What's this all about then?

[gaelicsheep]

First of all, apologies if this is a duplication but my original post a few minutes ago seemed to disappear into cyberspace.

I'm a mum of two and currently breastfeeding my 3 month old DD, but I feel like a complete novice. I've just ditched the nipple shields that have kept us going for 12 weeks and DD is exhibiting what to me seems like very strange behaviour.

Quite often she is tugging at the breast which is a pain but otherwise OK and I presume related to slow milk flow at times. But she is also kind of stretching the breast by pushing it towards me with her hand and simultaneously pulling away at the nipple. I'm sure that's not a good idea for the long term well being of my nipples! She also sometimes does a kind of front crawl movement with her free arm and generally seems tense and hyper.

Other than a bit of tugging occasionally, she doesn't do any of this when we use nipple shields. Does anyone have any ideas what could be causing her to do this?

BTW, this may sound like it could be the faster milk flow without the shields, but I'm sure it isn't as it happens with a soft breast rather than a full one.

Oh God, the stretch and pull!

DS used to do this, and yes it's really painful. I've no idea why she doesn't do it when you use the shields.

I think it's just an instinct thing, maybe to try and squeeze the milk out faster?

Sorry that isn't any help at all, but you are not alone!

It could just be a coincidence - start of a growth spurt? Early teething (my ds did similar at this age and cut his first tooth at 12 weeks - ouch)?

Or possibly just her getting used to the change in texture/sensation now that you're not using the shield? I only used one briefly as they didn't work well with my defective flat nipples, but I gather that even with normal nips the shield is longer than the nipple so milk kind of pools at the end (sorry if this is rubbish), so maybe the flow feels different to her?

I'm pretty sure she's just been through a growth spurt, but it's hard to tell as she would always nurse all day if she could! I do think I can feel the point of a tooth in her bottom gum and she's been drooling loads and chewing her fingers, so you might be onto something with the early teething. Yikes!

gaelicsheep asaargh DS is doing the stretch-and-pull as I type! I've mentally labelled it 'torture pressups.'

He's 9 weeks now and only started a couple pf weeks ago - I have no idea why he does it but, like you, it's only on a soft breast. I imagine when I'm a bit more engorged he's concentrating on swallowing, whereas when it slows a bit he's got time to lark about. Might be trying to speed things up? I dunno - but I don't approve!

gaelicsheep - I would give NCT or LL League a call and just talk through it with a BFC.

I used nipple shields with DS until he was about 3 weeks old, and when I stopped using them and was able to get him to latch on directly to my breast his feeding patterns really changed. He just wanted to feed and feed and feed, and the BFC I was seeing at the time said that the nipple shields had limited the increase in my supply and so DS was making up for it now that he could!

Sounds like the teeth might be a part of it too though, and I sympathise because DS had four little razors by the time he was 14/15 weeks. It is painful for a few days and then settles down until the next lot come through, so hang in there.

blackcurrants so pleased you are still going with the BF! I was on a lot of your posts when your DS was just a few days old :)

all of mine did this. no idea why... and it's intensely annoying. ds3 was the worst for it, but did stop after a few months!

A nipple-tugging baby may be trying to stimulate the let-down reflex. During a feed you will probably have several let-downs, this is the baby's way to keep them coming until she has had enough! (Guess this would explain why it is only happening with a soft breast?)

I think it is quite common at that sort of age, when your supply is still building to meet their growing needs.

My DD used to do it, I also found it pretty disconcerting but it never caused any nipple damage. (Just wait til they really bite you - it's pretty easy to tell the difference - ouch!!)

Ali I remember - and thank you! Gods, that first week was hard - once we got his tongue tie cut things improved immeasurably. We're positively unstoppable now! (I'll soon be one of those 'smug BFers' I keep hearing about but never meeting. ;) )
Certainly, I feel more haggard than smug most days, but DS is becoming a chubmonster and feeding him is getting easier and easier.

There are always new and interesting developments, though - and the stretch-and-pull is our latest. Oh, that and him being too long for the pillow now, and often uninterested in staying put but determined not to let go! Argh! :)

Ooh I sympathise :(

Does sound like a slower letdown frustration. She will be used to the way nipple shields work (with the milk pooling at the front). I would guess she'll be better in a few days but if not don't let it carry on as you could quickly get really sore :(

Is there a local BF support service? I know we were discussing around this stuff elsewhere ( :) ) but not sure whether you had that service nearby?

I'm in the middle of nowhere organic. There is a support group but as it's not affiliated to any of the organisations I'm not sure if it's just staffed by well meaning bods who mightn't give great advice. I got off to a bad start with them as I was told a peer supporter would contact me on my return home from hospital - standard apparently - but no one ever did.

Theboobmeister - yes I know all too well what biting feel like unfortunately.

