14-week old BF baby fretful during day feeds, angel during night feeds - help!

[bluesatinsash]

Quick background, DS2 was 8lb 3oz at birth and has steadily been slightly above average weight for his age (was 14lb 6oz at his 3 month jags). He has been exclusively breast fed with the ocassional EBM bottle.

He was a windy slightly colicky baby for the first few weeks but settled down with the help (I think) of infacol and just getting used to being here but over the past few weeks a worrying trend has happened.

He feeds @ 7am/10am/1pm/4pm/7pm/10pm then up to four times between 10pm and 7am again. His 10am/1pm and 4pm feeds have become very fretful with DS2 feeding fine for first minute then breaking off, crying arching back and me trying to wind him over shoulder, doing the sleeping tiger hold where he lies on my arms and I rub his tummy (this works best). Sometimes I get a burp but not always and never a pump and sometimes his crying stops as quickly as it starts.

The problem is that he neer really takes a full feed at these times as I get lost in the calming him trying to soothe his sore tummy etc. He is sometimes up four times during the night and I think its to make up for lost calories during the day .

Then a switch is flicked at 7pm after his bath and massage, he feeds like an angel and continues to do so during the night. I'm at a loss.

Have been going to breast feeding support group every week who have suggested changing colic medicine (which I have) and just hoping it resolves itself with him growing.

My latest theory (of which I have had bloody lots) is that he has baby heartburn as his fretting starts too quickly IMO for it to be trapped wind. But why doesn't he get it in the evening/during the night? Is my milk less acidic then ?

I'm going to speak to HV again on Tues and perhaps suggest some gaviscon.

Its so distressing and really getting me down .

Any advice welcome! Tiktok are you 'on' this evening??

Meant to add that he is contended and happy between feeds although he has started sucking madly on his fingers but then that might just be because he can now get them in his mouth .

bump before bed..

hi

i am having a similar problem so am not sure i can help but maybe we can discuss ideas. i really sympathise with you as am finding it very stressful and no-one else seems too bothered!

my DD1 is now 19 weeks. she was diagnosed with silent reflux at 6 weeks on the basis of crying and pulling off during feeds, arching her back (typical reflux) and a bit of puking (but not much). She was started on gaviscon which didnt help and ranitidine which blocks acid production and did help massivley. However, at the time she was having one bottle feed at 10pm of formula and while taking this well at first, she eventually got worse and worse with this, crying after a few mouthfuls and eventually refusing to take it all together - i am not sure if this is simply preferring breast, or reflux (as flow faster) or a cows milk allergy (awaiting paediatric appt for this). so she has been exclusively bf for last 5 weeks. About this time she started the behaviour you describe - feeding well at night but for her 7am and 10am and sometimes 1pm feeds she has a few mouthfuls, pulls off, arches away and cries and wont go back on. she catches up at night. unlike your baby she has lost some weight and dropped from 50th to 25th centile which she is now tracking along. we saw the paeds doctors 4 weeks ago who initially thought it was due to her reflux but i am not sure it is as not same as symptoms before (which was every feed, although better at night). My theories are: 1. distraction during day which apparently is quite common, although even if i feed in a dark quiet room she does it. 2. not hungry in morning as feeding at night - not sure what to do about this as there is no way i could make her wait at night she is REALLY hungry. 3. teething - but as this has been going on for 4 weeks i have been told it probably isnt 5. anatomical problem - unlikely as became problem only recently but am seeing a cranial osteopath next week anyway! 6. thrush - she has a sore tongue but no white patches - HV has looked before and said no but will go back next week and ask again. 7. using breast to fall asleep - she is really hard to get to sleep and although i try not to i have resorted to feeding her to sleep at times - i wonder therefore whether she associates feeding with going to sleep and so wont feed unless she wants to sleep - this explains why she feeds better at night. 8. hormones - the first time this happened 4 weeks ago i got my period and have heard it makes milk taste funny, but sholdnt last this long>??
I dont think its due to flow as pumping first doesnt help.

Other than that I am at a loss. I have read on reflux formums that babies with reflux feed better at night as half asleep they dont notice the discomfort so much. the HV was useless with diagnosing our baby's reflux and i ended up taking her along to paeds (my husband and i are both docs in adult medicine). i would ask to try gaviscon or be referred. Feeding is such a big part of babycare - it has really affected my ability to enjoy my baby.

If anyone else reads this and has some ideas or has had similar problems please let us know.

I would also say, dont forget to pump as if she isnt drinking your supply will decrease.

