Are these feeding problem

C

carey

Registered User
My boy is two weeks old and Since I don't have enough breast milk, I have been alternating feeding him breast milk and formula ( one meal formula, another breast milk).

I am hoping to get help with these situations.

He became a fussy at feeding time after we came home from the hospital. Situations are

1. He drinks slowing ( takes about one hour for feeding 100ml to 120 ml milk, I pumped for him too). He sometimes falls asleep in the middle or towards the end of the feeding, refuse to wake up even if we burp him. He then suddenly wake up later and cry for more food. This is quite frustrating

2. He vomits milk ( sometimes a bit, sometimes quite a bit, about 10 to 20 ml). I usually get quite upset when this happens. I know this could cause by improper feeding.

So, I try changing diaper before feeding, burping him in the middle or/ and at the end of feeding, and not to put him to bed right away after feeding. But vomiting still happens sometimes. I don't know what I have done wrong to cause this.

Thank you in advance.
 
it sounds to me like you are overfeeding him. if he falls asleep, he's done (most likely)

if he is vomitting after meals, it could be due to overfeeding as well.

he may also have something called reflux. take him to the doctor and have him checked out.
 
Its completely normal for a 2 week old baby to go to sleep while feeding, he may or may not be full you cannot tell. Don't get frustrated about this at all. New borns sleep most of the day for the first 1- 2 months of their life. They drink slowly as they do not have so much strength but get better as times goes by.
He may be having reflux if he is throwing up milk, many babies have reflux and there is basically nothing you can do about it. Don't lay him flat right after a feed keep him slightly elevated using a pillow, but make sure he is well supported. On his next Paed appointment discuss the reflux issue. As a new parent even little things can be stressful just be patient :)
 
I agree with geomum - it is completely normal for a 2 week old baby to fall asleep while feeding. My baby is 11 weeks old now and he still falls asleep while feeding. If he is throwing up milk, it may be reflux or he may just be eating too much. Though I breastfed my baby exclusively without use of a bottle in the first month of his life, I was told by the nurses at the hospital to just give him 3 oz (90ml) per meal. So if you are giving him 100-120ml, it may be too much. I would just let him eat as much as he wants to eat and just feed him more frequently - newborn babies want to eat all the time, so though frustrating, it's just part of what really young babies do. It will get better when he gets a little older! I remember having to get up a few times at night to feed him in the first few weeks - but by the second month he was already waking up less at night for feeds and now at 11 weeks, he sleeps for 6-8 hours at a time. So there is a light at the end of the tunnel. Hang in there!!
 
Dear Carey,

A two week old baby will usually be having between 10 and 14 feeds every 24 hours. And each feed will be around 2.5 oz (about 60 mls). Obviously some babies will have fewer feeds and drink a little more at each feed but drinking 120mls per feed would mean only 7 feeds and most babies so young prefer lots of small feeds to a few larger feeds.

We usually suggest that you feed on one side until the baby comes off (or falls asleep) and then offer the other side. If the baby takes the second side that is fine but if the baby doesn't want the second side that is fine too.

One suggestion is to lift the baby's head so that his cheek is against your bare breast when he's finished and fallen asleep. And then wait for five to ten minutes. If the baby stays asleep you can put him down but if your baby starts to root again then drop him down and feed him again.

I've attached an article I wrote for LLL-Asia's newsletter for breastfeeding mothers called Chocolate Cake and Chinese Banquets - it describes normal newborn feeding patterns.

The first weeks of breastfeeding are a very intense time. You feel like there is nothing else in life but breastfeeding. Life usually becomes easier somewhere between the fourth and sixth week.

Best wishes,
SARAH
 

Attachments

2 weeks old is still a very super sleepy time for you newborn, so it's normal for him to keep falling asleep. When my son was a newborn and I wanted to feed him both sides I would feed one side and then change him, and then try to feed the other side. The diaper change would wake him up a bit.
I also think 100-120mls sounds a bit much for that age, so that might explain the vomiting. Is it shooting out of his mouth or just kind of flowing out? If it's just flowing out it might be from overfeeding. My friend overfed her baby when he was little and he also threw up all the time.
Also, I'm just curious why you say you don't have enough milk. Maybe if you tried to breastfeed him more often, like whenever he seems hungry, your supply would increase. I would be afraid of your supply decreasing more and more if you supplement so much with formula.
And Sarah is right, it takes at least 4-6 weeks (and sometimes longer) for both you and your baby to get used to breastfeeding. Good luck - you are doing a great thing for your new baby~
 
Thank you all for your response. I am stealing a moment to reply while he is taking a cat nap. I sometimes hardly have enough time to put my breast back to the my bra when I try to put him to sleep. I can no longer multi-task like I used to.