Alibaba - her feeding pattern has definitely changed, but it seems to be shorter feeds spaced further apart so that suits me. However I still don't think her latch is quite right. Although it often looks fine I'm getting quite sore again after only 36 hours - the nipples are going noticeably pink at the ends and v sensitive. So I guess I might need some advice, but I think I could do with someone actually looking rather than just talking over the phone. I'll consider making a phone call though as a first step at least. It should be easier now - in the early days I doubt I could have even held an intelligent conversation on the subject.

Just adding my sympathies - my 6 month old DS4 does this and I intensely dislike it. The only time he doesn't do it is during night feeds (of which there are still many!) when he is generally more relaxed. He is, however, the world's most tense baby... He does do it whether the breast is full or not and tries to do a similar thing even when he gets a bottle kind of pushing against it while pulling back with his head.

Getting your DD's latch checked by a 'real' person with BFing knowledge sounds like a very good idea too.
Are you per chance in Scotland ?

Thanks Pacific. I should add, actually, that DD did this at the first feed this morning when I wouldn't have thought the flow would be that slow. DD is also a tense baby and v highly strung. Even though she doesn't do this to the same degree with nipple shields she is frequently rigid with an arched back and legs stretched. And yes, I'm in Scotland.

I am pretty certain that her latch is pants even though it often looks OK. The one good thing is that now she's bigger, and used to negotiating massive nipple shields, she is at least finally opening her mouth properly to take in the breast - she never ever did that in the early days which contributed to all our problems. But once she's opened her mouth and taken the breast she then immediately pulls back and relatches much more shallowly. It's very frustrating and although feeding is not that painful any more, it's usually pretty uncomfortable without a shield.

My thinking behind ditching the shields at this time is that if I'm more uncomfortable I'll be less inclined to let her go on sucking for ages and ages, plus the discomfort may just help me stay awake at night feeds. I've lost count of the number of times I've fallen asleep and woken two or three hours later to either find her still sucking, or in a very scary position in the bed at risk of being smothered . Obviously though, discomfort does probably mean there's something not quite right.

i am a peer supporter and one reason your little one is pulling you is to slow down your milk flow as your lo had got used to the slow dribble like flow through the sheilds what you want to listen to is the swallowing pattern most babies do a suck suck swallow pattern but if yours is doing a suck swallow then it could be that your little one is getting swamped also make sure that your lo is latched on properly as latching on with a sheild is slighlty different than bare breast as we were taught go with the angle of the dangle!!

I would double check your latch and try to be as careful as you can with it. DS used to tug and also sorta THUMP me (with his wee tiny hand), I think to stimulate flow, but it makes sense that others say it could be to slow it down.

I think getting rid of the shields will be a bit of a transition for both of you, so I would give it a good few feeds of careful latching without the shields before you assess the situation again?

As for the night feeds thing-can you try feeding lying down (it sounds like you sit up, sorry if this is wrong)?? My latch was always much better lying down. I have a good link on feeding lying down if you want it....

The link would be good please. I have tried several times to feed lying down and I just cannot make it work. I get all sorts of muscle tension and usually end up with leg cramp, and DD continually falls off.

I was giving bottles at night until 2 weeks ago was because I was so terrified of falling deeply asleep while feeding. That has since occurred on several occasions and I feel I've been very lucky that nothing terrible has happened. I am just so dog tired. DD doesn't sleep in the day for more than 15 mins at a time, a maximum of 3 times a day, and she's waking twice in the night between midnight and six. I reckon I'm getting 4 hours decent sleep a night at most, and I just cannot stay awake during a feed!

gaelic I always fall asleep when doing night feeds - deliberately really. I've got his side of the bed set up so he can't fall out, then I'm between him and DH. I do find it tricky to feed him and be covered by the duvet but I've taken to wearing a warmer top so I don't need to be covered, and DS wears a sleeping bag and mostly doesn't go under the duvet.

Basically what I mean is I've laid out the bed so it's safe enough for me to go to sleep and not worry about him (I'm assuming you're co-sleeping from what you describe?). On the odd time that I've thrown the duvet over him in my sleep he's just complained until I woke up and moved it (and no matter how asleep I was, he woke me - we're just programmed to it).

It took ages to get the lying down latch sorted out and I had loads and loads of problems with my right nip (still do as it's "faulty"!) and that's the side he needs to feed on with the way we lie so all I can suggest is reasearch,research,research - Google until you drop looking for pictures and videos of how it's done, then practise and practise. It took me quite a few weeks but it was really, really worth it (my DS is the same age as your DD BTW). I now get a decent night's sleep no matter how often he wakes. I know it's not helpful in one sense but I'm just trying to encourage you to keep trying by saying that for me at least, practise made perfect and it was worth the effort.

I think you may find this useful:

analyticalarmadillo.blogspot.com/2010/09/effective-breastfeeding-its-not-all.html

I'm wondering where you can get help. Who was supposed to come and see you at home? Can you chase that up? How about the hospital - do they have breastfeeding nurses? If not the midwives will certainly be able to help. It would probably mean a trip there but if that's possible you get the benefit of someone seeing you in person, and they may also be able to help you with the laying down position, too.

