4mo keeps pulling off breast and crying - slow let down?

[cirillaofcintra]

4mo DD is almost EBF except for one formula bottle of 3oz or so at bedtime before her breastfeed.

Feeding seemed to be going fine up until recently, she started to take less time feeding in the last month or so but I read that that's normal as they get more efficient.

Unfortunately in the last few days, maybe a week?, she has started pulling off the breast and crying. I usually offer feeds every couple of hours or so in the day / on demand. Previously she seemed happy to feed at these times but now, at most feeds, she sucks for a while and it seems that if she doesn't get a let down sharpish, she starts grizzling/grunting while on the boob and then pulls off and screams at me. I try relatching her again and again but same happens. If I do eventually get a let down she then seems to feed OK - but not for very long.

I should say that I have never felt let down, but I can tell it's happened by her sucking changing and the sounds - swallowing, pausing for breath etc. Can hear that there's milk there.

It seems to me like my let down is sometimes taking too long and she is getting frustrated? At one feed yesterday it never seemed to come. Am getting quite upset and stressed which I know won't help. Her sleep has been awful since Christmas so I'm exhausted and sleep deprived too - could that have caused this issue?

I'm trying to persist with each feed even through the screaming until I hear what sounds like a let down / until it sounds and looks like she's getting some milk, but not always possible.

It's affecting her naps too I think as she's started fighting them more and I think it's because she's hungry.

Not sure what to do. Worried my milk supply will reduce because she's not feeding so well.

She has been hovering around 25th percentile since birth but when I weighted her most recently she was 22nd and hadn't gained anything since her 3rd round of jabs on New Year's Eve.

Any similar experiences or words of advice?

Could she have thrush?

Sorry, should also add, every nappy I change is wet (with blue line indicator) and very heavy first thing in morning, but she is pooing less frequently than she used to. We used to get a few poos a day, now it's zero or one. But I did read it's OK for breastfed babies not to poo every day?

Do not want to daignose without observing. Could be one of several things including a cold.

Are the poos a normal yellowish orange colour or are they at all green and foamy (pesto poos i used to call them)?

I can suggest something which may help, providing you are on mat leave and don't have other responsibilities? Take your top off, strip baby to nappy, get into bed and lie her near your breast. You can nap, read, watch TV, snack - whatever, but let her have skin to skin, unlimited access, suckle as and when while you rest a bit. If its to do with supply this should help. Sometimes itit'common at about this age to need to readdress how you hold them to feed as they've got bigger but you're still trying to hold then like a newborn so they can't latch on as well. It can also cause pain in your nappies. Feeding lying down will also fix this, but be aware when you feed sitting up. You may need to lower her a bit, maybe rest her weight on your lap rather than your arm etc

If you notice anything else, like white gunk in her mouth, pain in your breast, snuffling like she has a blocked nose etc then it might be something medical (thrush, a cold, maybe a tongue tie restricting her now she's getting bigger)

Are you drinking enough yourself ? Try to up your water content.

Serenschintte - I can't see any symptoms of it, her mouth looks nicely pink and healthy? I also have no pain whatsoever in nipples.

iveputmyselfonthenaughtystep - Poos are sort of brownish yellow. Definitely not like pesto and not foamy.

Thanks for the suggestions re. skin to skin and positioning. Will give the skin to skin a go although I can foresee her being a bit fussy - she seems to need constant stimulation these days when not napping or feeding, hates being put down, not a big snuggler, definitely not content to just chill while I read or watch TV. Just wants to be carried around the house looking at things. But she's always been super fussy, not a new thing.

Don't think she has a cold, no snuffling, and see above re. thrush.

Jennalong - I almost certainly don't drink enough - going to make a concerted effort to do so! Thanks.

Sounds like the 4 month fussies! Have a look on the Kelly mom website, lots of good advice there!

If you're not getting pesto poos then that suggests she's not coldy or tongue tied, providing she's weeing frequently. Poos can be as rare as every 10-14 days with fully bf babies. Do the skin to skin (can do it in a sling, too, if she's a nosy beggar), up your water intake and see how it goes

@Iveputmyselfonthenaughtystep

If you're not getting pesto poos then that suggests she's not coldy or tongue tied, providing she's weeing frequently. Poos can be as rare as every 10-14 days with fully bf babies. Do the skin to skin (can do it in a sling, too, if she's a nosy beggar), up your water intake and see how it goes

So we tried a different position today. I had been relying on rugby hold as that got us the best latch and milk flow up to now. But I think maybe she doesn't like it any more. I put her in a sort of upright cradle, her head in the crook of my arm, and she seemed to drink well and has now gone down quickly for a pram nap. Hopefully this is the answer, but going to see how we go. Thanks for the tip!!

That's fab news. Keep up the great work!