Fussing and Tugging

My DD is 5 weeks this Monday and the last two days she has been fussing alot more when BF'ing. She has been primarily BF since birth with the odd FF thrown in when necessary but only probably a total of 3 FF since birth. I do also express and use the EBM to top her up at night or when needed.

The last two days she has been very unsettled in the afternoon/night period and will not go down for a sleep. This is meaning she is awake from noon onwards and she really needs some sleep.

I've noticed she is more and more tugging on my BB and pulling herself off, reattaching herself, coming back off and so forth. She seems to be ok for the first few minutes and then starts with this nonsense which drives me nuts.

I was taking motillium but yesterday & today have forgotten to take it due to being out and about and having guests etc so I don't know if my milk is still struggling or if she is not wanting the breast anymore.

Any tips on what this might be or what i can do to solve it.

I lost patience tonight and gave her a FF which is the first major one she has had since birth. She had 5 minutes of BF and stuffing around and then 100ml of FF. (;) Don't really want to hear how I shouldn't give her FF as I'm aware of this but my patience after being tugged on for 3 feeds in a 6 hour period was at a low).. She normally only feeds every 4-5 hours and has done so since week 2 but she has even been waking between 4-5am the last 3 nights whereas she normally has been sleeping through till 7am. I gave her a feed at 5am this morning (about 20-25 minutes) and she went straight back to sleep till 9am but again this is not the norm for her.

I have the number of an ABA consultant so am going to call her in the morning but thought I'd see if anyone could give me some suggestions about what the cause of the tugging and fussiness might be..

Sorry about the long rant..

They change so rapidly......as soon as you think you have them sussed, they change their routine!!
At five weeks, I'd be expecting a growth spurt which in my case lasted right thorough to over four months with 2 hourly feeding round the clock with my second.

The tugging could suggest trying to get another let down or to try and make your milk come out quicker and feeding more often would back that up. Your baby is trying to increase your supply and by being given complete access all the time, is the perfect way of doing it.

So by her pulling on my boob she is trying to get a let-down? I thought once let-down happened that it didn't stop during a feed? I know when i express that when I have let-down my BB goes very warm and then it just flows till it's empty, i assumed the same when she is feeding.

Maybe I'm not 100% relaxed do you think which is why let-down not happening? I know it does when she first attaches because I can hear her guzzling the milk rapidly.

With the heat I was thinking the increased feeding was her being thirsty. She had some short feeds today, but mainly because she was screaming so I offered her the BB and she took it, not sure if she was actually hungry or just taking advantage on the offer.

I managed to express 50ml tonight and I'll try again before I go to bed. She is asleep now so I'll see if she sleeps through or if she wakes. If she wakes during the night I'm going to assume she is having her growth spurt, which i did suspect earlier, but if she sleeps through could i assume that the 100ml FF has filled her up and maybe the other feeds haven't been?

Just such a confusing thing this whole BF situation. I'm so happy that I've been able to BF this long (even though only 4.5 weeks) as I had always prepared myself that I'd have troubles BF'ing (reason being I had a TERRIBLE pregnancy so just expected the worse case scenarios, plus I am quite a flat chested woman and just assumed I'd probably have issues). I know I won't BF forever and I was happy to make 4 weeks and i'll be even happier if i make 8 weeks but at the same time I love the closeness from BF'ing so will miss that, but not the stress and anguish from it. Some times I feel like just putting her on formula but then I feel like I need to at least do what I can to keep BF'ing. aaahhhh

As another question - would stress affect my supply dramatically??

I've never found stress to affect my supply really, more lack of water drunk that day!

I'm no expert though!! This is only my personal thought but I've had multiple let-downs during a feed on both sides, so I would think tugging would be about getting another let down happening. The formula may well feed bubs up but that would then have a knock on effect on your supply, because in the early stages it's critical to have access to the breast whenever needed. Like I said, I fed 2 hourly for months and months, whether it was offered by me or asked for by him.

Your breastmilk is perfectly designed for this stage, it's really dificult to not be concerned about length of feeding and duration with your first (I know!) but you'd do yourself a big favour if you trusted your body to produce what baby needed when it needed it. I found blind faith helped a lot! Obviously eating healthily as much as you can and drinking plenty of water.

