Fussiness in 2 week old, and a couple other questions. Please help!

eabaldwin Posted: 03-09-2010 9:43 AM

Hi, ladies.  I could use some help.    This BFing stuff is harder than it looks and harder than I ever thought it would be.  My DD is 2 weeks and 3 days old, and we have had some issues since the beginning.  A little background info...  Initially in the hospital, she didn't latch, and then she would latch but wouldn't suck.  We finally got going with a shield, which I didn't mind, because it was working and she seemed to be eating.  She had lost a pound by the time we left the hospital 4 days after her birth.  Weight gain has been an issue for her, so we worked with the IBCLC at our hospital.  I pumped and my DH (or my mom while she was here) supplemented DD, giving her the BM with a syringe.  I'm really hoping that she'll show some improvement tomorrow at her ped appointment.  Last week at the BF support group meeting (they are every Thursday), the LC said that we should be working on using the shield less, but it didn't seem that would ever happen.  Sunday was horrendous...  She didn't seem to want to eat from me and I was an emotional and hormonal mess.    My DH was fabulous and helped me all day long.  Then, yesterday was great!  She seems to have given up the shield on her own.    I offer her both breasts without and with the shield.  The right side, she takes without the shield with no problem.  The left side is different, since she seems to prefer the right.  She has about 5 wet diapers and between 2-4 poopy diapers each day, which is normal according to the LLLI website (this is normal, right?).  Her poops are yellowy, BF poops, no green or anything.

Now, the biggest problem is that she is really fussy when I go to feed her.  Last night and again this morning, she wouldn't take either side and just fussed and cried.  Finally, DH fed her some BM with the syringe.  Then, she spit up most of it.  I didn't eat anything out of the ordinary.  What would cause her to be so fussy?  Especially since she was so fussy this morning (6am feed), but then ate fine at 9am.  I don't get it.  Sometimes, I can get her to latch (without the shield, since that seems to make her fussier at this point), but then she just takes a couple of sips and then unlatches.  This can go on for about 5 minutes before she gets super fussy.

She also seems to be showing preference for the right breast now.  What do I do about that?  I have been offering her the left one first, to try to get her on that side.  Should I offer her the right first and then the left if she wants it?

We haven't introduced a bottle or a pacifier yet, because of all of her issues.  When would be a good time to introduce them?  I don't want to make things worse for her, but I don't want to wait too long and then she won't take them.  I'm more concerned about her taking a bottle, but it's not a necessity since I'm not returning to work.

Thank you for making it this far.  This turned out to be longer than I'd planned.  TIA if you have any advice or thoughts to help me.  I really want to BF, but there are times when it just doesn't seem possible.  I'd still pump and give her BM, but I'd much rather BF her.  I appreciate your help!

atavares replied on 03-09-2010 10:14 AM

I'm sure that there are others who can offer more advice than I can as I am 3 days behind you, but when our DD began to get fussy and therefore had trouble eating starting over the weekend, we found that if we fed her more often, she didn't get finnicky.  It seems like she doesn't necessarily wake herself up to eat and so we have to be especially vigilant (especially in the evening when all she wants to do is sleep and at night) to be sure she feeds every two hours.

mrss replied on 03-09-2010 11:51 AM

I wouldn't worry about introducing a bottle yet.  Is it possible she's fussy because she's really hungry and impatient that she has to wait for a letdown?  If you think that's the problem, I would suggest feeding her more often--as soon as you pick up on her nursing cues (rooting, opening her mouth, etc.).  Sometimes a baby will also fuss if you have a strong letdown and she gets flooded when she first latches on.  Is milk still spurting out when she unlatches?

code3chica replied on 03-09-2010 9:54 PM

First off, CONGRATULATIONS on the birth of your daughter!

Second, CONGRATULATIONS on choosing to give her the best possible - Mama Milk!

I, too, have been going to a BF support program since DS was about 3 weeks (adjusted age of 3 days). There are a couple of things that you have mentioned that concern me:

1. Why does the LC think you should start weaning off the nipple shield? The LC that runs one of my groups (I go to two) would tell you that that should be low on the list of goals at this stage (we had this discussion with a mom this morning). The main reason that MOST LCs want you to get off the shield is because you get better stimulation, and therefore better milk production when you are trying to establish and regulate your supply. I would make sure this is her intention and not "just because." I know moms that successfully used one for 4+ months and their child magically weaned themselves one day.

2. How do your breasts feel before the 6AM feeding vs before the 9AM? Your hormones are regulated to produce more in the wee hours (3-5 AM) than later in the day, therefore you are more likely to be more full, or even engorged at this time. I agree with a PP that this could be a letdown problem. My guess is you have a forceful letdown or your letdown is not fast enough. The cure for both of these is to massage and hand express a little prior to nursing.

3. The fussiness and spitting up sounds to me like reflux. (DS has this BAD). Babies who have reflux will either have an aversion to nursing because they associate it with pain, or they will want to nurse more often because they confuse hunger and pain, and nursing is soothing. However, this causes a cyclical problem. Also, if it IS reflux, a lot of times eliminating dairy will fix the problem, or at least help. You have to do it for 2 weeks to clear the protein from your system. I did it for a month and was able to add back everything except liquid cow's milk. I drink almond milk instead.

4. Be very careful with pumping at this stage because your supply hasn't regulated and you can easily become an  over-producer, which would add to the above problems.

5. The bottle issue. Some kids never take a bottle, and that's ok. You can syringe feed, cup feed, spoon feed.....any of those. I would not even think about a bottle for at least another 2-4 weeks, and then ONLY use a slow flow nipple because it will keep her from over-eating AND keep her preference for you.

6. Do lots of skin-skin time. This allows her to have enjoyable time with you that is not associated with the (apparent) pain she may be experiencing with nursing.

7 Lots of babies have a preference for one breast over the other...sometimes because of flow, sometimes because of the teeny little difference in breasts that makes one easier to latch than the other. Try a different hold on the one she doesn't like as much and see if it makes a difference. 

8. There is a growth spurt at 2 weeks.

Ihave some other things I'm sure I could add, but I'm drawing a blank right now. I have dealt with reflux, over-production, excessive weight loss in an infant, prolonged jaundice, even worse reflux with poor weight gain, food sensitivities....and the list goes on! Feel free to PM me or email me (code3chica@yahoo.com) for anything. I have been in your shoes. It is frustrating, and scary, and you just want to fix the problem. It's SO hard to feel so helpless. I used to feel so sad that I hated to feed DS because I knew he would spit most of it back up afterward. We have a wonderful BF relationship, and we're going strong. I highly recommend you check out kellymom.com...you can find ANYTHING and EVERYTHING there regarding BFing!

Just remember, it may be a "natural" thing to BF, but it doesn't come naturally to us like it does to some other cultures because BFing is private in this country. You are doing a great job, you have great help, and it will be ok....it gets infinitely easier after 6 weeks. Remember - the baby is learning, too!

to you!