My baby won't feed when he's awake

[JoneseyA]

Hi
My 5mo son only feeds at night or if I put him on my breast whilst he is asleep during the day. However, as he is sleepy he doesn't take enough and isn't gaining enough weight. This has been a slow deterioration since around 12 weeks. I have tried feeding in the dark, rocking, offering the breast more frequently and less often but nothing seems to work. He turns his head away and starts to cry if I persist and I am concerned he will develop a bad assocatioin. I have tried to bottle feed him and sippy cup feed him expressed milk and also formula but he hasn't taken to these. I have rather half heartedly tried doing more skin to skin but he wants to play and kick his legs rather than snuggle up against me! He does suck his thumb a lot and often removes my nipple and replaces it with his thumb so I did wonder if this was related. I rarely use a dummy so this isn't an issue.

He is otherwise developing well in all other ways and is generally very content if he doesn't go near my breasts! I was hoping to breastfeed for a year or more but it is proving rather tricky. My GP says my son looks fine and there is nothing wrong with him but that the weight gain is a bit of an issue. I have spoken to various breastfeeding councillors but they are all rather baffled. I have started him on solids with GP's approval and I add my milk to whatever I feed him, however this tends to be in pretty small quantities.

Any suggestions greatly appreciated!

Hmm that is a bit strange, was it a tricky/ difficult birth? I only ask because I'm wondering if he has got some discomfort in his neck or shoulders, some crainiopathy may help if that is the case.

Is he in much of a routine, I found my dd fed better when I had approx times to fed her (these were not set in stone!)

Is he starting to get teeth? Maybe sore gums are putting him off.

I would offer him a feed when he wakes up from naps and if he cries in between, I wouldn't try and feed an asleep or very sleepy baby.

Is there a bfing support group you can go to?

And finally I accepted with my own dd that she wasn't and still isn't a big fan of milk, she started on solids at around 5mos and never looked back as she was far happier chomping on food rather than drinking milk, she has never to this day (to my knowledge) drunk more than 4 or 5oz!!!

Are there any signs of reflux-even if the silent type? Might be worth checking the list of symptoms on the reflux threads in feeding just to check. My sons both gave up breast feeding at about 4-5 month as they found it too painful to do it. Eventually I got them both onto bottles, with my husband's help-i.e. I left the room with him, the baby and the bottle until it was drunk- and they got on better, but feeding liquids was never easy for them. Luckily, they both eat well.

Have you also checked for oral thrush or tongue tie? Both mine were checked for them too. Several medical types missed the silent reflux in ds1 for 4 months and I was distraught at not being able to get fluids into my baby. By the time ds2 came along, we were experts, sadly, and his reflux was very visible! Good luck.

Hi
Thanks for your speedy replies.
It was a difficult birth, long and ending in forceps. I have seen a cranial osteopath but it didn't help! In terms of a routine, I put him down for a nap every 2 hours as he generally shows tired signs then. He tends to only sleep for 30 mins. I might try feeding him at the same time each day to see if that helps. He wakes at a different time each morning so his naps are at a different time each day...
I do feed him when he wakes from naps but he only stays on for 30 seconds if he is properly awake hence I try to feed him when he is still asleep.
I don't think it's teething as the problem has been going on for so long. I have spoken to a number of breastfeeding support people but none of them have found a solution!
I don't think it is reflux as he doesn't show signs of discomfort when he's lying down, would that rule it out? There are no symptoms for thrush and he used to feed brilliantly when he was younger so not a tongue tie issue either.
He had quite bad colic for the first 4 months, I think this could have been wind related.

I would go back to hv or gp for advice tbh sounds a bit strange.

Trying to remember roughly routine I had for dd at about that age and I think it went about (!)

7ish wake up and bf
8am breakfast
9am nap
9.45 wake up and bf
12 lunch
12.30-2.30 nap
2.30 wake up and bf
4pm nap
4.30 wake up and bf
5pm tea
6pm bath
6.45pm bf
7pm bed!!!

