchariot]

I'll give that a try - we had been doing 45 min awake times up til about 7 weeks, then she seemed more alert, so we started extending, but maybe she really isn't ready.  And I know when she doesn't nap well, she doesn't feed well (it seems to then be the only time she wants to sleep) so then she doesn't sleep well.....and then the cycle of crying begins and so goes my day 

[hulababysmommy]

My LO was doing the same thing as yours; she would just start screaming after bf-ing for a little while. So confusing and frustrating! I don't know anything about reflux, so I can't help you there. But I do think that with my LO it had to do with her being (over)tired. She was able to stay awake for only 45 minutes- 1 hour and then she would nap for 45 minutes. This would cause her to be tired at eating time a lot and all she wanted to do was sleep. She would just take as much milk as she needed for her to be going to sleep it seemed.
Now, at 3 months and 3 weeks old, we luckily got passed the screaming issue. She is able to stay awake longer and naps better. Hope things will get better for you soon as well!

Ankie

[deckchariot]

so if I can hang in there another month it might get better??? I guess at least that's a light at the end of the tunnel

[hulababysmommy]

If your LO is like ours, it should get better! But guess what? There will probably be something else "crazy" going on.....

Ankie

[Bryony]

Hi - just saw this thread and wanted to add some encouragement!  My LO did this too - starting around the same time. We think Katie does have reflux (the "silent" type, with no spitting up) - but only mild - and that it was a combination of reflux plus overactive let down that got to her. It did sort itself out in time and I am sure it will for you too.

A few things that I think helped for us:

- trying different nursing positions - we found that side lying worked best so for a while I did all her feeds like this (although not very practical if you go out a lot)  and that a "horserider" position with Katie straddling my knee in an upright position worked well if she was particularly uncomfortable (although it made my back ache as I am not very tall - I need a boob lift for this one!)

- we did start using Gaviscon for the relfux, plus elevating cot etc as you have done

- also I found that waiting until Katie started fussing and showing sides of hunger (rather than feeding by the clock) helped as she would be more hungry.

- I also has a phase of letting her come off when the fastflowing milk started to bother her, catching it in a muslin and then putting her back on once it had stopped doing an impression of a power shower.

Don't know if any of those will help for you - our LOs are all different - but you never know..!

Bryony

[deckchariot]

Thanks for the encouragement....I have been experimenting with some different nursing positions, and thought your description of the "horserider" position was great!  I actually tried that yesterday, so I felt a bit more confident in my "mom" skills to see that someone else tried it too    I also am short, so it was a bit of a challenge, but it did seem to work for dd, so that was great!  This morning I pumped a bit before nursing, and that seemed to help her as well, morning is the worst for my overactive letdown, that gets better as the day goes on, but the screaming/pulling off seems to get worse, so we'll see how today goes - every day is different!

[*Carrie*]

Hi, just thought I'd add my tuppence!
Has anyone else noticed these problems seem to rear their heads around about this age?? I had similar problems with my lo at 9/10 weeks and when I looked in the archives for previous advice I found that almost without fail the babies who were showing these behaviours were in that 9/10 week window. With advice from this forum I rode it out and am still exclusively breastfeeding 10 weeks later. (We decided it was a mixture of the lo being more interested in the world around him and getting frustrated at my slow letdown on one side in particular - for a while I fed him in the dark and whilst standing jiggling him and singing! He still bobbed on and off but at least this time he was smiling at me not screaming. I still have to cajole him when he is feeding on that side but we don't have to do it in the dark anymore! )


Definitely hang in there and soon everything will be much more managable - at least that's what I found. Hope this helps,
Carrie