New feeding behaviour of 3.5 wo with difficult history - worried, what is going on?

[ardenbird]

So, my DD, after squeaking by the HV's re-weigh on Wednesday not quite back to her birth weight, but close enough, has now developed new feeding behaviour that is confusing and worrying me, especially as she's had problems gaining weight.

A quick history: EMCS, poor feeding start in hospital, milk slow to come in, a few days of good nappies but then mastisis which was a set-back, and just last week finally appeared to be doing better with many wet/dirty nappies per day.

Until now she's been a "sleep feeder" - she drifts off a few minutes after latching on and nothing I do seems to wake her, but stripping her to her nappy and constantly blowing/tickling at least seemed to keep her in a light enough sleep to eat. She more recently developed a habit of slipping to a poor latch in her sleep, which meant I had to take her off and start again.

Last night and today she has appeared to be a bit more awake at the breast, although often with eyes drifting closed. For the first time she has pushed herself off the breast: usually accomplished by first a bunch of grunting and wriggling and moving the latch about, reaching a poor latch, and pushing off with her hand. She comes off crying, many times without even opening her eyes.

Also, she has not had a dirty nappy since last night around 6pm, whereas since their return, she's had a good 10-12 a day!

I'm not sure what to make of this. I've been putting her back on the same breast until she seems to do this quite quickly, and then I move her to the other breast. She never quite seems to give a "I'm done eating" signal that I can find, and often gives tongue-out open-mouth for a little while whenever she comes off. I've been taking occasional breaks when she appears to be content to be held for a little bit, and sometimes she drifts to sleep. She'll wake up in a hour usually if this happens, making feedings every 2 hours (each of which lasts 1hr+ with all the bad-latch coming off stuff), every 3 overnight.

What's going on? I'm really worried that she hasn't had a dirty nappy yet and that she isn't eating well again.

Hey, Im no expert but I would think you need to see m/w or gp about this. Shes young and no dirty nappies is a bad sign. do you mean wet or poo? if she hasnt had a wet nappy she could be getting dehydrated and i would think you need to see someone pretty sharpish?

Ah, I meant poo - she's still making wet nappies (sorry, that's how the MW/HV called them).

If she is having plenty of wet nappies (at least 6 a day) then I would say the next thing to do is get her weighed at the next available opportunity. Dirty nappies are often considered less of an indicator as it is not unusual for ebf babies to go days without pooing. However, if you feel that her behaviour is out of character and that she seems more sleepy than usual, I would be seeing the Gp or Hv if only to put my mind at rest. With regards to the feeding, wriggling around and pulling off can sometimes be a sign of wind so maybe give her a good wind between breasts and then pop her back on. This should wake her up a bit too! When was the last time you had her weighed? Did she start to gain well after your initial rough patch?

Sorry, just reread your opening post re. weight gain. What did the Hv say about it? Maybe feeding more frequently also and continuing with the techniques to try and keep your LO awake for longer during feeds, I found that stroking the cheek and taking a deep breath in helped to keep my LO awake.

She had a massive poo last night! Talked to HV and she wasn't worried. She also suggested wind. Are there some resources about how to wind? I've been trying holding her upright and patting her back and also the 'leopard lie' across my forearm.

I guess it's now the awakeness that confuses me - I used to figure she was done when I simply couldn't wake her to eat, but now that she stays awake the whole time the fact that she always gives feeding cues when she comes off is very confusing. And now I'm back on antibiotics, as I have a Staph infection in my fissures (why they weren't healing), but I recall those served to make her agitated.