Let me know what you think, good luck

Hi JPK and thanks for posting - its a relief to know I'm not the only one with this going round and round in my head! I so agree that feeding is such a big part of their babyhood and when its going wrong its so so upsetting. Also agree that HV don't seem to take it as seriously especially in my case as DS2 is chunky and a good weight.

I'm away out for my Mum's lunch but will be back on tonight to give thoughts on your points.

...Back.

Hi again JPK. My thoughts on your theories:

1. distraction during day - could be. DS2 is getting quite nosey and I did wonder if the chair I always feed him in in the living room was getting too small width wise. I actually fed him standing up this afternoon to see if holding him upright helped and it seemed to

2. not hungry in morning as feeding at night - definately have this going on i.e. last night DS2 was up at 2am and 6am (it was a good night by our standards!!) so didn't feed him until after his 9am nap (he fell back asleep after 6am feed until 8.45am and wasn't hungry when he woke)

3. teething - no sign this end...

4. anatomical problem - unlikely as became problem only recently but am seeing a cranial osteopath next week anyway! Do worry about this the most that he has something wrong with his bowel/tummy... Let me know how you get on with the CO

5. thrush - nope

6. using breast to fall asleep -this is an interesting one but before it got worse DS2 was pretty good at doing the Feed/activity/nap cycle so very rarely fell asleep after his day feeds, if he did it was one of those kid on ones for 5 minutes...

Also found the reflux forum points interesting in terms of babies being too sleepy during the night to notice their reflux just as much..

Does your DD sometimes bring up a splatter of milk up to an hour after a feed?

We actually had a much better day today which I've probably gone and jinxed tomorrow by saying it. I gave him his 8.45am feed in his rocking chair in his room and he fed well for 15 mins. Next feed was at 12.45pm and this was the one standing up and went OK but only fed for 10 mins. We were then out for lunch and he fed at the table at 3.45pm and fed for 10 mins again no fretting. Just fed him there at 6.45pm and he fed well for 20 mins...

I tried to introduce a bottle of formula on Friday to see if it was my milk causing the fretting but he point blank refused it. He did get EBM couple of times a week but I let it slide as simply had no time to sterilise/express whilst looking after DS1 and 2!

I will bring up all your points at the HV on Tues. and report back. Let me know how you get on with your referal too.

Fingers crossed for the both of us and our DC

Hi

Thanks for your replies.

Thought of a couple of other things: with our baby's reflux at 6 weeks she was really unhappy and clearly v uncomfortable, it was a total nightmare and i was in tears every feed because she obviosuly wanted to feed but was in pain - this time she gets upset after a few sucks and cries but stops as soon as you take her away from the breast - i think reflux is hard to diagnose because the arching thing can sometimes just be general "stop this" speak. if you google sandifer syndrome there are some videos of what reflux looks like, but of course it can range from mild to bad so doesnt necessarily exclude it if your baby isnt like this.

I was thinking though that your baby is a bit old to suddenly get reflux - it does peak at 4 months but would generally appear earlier as oesophageal sphincter getting better not worse as get older. Unless you have suddenly introduced formula/cows milk as an allergy to this can present like reflux?

Other thoughts i had were that my baby seems better if i feed her 4 hourly so i was wondering if she maybe just wasnt hungry enough when offered at 7,10, 1 etc anymore. Although having said that, today she was really hungry but was still doing the pulling off thing and getting upset - so frustrating. I also meant to mention that i have had more luck feeding her lying down in the last week - have been told this makes flow slower which i didnt think was a factor for me but you could try it if havent already and see - today it was the only way she would feed.
Finally, my DD started doing this the first time after her 3 month vacc, was bad for a couple of weeks then got better and got worse again after her 4 month vacc last week - i asked the HV but they said they had never heard of vacc having this effect.

Its a mystery.
Will let you know what paeds say and if CO helps. Let me know how you get on. Good luck! xx

hello

my little girl, who just turned 6 months, went through a few spells of this...I have no idea why but it did resolve itself.

She has reflux mind you and is on meds. but she still went through stages of very very very fussy short feeds during the day and no trouble feeding at night.

Sorry not much help but just so you know it did settle down.

Hi everyone, my son was exactly like this - feeding in the day was awful, while at night he was super.

Lots of wind (I once in desperation counted 39 farts in an hour), arching his back, etc...

I am afraid, I have no idea what helps - nothing helped in my case, though to be fair, when I eventually introduced formula aged 4.5 months things got MUCH better, but it could be b/c he was over his colic/reflux/whatever it was anyway by then.