Hi,

When baby fusses at the breast some-times it makes us think that that they don't want to feed as often or as long. But, it's usually the case that they want to feed more. Its fairly unusual for a baby to only be feeding 4-5 hourly, and sleeping all night at this age. Some-times they can seem quite placid for a few weeks after the birth as they recover and get used to their new surroundings. So, when they start "demanding" feeds it can be a bit of a shock for mum! Try offering the breast every 3 or so hours. You will find that she feeds more easily than you would have thought, and that your milk supply improves. Motilium acts to increase your prolactin levels (one of the hormones that makes milk) but it won't have any real effect unless you feed your baby more often.
The letdown reflex is triggered in response to the baby suckling. (or the pump) Most women only notice the first letdown relex, but in fact you get smaller relexes throughout the feed. You might notice that when you feed she seems to be snoozing and just "butterfly sucking" and then she will get "stuck into it" and be sucking strongly again. She has probably just stimulated another letdown. Or, if you are pumping, you will notic the flow slows down, and then when you get another letdown it will start to spurt again.
Stress won't affect your milk supply - women continue to breastfeed in some of the most stressful situations. But, remember, it is normal for babies to feed 8-12 times in 24hours. The Australian Breastfeeding Association's book "Breastfeeding Naturally" is fabulous and only $34.95 - and comes free with a subscription to the Australian Breastfeeding Association. It is a fabulous and informative guide to breastfeeding
Warm Regards
Barb

OK so here is an update on the situation - which really isn't much better..

Early this week we had our clinic visit for 2nd weigh in and Chloe had only put on 50g. The clinic nurse was a little concerned and asked about my milk supply which I knew was lacking after our previous issues where this thread originated. I had already started back on motillium the day before seeing the nurse. She advised me to start giving her 2 x 60ml FF per day for the next week to get her weight up again and that i had to come back in a week for another weigh in to see if she gains weight. She is still in 0000 and would be in 00000 if she didn't have the length she has. The 0000 are still large around her upper body.

So I've been taking the motillium as advised and also got some Aktavite as seen on this site. My milk has increased and I can now express 60-80ml (previously would get 40ml and only 20ml when my supply died) but for some reason Chloe is fussing on the BB still so I'm thinking she has figured the bottle is easier and why worry about BB anymore. As she isn't feeding properly I'm giving her BB first, then once she starts fussing or they feel empty I give her EBM, or for 2 feeds per day 60ml FF.

Any suggestions on how I can keep her interested in BB?? Obviously I need to follow the clinic nurse with the FF's to make sure she gains weight this week but don't want this to turn her off the BB if I can avoid it. I've went and bought the Tommee Tippee Breastfeeding bottles that are supposed to mimic the nipple to make moving between BB and bottle easy but I've also got some Avent bottles with a newborn (#1) teat. Any other suggestions???

Either way since the additional feeds she is much more settled and has started back sleeping through the night. For about 5 days she was waking anywhere from 3-5am and I'd have to feed her. For 1.5 days I was feeding her every few hours and boy can I admit that it was very tiring and I was completely over the whole thing and being tugged on and was just hoping for someone to say "put her on the bottle, BF is not working for you"..

I know that I'll get alot of "Pro BF'ing" responses here but to be 100% honest I'd rather do what is best for Chloe (which I know BF'ing is over FF but I don't feel it is if she is not getting enough from it) and if she is not thriving while BF'ing anymore then I'd rather change to FF and make sure she is doing well. There is nothing worse than seeing her unsettled due to hunger.

As Chloe gets a bit bigger and stronger she may well fix this herself.
In the meantime you seem to be doing the right things - giving her boob first, etc. There is a risk that "fussing" is not providing you with enough boob-stimulation to make enough milk - so expressing as often as you can until she really gets sucking is probably a good idea.
And it is preferable to "top her up" with EBM rather than formula if you have it.