This wasn't set in stone but worked as a guideline, my dd was a sensitive baby and we def needed some structure to our day for her and my sake!!! Like I said she still wasn't a big milk drinker but def fed better in this routine than just guessing or putting on the boob everytime she cried.

Good luck

I have a similar issue at the moment with my 4 month old. He is very difficult to feed during the day, constantly distracted by the slightest noise, and fusses and pulls off all the time. He doesn't do it when sleepy or at night.

I read on kellymom that 4-5 months is a really difficult age for distractibility and apparently they do grow out of it (here's hoping!). I went to my local bf support group and they suggested lots more skin to skin, baths together etc. just as you have tried. I have tried more skin to skin and like yours, my baby just wriggles and kicks around a lot! However, I have persisted for a few days and he does seem a bit better already.

Also positioning is key - I had one of the counsellors check his latch, and he was coming in quite "top lip first" instead of chin first. She thought that could be causing him frustration, and doesn't allow him to properly milk the breast tissue. The chin should be fully touching the breast, there should be no gap, and the nose should be clear of the breast. I had to go back to basics with the latch, and already i have seen an improvement - he doesn't pull of or fuss as much, and it feels like he is having a better feed and hopefully getting more milk than before.

Hope you get some answers x

When you say he isn't gaining enough weight, what do you mean? He is losing or not gaining any at all? Or just weight gain is slowing down? Because the latter can be normal for breastfeed babies around this age.

Ds was a distractable baby and needed to be sleepy to feed. Kellymom was really useful for reassuring me some of them are like this. It passes after a while and they are more able to feed and be nosey at the same time.

Sorry you're having such a difficult time. My DD started getting fussy about her feeds at about 12 weeks and we were at the point where she would scream when I tried to feed her (unless it was the night or she was sleepy). I ended up feeding her when she was napping during the day. At 4 months I decided I couldn't cope with this any more and took her to both a cranial osteopath and a homeopath, we found she had some discomfort in her neck which was treated and she also had a few homeopathic remedies. She stopped the screaming and the feeding improved a lot but she was still as nosy distractible as ever! I don't know if the remedies helped or if it was conincidence but she definitely became a much happier baby. She's now 6.5 months and feeds well at home during the day as well as at night, but is still very difficult to feed if there are lots of people about or if we are out. I've now accepted that it's just the way she is and found accepting this has helped me relax more, which has helped with the feeding.

Hi all
Thanks for the suggestions. I think I'll try again with the skin to skin and see what happens... I guess it's good to do this at the beginning and end of the day? Well, more convenient then anyway as we'll both be undressed! I'll also work on the latch, it isn't always perfect but I hate to unlatch him in the day in case he doesn't latch back on again!
Thanks

I don't think you should exclude reflux just due to being okay lying down, especially if he had colic for the first 4 months. I think sometimes the symptoms van he blurred. Could it be that he has developed an association even if it was 'just' colic? I don't mean that lightly as I know it can be awful.

Thanks, I'll discuss the reflux with my
GP. I guess that it's maybe too late to do anything about it now though? Or do the symptoms I mention sound like he still has it?

My 18w dd is exactly the same. She hasn't got reflux. It's a cross cry not a pained cry. Dd1 had reflux and the cry is horrible. Is yours feeding v frequently at night OP? If so you have my sympathy. No advice - but you're not alone!

Hi skibum
I think it does sound angry rather than pain and I don't think it is a distraction problem. It feels like he has developed a bad association and I don't know why

In terms of night feeds, he develops a different routine every few days depending on how much milk I manage to get into him during the day. At the moment he only wakes twice for a feed in the night plus one sometimes at 6am but he wakes at about 4 for around an hour or longer and is totally wide awake. Not hungry, not unhappy provided he has someone to play with! He is also quite difficult to settle after a feed. Up to around 3 months he was totally different, one or two 10 min feeds then straight back to sleep like an angel!