Things got really good when I started solids at 5.5 months. He is now 22 months and an excellent feeder. More than excellent. Complete joy to feed, in fact, as opposed to the utter nightmare he was when he was little.

Hi Blue Satin & JPK. Am having same problem with my son - also 14 weeks. Pulling off, crying, only feeding from one side for a few mins in day - same feed times. Unless 1/2 asleep - today at 1pm feed he was very sleepy and relaxed and stayed on for 20 mins.

Am finding it frustrating, stressfull, upsetting, as he was going for long periods at night up until last week (dream feed around 22:30, then usually a feed around 03:30 - day feeds same as yours 7am,10am, 1pm, 4pm, 7pm give or take 1/2 hour, but usually 3 hrs apart) He is now back to feeding several times in the night.

Try as I might to get him to latch on longer and take more it doesn't work, he latches on, comes off, cries and might do this for 10mins before giving up.

My son has always been windy - waking up several times a night with trapped farts. I'm thinking of giving Cranial Oseopath a go.

Struggled with feeding a few weeks old - pulling away, I have been using Infacol since then, and it helped, but not helping now.

Let me know how you both get on - if you find something that helps! Thanks

Hi Emalina, msupa and willowstar its reassuring to know there are others out there and willow and msupa that it resolved itself.

Well had another breast feeding support group this morning and swear I could almost detect the HV rolling their eyes as I once again launched into my frustration at his fretting . JPK I mentioned ranitidine but need to get that from Doctor HV can prescribe it. Phoned surgery to be told no appointments but if I phone 8.30am tomorrow they can squeeze me in.

I always have a bit of a heavy heart going to docs as they only half listen and worried they will take one look at my chunky boy and just shoo me away but I'm going to stand my ground and insist that something be done whether it Paed referral or meds..

JPK - DS2 has only had breast milk so it can't be allergy unless its through my milk he seems to have evolved from windy/colicky to refluxy/acidy - its just so damn confusing. Do any of your babies projectile about an hour after a feed? Its not much but can come out at some speed...

I'm really trying to not wish his babyhood away but can't help thinking how easier it all is when he will be DS1 age (nearly 4)...

that should read HV can't prescribe..

Hello, it's my first time posting on Mumsnet, but I have a similar problem to you. My DS is 10 wks old and EBF. He often pulls away from the breast, arches his back and cries, but is absolutely fine during the night. He has also gained a lot of weight quite quickly. I worked out, with the help of a breastfeeding counsellor that I have a fast let down, and when it happens, it is too much for him and he gets overwhelmed and pulls away. At night, because we lie down to feed, he is much better as gravity apparently plays a part.

The counsellor recommended that I have a look at www.kellymom.com which has been really helpful for me. I hope you find something there that might help you.

Coming to this a bit late - I'm another one with a tough-to-feed 13wo DS. Again, it looks like a fast let down is the problem - he's fine for the last couple of feeds of the day, when I'm 'running on empty', but during the day we get a lot of writing, arching, farting and general messing around - and pulling off the breast screaming, then a massive burp. I've started following some of the advice for fast let down on Kellymom, and it does help - so, feeding on one side, unlatching for a second at start of let down, different positions so feeding more 'uphill'. Worth a try...

hi

thanks for all your replies. reassuring to know we are not the only ones - wish id discovered mumsnet sooner.

i agree fast let down defnitely makes things worse - when my baby had reflux first, she wouldnt feed from right side which had a bit of milk spray effect going on, however, i have quite a rubbish supply these days and doesnt seem to be flow related - would explain why better lying down though....

i will look at kellymom but have tried taking her off as i soon as i get a let down but she wont go back on - just screams if i try to offer it back to her, even if i keep trying over a period of time and have winded her.

bluesatinsash - forgot to answer you re vomiting - my baby possetted a couple of times post feeding at first which i guess is normal, then started projectile vomiting across room which was when she was diagnosed with reflux - even on meds she contiuned to vomit a bit (ie clearing body rather than spitting up) but this stopped completely when i gave up dairy. for cows milk allergy it comes through your milk so even if only had ebf he could be reacting to milk protein - not that im saying yours does have this atall.

i sympathise with being made to feel like a worrier - it is so crap and unhelpful and makes me doubt myself but the older she gets the less i care what the HV and GP think!

maybe you could get a paeds ward referral as GP might not be keen to start ranitidine without a definite diagnosis (not that there is a great way of doing this)

bye for now xx

hi bluesatinsash my DS is 16 weeks today and has been exactly as you describe until very recently. Part of the problem was definitely a fast let-down and I started seeing a massive improvement after following this advice.