BUT - she is still a little tacker, and it is totally normal for her to feed every 2-3 hours during the day and also to need a feed or 2 during the night. In fact the night feeds are part of increasing supply!
So - horrible thought I know - but middle-of-the-night expressing would also boost your milk supply, and middle-of-the-night feeding if she is awake would be a good thing. Being grumpy for several hours a day is also normal for new babies. So is cluster feeding (where they want to feed very often, like every hour for a few hours, and are unsettled) - so if she seems hungry, it may be best to give her the boob back again, rather than think "you only stopped sucking half an hour ago, how can you be hungry".

Have you had someone recently observe how you are feeding her - imperfect attachment will also lead to fussing and so on. Some clinic nurses are also skilled in lactation, or an independent lactation consultant (there's a list available here: Australian Lactation Consultants Association Ltd - ALCA), or a day-stay at a lactation clinic could all help here. And what you see as "fussing" may actually not be "I can't get milk out of this boob, Mum", but some other issue.

There is no reason to change to formula entirely whilst you still are making some breastmilk and are able to feed her OK - the only issue seems to be that you are not sure she is satisfied. And you are taking steps to deal with that. There are quite a few people on this board who combine BF, EBM, and FF successfully.

But beware of using formula too often - that can then lead to a sort of spirally effect, where your boobs make less and less milk. Once you have had her weighed again you may be able to reduce the amount in the 2 bottles.

Sorry for the brain-splat. Hope there's something useful in here

Hang in there
Kate

My DD and I had a very rocky start to our breastfeeding relationship and she was exclusively fed formula for the first 3 days of her life (given without asking me but that's a whole other story).
It was very important for me to breastfeed her, so I ditched the bottles. I would breastfeed her then top her up with EBM and/or ABM from a spoon or small cup. I needed to help stimulate her breastfeeding response, because obviously it was a lot easier to get the milk out of a bottle than my swollen breasts.

It's do-able if it's what you really want to do. My first impression of breastfeeding is that it requires a lot of determination so if you set your mind to it, it can be done.

Kate - I do think that it's potentially a supply/attachment issue. Early on and up till last weekend her attachment was perfect. My LC in hospital said she attached really well and was a great feeder, which she has been. After about the 1st week home she was attaching herself with very little assistance from me. I have no pain, no damage from her other than the initial stuff in hospital. I am topping her up with EBM on all feeds except the 2 with FF. Simply because my supply isn't huge so it's hit and miss with expressing and the amounts I'm getting. YEsterdsay I got 1 x 60ml EBM and then 1 x 80ML but today only got 30ml.
I had a follow up apt with my LC around week 3 but I've not been back since. I will need to check if I can still see my LC through my hospital or if I need to find a consultant outside the hospital. Will try and see someone on Monday.

Claire - Thanks for your post. We've been successfully BF'ing since birth up till last weekend when we hit this hurdle. Chloe was also given FF in hospital as she had low sugar levels but it didn't affect her willingness to go to the breast. BF'ing certainly is about a lot of determination but at the same time it can be such a stressful process. Up till now it's been great so just a matter of getting through this part. My biggest concern is her lack of weight gain over the 2 weeks. Will see what happens at her next weigh in on Wednesday.

I have just fed her for about 30 mins on BF, which is considerable considering she's only been doing 5-10 each side lately. She seemed somewhat full on the 2nd breast. I gave her 30ml of EBM and she is content. No crying etc so I'm guessing she was satisfied with that feed. It surprised me as my BB did not feel like they had much in them but she was making the right noises to say there was milk there.

Well today I've spoken to an ABA consultant who was very sympathetic. I've figured out and confirmed by the LC that Chloe just doesn't want to suck anymore. I'm lucky to get her to do 2-5 minutes each side now before she screams the house down. The LC advised if I cannot get Chloe back interested in BF'ing then no matter what supply I try to achieve she won't drink.

Essentially she has discovered that the bottle is easier to drink so she is not interested in having to suck for longer than about 2 minutes or she screams blo00dy murder. She pulls off goes on pulls off goes on and the pattern continues. I have milk. Those first few minutes it leaks out the sides of her mouth. I can express up to 80ml but she just doesn't want to suck it out.

I asked the ABA consultant about just feeding constantly but she said that all it will achieve is upsetting the both of us and that if Chloe was happy to suck for a normal length of a BF then problem would just be supply, but it's not as I have supply just no child that wants to suck anymore. Give her a bottle and she is milk drunk quicker than you can blink an eye and sucks it down quicker than she can swallow it.