And I forgot to mention, with regard to weight he has gone from 25th to 2nd percentile in the last 12ish weeks. HV said not to worry as he looks fine and I should increase solids but ultimately I feel really sad that I cannot breastfeed normally...

Jonesey I think if your HV is not worrying about the weight then he should be fine, but if you're worried could you ask to be referred to paediatrics? My DD also sounded angry when she was going through her screaming when I tried to feed her phase and I also felt like she'd started to associate feeding with bad things and I was going to have to give up BF as she clearly hated it. I spent so many evening in tears to my DP about how my little girl didn't want me and didn't want to BF and I was going to have to give up and it was horrible. Anyway, I didn't have to give up and we did get through it. There is no "normal" as far as BF goes, you do what your child needs at the time, I know the sadness is horrible but please hang on and know that you will get through this.

Thanks Highheels! How long did you have the problem for and how did you get through it?

We had the same thing. Dd had tt divided at 10 days old and seemed ok at feeding, though never fed frequently or for comfort. At 4 months she started refusing feeds, by 5.5 months she had stopped feeding from me completely and we began weaning onto solids. I expressed the whole time and she had milk from a cup and in lots of food.

Anyway, long story short, we discovered that she still had 'mild' posterier tt. Had it divided and she is now feeding really well at 8 months. She still won't feed outside of the bedroom but that is definitely because she is too distracted. we don't have a ' normal' breastfeeding relationship, but I am so happy that she enjoys feeding now and plan to carry on for a long time :-)

Might be worth getting lactation consultant to check for tt just in case. Either way, hope you get back on track soon. I was devastated when I thought we were going to stop feeding.

She started getting fusy around 12 weeks and gradually got worse and worse. Saw a homeopath and cranial osteopath when she was 4 months which maybe helped a little (but DP wasn't convinced). By 5.5 months she was a bit better and by 6 months better still. She still has her moments (6.5 months now), but usually only if she either has wind or is wanting to see what's going on (she is a very nosy baby). I think that now she's spending more time sitting, she's bringing up her wind more easily as well and am sure that's helping. At the time I didn't think I was going to get through it and I don't know how many times I must have said "I can't do this for another day, I am seriously going to have to give her a bottle because I really cannot keep doing this". Of course I didn't give her the bottle as I desperately wanted to keep BF (am hoping to BF until at least 12 months). I also had some days where I would feel like she had had hardly any milk at all.

I think that she probably just got over the phase (whatever it was) and I learnt to stop comparing her to others and stop worrying about timings and routines but instead look at her and just go with the flow but found the following helped us through the worst:
Trying not to worry about when she last fed or when she should be feeding but looking for her cues.
Burping before offering a feed.
Carrying her around upright more, and carrying her in the sling.
If she started screaming when I tried to feed her I'd put her down and try again after a little while rather than trying to feed through the screaming.
Offering feeds but trying not to worry if she didn't take them.
Feeding her during her naps so I felt she was at least getting some milk!
Trying different positions, she would sometimes feed if I stood up and rocked her but not if I sat down (not the most comfortable but I was willing to give anything a go).
I do think the cranial osteopathy helped, less convinced by the homeopathic remedies but I did find having somebody listen to me talking about the problems I was having very helpful so in that respect the homeopathy definitely helped.
I also tried to have baths with her and, even if we couldn't always manage skin to skin, I started lying down with her for her naps and cuddling her, she would sometimes then feed on and off whilst napping.

It was such a relief when I suddenly realised "hey, she hasn't screamed at all today when I've fed her" and yet at the same time the really bad days seem like a distant memory already. One of the nicest moments we had recently was when I lifted my top to offer her a feed and she opened her mouth and grabbed my boob! It was so nice to feel wanted :) Don't know if any of this helps you, have some hugs as well.

Sorry, that post ended up a bit long and rambly!

Thanks Highheels, your baby does sound v similar to mine so it's reassuring to know you made progress!

Glad I can be of help Jonesey and really hope things improve for you soon.