Forceful let down (?) but no dirty nappies - help!

[HollyFP]

Hi, am BF my 3 week old DD, has been going well so far but over the last few days she has reduced the length of her feeds while needing to feed more frequently (used to feed for 15 minutes or so every 2-4 hours, now feeds for 8 minutes every 1.5-2 hours), and has become really fussy at the breast and is also really gassy which affects her sleep.

I think some of this may be due to forceful let-down, as she chokes and spurts a lot during a feed, and suddenly pulls off when i know she hasn't had her fill.

Coupled with this is that she only seems to have one dirty nappy every other day, and this comes after lots of straining and upset. It's nothing like the 4 dirty nappies she used to do in the first 2 weeks...does this mean she's constipated? Or does it mean she isn't getting enough hind milk? Or something else?!

I've read some advice about positioning to counteract forceful let-down (ie in a more reclined position), but i've no idea what to do about the lack of dirty nappies.

Please help - it's distressing me not to mention my little one.
Thanks

YOu may be right about forceful letdown, HollyFP, and possible over-generous supply.

The nappies thing means nothing, really, in an otherwise healthy, thriving, growing baby, though it can be one of the signs of poor milk volume in a baby who is not healthy, thriving growing, at this age.

What is her weight and what is her weightgain rate?

Thanks - she was 8lb 7oz at birth, lost 5% at first weigh (5 days) but then was 8lb 11oz at second weigh (10 days) so pretty good weight gain :-)

She hasn't been weighed since then, am meant to be going to the Health Centre this week...
I did read that BF babies sometimes don't have a dirty nappy for up to 10 days ??!! so perhaps this isn't so bad. I just wondered if the feeding problem/pooping was all related...

Will she be getting enough milk though even on such short feeds? Should i offer the same breast the next time so she gets hind milk, or should i continue to switch sides each time?

Any other advice gratefully received!

Thanks for your help

HollyFP - it can be normal for bf babies to go several days between poos but it is unusual for this pattern to start as soon as this, so it would be good to get her weight checked out as you plan.

Please don't worry about 'engineering' her intake of foremilk and hindmilk unless you discover that you may be over-producing (this would be indicated by a massive weight gain, along with the other signs you described).

Keeping a baby on one side only is called 'block nursing'(you can search for the term in mumsnet archives) and it can be helpful in situations where the baby is struggling with forceful let down linked with over-supply.

Thanks for your advice...so hard to know what's 'normal' with a first baby!

Hi HollyFP, don't know if this is any use to you but I always only feed on one side at a time and if baby comes off would let her/him go back on that same side.I always do that cause of the hind milk. I haven't experienced problems about constipation, especially in the early days when every nappy is a poo one.It's always a bit confusing with the first baby, hope things even out for you.