Have got a few things to try in terms of trying to get her interested in BF'ing again but if anyone has any suggestions please throw them at me!!

Could you give her EBM? That way she will continue to get 'the good stuff' from you and also will not get use to the FF taste and consistancy.
also you need to figure out what helps you let down quickly? i know if i am worried about somehing i will have a slower let down... in your case, worring about a slow let down may make it slower so its a bit of a catch 22.

Sorry i cant be of more help
:hug: hope things improve for you both :comfort:

ditch the silicone..enrich your diet and let her suckle .. maybe even dream feeds could help.. express often and give it ti her in a cup.. there is a bottle "adri" is the maker and its a boob, looks like one and feels like one , she has to latch to drink from it . so if she has to latch to it , she might aswell attach to the boob ..

when gab fusses and tugs i find that she has pain and i have to get the wind out of her .. or she has to poop..

i hope this post doesnt sound rude , its not meant to, but i m typing one handed :)

Sammiejane - Yes she will taken EBM and I've been topping her up with that for 3/4 of her feeds.

Charmalea - My diet is as good as I could get it at present. I have always been a healthy eater and I'm taking motilium and also drinking aktavite etc etc to help with supply. If i could get her to suckle then that would be the answer, but that is the problem, she won't attach/suck and considering she did not gain weight her last weigh in I don't want to deny her food (which I would be if I perserver trying to get her to suckle and not comp her) hence I have to comp her in some fashion whether it be EBM or FF. I am using EBM wherever possible but she gets herself very worked up and I do not want her to associate me with an unpleasant experience in that she is not enjoying our BF time as she is screaming the house down due to hunger and obviously frustration. It is also not helping me as I'm getting stressed and worked up because she won't attach and hence the cycle of me being worried so therefore even if she'd attach probably wouldn't get a let down and so the cycle continues.

If worse comes to worse and I cannot get her to attach anymore then I'll just express and use EBM for feeds as long as I can and comp with formula. I've arranged to see my LC from hospital this Friday but still have 5 days between now and then to try to work out some workable solution that won't stress me or her out of our brains but will ensure she gets what she needs. Her next weigh in is Tuesday so that'll give me a better idea of how she is going weight wise.

Tonight I am going to try using the nipple shields. The RN at my hosi suggested it as she might confuse it with a teat and suck better. I can then try to ween her from the shield back to bare nipple. I'll keep expressing to keep my supply going so just need to sort out her attaching. I will try all that I can to sort it out and get back to BF'ing but I won't do it if it means she is being denied food.

Sorry if that seems odd and I don't want to offend anyone but I went into this PG and birth/parenting with a completely open mind about what I would and wouldn't do (ran into many obstacles my entire PG) and I am BF'ing simply because she took to it like a duck to water immediately after birth which I really didn't expect. I did not and do not have any preconceived notions on how long I would/will BF and I've said from the start that I'll do it as long as it gives her what she needs. If she cannot or will not attach anymore then that will no longer be the case.

I really do appreciate all the replies as the more ideas the better and possibly something has worked for someone that I haven't heard or hasn't been suggested.

It sounds to me (and I am no expert) that you may have the same "weak suck" problem that Laranna's bub on BB had - the whole story is in several threads around here which I'll try to dig up. She has done a tremendous job with exercises for bub and a supply line, and has managed to continue BF/FF combination for 4 or 5 months - hopefully she can chip in here!

Firstly, a big hug snowchickie :hug:

This first time mum stuff isn't easy is it??

You are doing such a wonderful job perservering with BFing, you know how great it is for your DD, even if it is really testing your patience.

I'm by no means an expert, but I've found with my DD fussing at the breast is when she is hungry and not getting enough milk from me. I went on a diet a couple of weeks ago (I know, not ideal when BFing I found out) my supply dropped dramatically and poor DD was really hungry, she fussed and tugged at the breast - trying to encourage more milk. I got my supply up by expressing after each feed, even if I didn't get much EBM the nipple stimulation increased my supply within a couple of days.