However, it wasn't a miracle cure and about 2 weeks ago I realised that another factor was his EXTREME "distractibility". I now feed him mostly at home in a quiet spot (often I need to add white noise) or in the back seat of the car when out. I have a white noise app on my phone which I use if necessary in the car.

I have noticed this week though that he is getting a little better at feeding through distractions and am considering getting a nursing cover to try public feeding again.

Hope that helps

Hi guys and thanks for the kellymon link. I had a good read last night and found myself nodding at so much of what was written.

My theory (for today ) is that DS2 has a combination of most of the kellymom suggestions - fast let down, possible cow's allergy with mild reflux in there too.

Spoke to my Mum last night and didn't phone doctor today as going to make concentrated effort in holding him upright and trying to be as calm as possible.

His feeds today were:

6.30am - brough him through from his room fed him lying on my side and he was content

9.45am: fed in living room and he was fine for 10 mins then had crying spell, had him in sleeping tiger hold and he settled and took some more milk

12.30pm - fed him in living room similar to 9.45am feed

3.45pm - fed him whilst watching DH and DS1 at swimming pool, he was fine just a little cry but didn't feed for long

5.15pm sneaky feed before tea as he was cranky and felt he hadn't had full feed earlier. He was fine

7pm fed after bath and massage, good 20 mins and fed like an angel

JPK - I'm so torn between going to docs or just following kellymom advice. He is a contented baby between feeds but thr thought of this going on for months. Also don't want to think about it being a milk allergy as I eat alot of dairy and don't know what I would eat if I had to cut it out...

hi

just had a chance to catch up on this. i agree with your theories and think my DD is prob sim combination of factors.

slightly changed for me as saw HV on thurs and hasnt put on ANY weight for another 2 weeks and dropped to 10th centile (from 80th) so they are finally taking it more seriously and GP has done an "urgent" paeds gastro referral. in the meantime am thinking of changing to omeprazole but actually im not really sure it is entirely reflux - she just doesnt seem to have the appetite whereas before she was REALLY hungry and frustrated - now she doesnt seem to care really. i was so upset yesterday - totally embarrsedd myself by crying in GP surgery. Its so stressful when you sit there offering milk and they wont take it and you know they need it.

anyway. we have started her on iron drops (prescribed by paeds) too as she is a bit anaemic and this can cause loss of appetite.

I do think if your baby feeds for 10 mins this is quite good - the paeds reg i saw said 90% of nutrition comes from first 5 mins. have been timing DD and her max in day is 2 mins, then like you say has a good feed at 5pm, 7pm and about 2am.

I think if it doesnt improve with kellymom advice i would go to docs and discuss reflux - it was an amazing difference with my LO when we got the ranitidine but was slightly different - she screamed for ages after each feed. by the time you get a referral it may be better but there's no harm in getting ball rolling. i wouldnt give up dairy just yet although i ate alot prev too and it hasnt been that bad - also, i am still having probs despite giving up dairy!

the other factor wth mine i think is teething - she rams her fist into her mouth seconds after starting to feed and is drooling like crazy - i think shes a bit of a fusspot/sensitive to things so it may be putting her off although probably shouldnt cause weight probs.

let me know what happens

Hi JPK - so sorry you had a rubbish day and were crying in GP surgery. If its any comfort I was that girl with DS1 when he was 12 weeks old and had similar feeding issues. Think he was same as DS2 but refused to feed off me altogether in the end (came to a head one night feed when he woke hungry and refused the boob) and Doc suggested next morning I put him on a bottle to save my sanity and he took to it like a dream and all wind/colic/fretting disappeared in an instant. It baffles me to this day!

Sorry to hear your DD hasn't put on weight and is losing interest in feeding, it must be soul destroying wondering what's wrong. How quickly will you get seen by Paeds?

Another trick I'm trying from today is not holding DS2 by his waist/bum - i.e. when he is facing out as I think it puts pressure on his tummy and that's when he has his projectiles. I'm going to try and hold him to the side. Still a bit tricky as his head is still a bit floppy.

He has still been mnore settled at feeds since I made the effort in holding him upright and just letting him lead when he needs winded etc.... He has his 4-month jags on 21st April so will see how his feeding goes until then and if still fussing will make appointment after speaking to HV.

Really hope things improve for you and your DD soon. Keep me posted.