Oh and I also meant to say, has anyone mentioned silent reflux to you??? The arched back/tenseness can all be symptoms of this.

Thanks for that organic. We're not deliberately co-sleeping, although I have ended up having to on occasion to get her to sleep. We have a bedside cot, but I recently shifted it away from the bed and put the side up as I found it really awkward manouevering her back into the cot and always woke her up. So currently the bed isn't that safe and she could fall out if I dropped her when asleep, god forbid. I sit up in bed to feed and like you I wear a warm top or slip on a cardie. DD has a sleeping bag as well, and I keep her above the duvet, but once when I was feeding DH moved and managed to flip the duvet over her head so I'm scared that could happen again.

I will try to contact the peer support group I think and try to get someone out to see me, if they can be bothered to make the journey from town... I think they were just supposed to make phone contact initially but no one ever did - I did get a call to check if I'd registered DD with a dentist though!

Thanks for the link.

I've mentioned silent reflux to the HV, but she dismissed it because DD has been gaining weight really well. I still think she might indeed have reflux as she is very hard to settle lying down, is much happier when held upright, is quite sicky and hiccupy and generally a pretty difficult (though lovely) baby.

Oh no! Reflux doesn't affect growth (unless it's REALLY severe). My first boy was PV 5-6x/day yet grew like a weed. Fortunately it didn't bother him (just meant a lot of washing for me!) but DS2 has it much worse. He's not so sicky but struggles far more with the pain and hiccups, etc. In fact your description above sounds like him. This may be her feeding problem as feeding may cause her pain :(

There is loads of info on it online. For me, dropping dairy has made a HUGE difference. We tried Infant Gaviscon and it made him terribly constipated, to which the doc said the only option was laxatives, which I was most unhappy with so I took him off the Gaviscon and just stuck with the dairy.

But, you know, IG is a really gentle medication and your DD already takes a bottle (mine won't which is a hassle) so it's worth trying to see if it helps her. Try your GP for that one. I'm never into medicating babies (or anyone else) and for mine if it was just him being sick I wouldn't have considered it, but he was in so much pain that I went for it. I'm lucky I've found a non-medicative solution.

See that all makes sense. I even read on Kellymom last night that reflux babies can feed more and be really sucky because breastmilk is a natural antacid. From the word go DD has been an incredibly sucky baby. She just exhausts me in every sense, so if there was an explanation and possible treatment I would rejoice.

I think I'll definitely make an appt with the GP and go armed with some facts, as I'm not sure how much they know about infant feeding.

Morning, gaelic, after a spectacularly bad night here I am not sure I should be giving anybody advice , but here goes anyway:

Re latch - videos showing good and 'bad' latch with effective swallowing and erm, not.

Lower lip flip was my life nipple saver more than once .

Latest research on safe co-sleeping. I have co-slept with all my children, not because of any kind of Attachment Parenting type conviction, but because it was the only way I could survive; the same way I turned into a sling-using, BFin on demand, BLW mum - it works and keeps everybody happy - or at least happier...

FWIW, arched back and lots of sucking could indicate a problem with reflux, but wasn't in my DS's case. Infant Gaviscon is a pain to give to a baby that does not take a bottle so we gave up as it did not make a difference to him.

Also, Cow's Milk Protein Allergy is a possibility (not to be confused with Lactose Intolerance) but incredibly rare in a fully and exclusively BF baby. Again I went dairy free for a while with absolutely NO effect on DS so I am back to drinking milk and he is no different.

GPs do not know a lot about infant feeding/BFing (I can say that, I am one, nothing in my medical training prepared me for having/looking after littlies); a dedicated BFing adviser would be better.

How remote do you live? If you delivered in hospital there should be a BFing adviser there who should be able to actually see you and observe a feed. And the peer supporters IME are great - do give them another ring.

Right, I hope all this makes some sort of sense.
Good luck !

Thanks Pacific. I watched those attachment videos last night as it happens (I couldn't watch them when I needed to a few weeks back due to rubbish internet connection). I picked up some useful tips and with more practice today I now think that DD and I are doing pretty well. My nipples are getting less sore on the whole and I'm pretty sure her latch has improved immensely. She's certainly drinking effectively which is just great.

Thanks for the co-sleeping link. I'm trying to follow most of that, but I think the single best thing I can do is to learn to feed lying down so I'll be researching and practising as OrganicCC suggested.

Crucially, I can't tell you how much easier things are now that DD is actually opening her mouth! At last!!

Oh, and she's been much less fussy today. Perhaps it was the change from nipple shield to bare breast more than anything. She does still have spells of sudden crying though, as if she's in pain - but no wind - so I do still suspect reflux. It's probably fairly mild though, but I'll keep an eye on it.