My DD is 3 months old and I feed her every three hours during the day, then at night 11pm, 3am then 7am. She wakes for the 3am and 7am feed, but at 11pm I do a 'dream feed' which may work for you to re-introduce BF to your DD. I get her out of bed when she is asleep, don't wake her, keeps the lights dim, then I offer my breast to her, it may take a minute but she will take it and have a feed in her sleep, then straight back to bed. Perhaps having your DD in such a relaxed state will help her take to the BF? You could also try it at about 3am to increase your supply - I know night feeds aren't fun but it should only take 15 minutes or so.... Short term pain for long term gain is what I tell myself every night!

Keep us updated on your progress!

I have had a small win tonight. A RN from my hosi suggested I try using nipple shields to make her think it's the teat of a bottle. Needless to say I gave it a try and voila, she fed for 30 minutes and happily with no screaming or tugging. I could see she was getting milk as it was leaking out the side of her mouth so that was a small win. I did try at the end removing the shield to give her bare nipply again and she starting fussing once again. I'm wondering if her mouth is sore or something as to why the teat or shield would be nicer for her than my bare nipple. If the shield is meant to protect us from pain maybe it was doing the same for her???? Any thoughts anyone???

Kmn - My LC in hosi told me she had a fantastic suck and previously, up till about 5 weeks, I've had no problems with her suck or attachment so not sure if it would be a weak suck. The first week of BF'ing she actually grazed me and the LC told me due to her strong suck. When she does suck she gets so much milk that it leaks out the sides of her mouth. But hey it's something to consider and I'll ask my LC to check it again when I see her.

Kristin27 - No this stuff certainly isn't easy but made all the more annoying as we've had no major BF issues until last week. Initially i believe the fussing started because my supply dropped off but I know that it is much better so I'm thinking, and by all means could be completely and utterly wrong, that it's not so much of a supply issue at the moment but an attachment issue. At the moment Chloe is feeding every 4-5 hours during the day but does sleep from around 11pm till about 5am. At 5am I either given her a feed if she won't settle or she sleeps with me after her daddy has left for work. She then normally wakes at 7am (on the dot i might add) and she has a feed. Her morning feed is her best and I try to lay and feed her in bed. I have not had to comp her first morning feed as she seems content afterwards and normally falls back to sleep. Then wakes around 10am-11am for her next feed.
I did a dream feed with her last week but gave her 60ml of FF as my supply was still off a little. She drunk the 60ml without a problem. I didn't get her out of bed at all but at the end she let out a huge f@rt and knew I needed to change her so she woke up and then wanted more food which I gave her. When I first left hosi I was told to wake her at night but trying to wake her is near impossible and when I did manage to get her awake she would then not want to feed but also not want to go back to sleep. At my first clinic check they told me what I was doing was fine and to just demand feed and let her sleep if she wanted.
I'll try waking her tonight but if that fails then I'll express at the very least. I know this will only increase my supply but I'm also just worried about getting her attaching properly and consistently. I'm curious why the shields work but when i removed them and gave her bare nipple she begun fussing again.

Hmm not sure about the nipple shields, I would have thought the nipple shields would be more uncomfortable that just a nipple for the baby, nipples are nice and soft, better than plastic? Maybe thats just what Chloe likes at the moment. But if it works go with it.

Yeah it takes me a while to wake DD for a dream feed, but I do know some babies won't wake for it. I guess you can only try if she doesn't want it put her back to bed. And you're right if shes getting enough during the day you don't have to wake her for a feed. I do D/feeds to get DD to sleep longer through the night, but your DD is already sleeping very well!

How did you go last night?

Morning Kristin,

Well Chloe woke at 4am so i popped her in bed with me and offered her a feed. She took it and didn't complain. She fed for about 20-30 minutes and fell back to sleep so i popped her back in her cradle. She then woke at 7.45am and i fed her again. 4am feed was normal BF without shields and this morning was a mixture as she fussed a little. She fed for 40 mins and was falling asleep. So far no comps needed.

The shields I have are a rubber silicone, so nice and soft and flexible. They are actually softer and more flexible than the teats and very thin. Very comfy to use i must say.

I will see how her next feed goes. I'm just curious as to why she likes the shields. I'm hoping she does not have a sore mouth or something.