Special thanks to Sarah for the article. It describes exactly my experience and how I have been feeling. (Where Can I get more of these articles/ or book ? I don't have a lot of time to surf the internet now with a new born, But I would like to read more)

Now I know that this is normal for a new born and with all your support, I will stick to BF as much as I can.

Shenzhennifer--- thinking about it now, I believe I have enough Breast milk. My milk came dripping wet my cloths on the 3rd day of delivery. Now, I soak about 6 bra pads every day. Convince that I don't have enough, I am pumping about four to five times a day for him to drink from the bottle. Other feedings are formula.

I get quite a lot of pressure from my mother--who breastfeed three of her daughters but want me to have enough rest during the confinement month. So, she suggests to have the helper to feed the baby formula in the night or pumping so that I get a good night sleep. All of the other babies in my big Chinese family are formula fed. So, I also get discouraging comments from them about breast feeding too.

He is 3 days past two weeks now. Giving him 100-120ml was my solution to him frequent rooting about half an hour after feeding. It has worked for night times. In the day, he tends to want more frequent feeding.

So far, he seems to have no problem with nipple confusion. He takes bottle as well as my breast without even think for a moment. I guess for him, food is food. He does not concern where he gets it from. Hopefully, this would last.

I have a few questions here:

Do baby's know when they are full?

Do you wake your baby to feed is he sleeps over 5 hours straight?

Is it better to have another person to put the baby to sleep in order that baby won't smell my milk and mistaken for feeding time?

Since I soak so many bra pad every day, I feel that if collect and store those milk, there would be quite a bit of it. My friend suggest me to wear no bra while at home and pump as soon as my breasts leak milk. But this way is very messy. I would end up wetting my clothes all the time.

Do you have other suggestions?

Thank you very much.
 
Dear Carey,

Do baby's know when they are full?

Usually because the baby comes off or goes to sleep.

I would caution you about giving bottles after you have finished a breastfeed because a baby will nearly always drink some from the bottle. This doesn't mean the baby didn't get enough just that babies like to continue sucking and with a bottle when you suck you get milk.

I think it helps to think of a bottle like going to a buffet. When you sit at home and eat dinner one plate full is enough. But when you go to a buffet you eat one plate full and then look around at all the food and so have a second and sometimes a third plate full. At buffets people usually stop eating because they feel full but 15 to 20 minutes later they realise that they are actually over full! This often happens with babies when drinking from the bottle. They then sleep longer because they are overfull. And they do this if the bottle contains formula or expressed breast milk.

Do you wake your baby to feed is he sleeps over 5 hours straight?

If your baby is doing well then there is no need to wake the baby. Signs that the baby is doing well are:
  1. Baby has at least 8 feeds every 24 hours
  2. Baby has at least 6 wet nappies every 24 hours
  3. Baby has at least 2 dirty nappies every 24 hours
  4. Baby seems alert when awake

Is it better to have another person to put the baby to sleep in order that baby won't smell my milk and mistaken for feeding time?

I don't think that getting another person to put the baby to sleep is better but it is definitely an option. When my last baby was little I would feed the baby in bed around 9 o'clock and if she didn't go to sleep I'd pass her to my husband. He would then look after her (mainly they watched TV together) until she wanted another feed usually somewhere between 10 and 11 o'clock. when he'd return her to me. This allowed me to get an extra one to two hours sleep and made all the difference to how I coped during her first six weeks.

If you feel that you have enough milk for your baby then try stopping the pumping and feeding the baby directly. You may find the first couple of days quite trying but after a few days all will be well. The things to watch for while you are doing this is that the baby continues to have the signs of doing well listed above.

If you would feel more comfortable to reduce the formula slowly then Kellymom.com has information about weaning from supplements to the breast and a useful form to fill in which helps you know exactly where you are and what the next stage is.

Weaning from Supplements Instructions
http://www.kellymom.com/store/handouts/concerns/wean-supplements.pdf
Weaning from Supplements Log
http://www.kellymom.com/store/handouts/concerns/wean-supplements.pdf

You asked about books on breastfeeding. The one I would recommend is The Womanly Art of Breastfeeding. Details are at LLL-HK Womanly Art of Breastfeeding

It is available in Hong Kong from La Leche League, LLL-HK Home Page

and also from geobaby at The Womanly Art of Breastfeeding : Seventh Revised Edition (La Leche League International Book) | 0452285801 | General | Babies And Toddlers | Parenting | Parenting And Families | Bookstore...

If you are interested in reading more articles from our newsletter, Close to the Heart, back issues are available at LLL-HK Publications.

The current issue is available with LLL membership in Asia.
You can join in Hong Kong at http://www.lllhk.org/Membership Matters.pdf

There may be a closer LLL group as we also have some in China, LLLI | La Leche League Groups in China

Best wishes,
SARAH
 
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Thank you very much Sarah. I was determined to breastfeed him this morning after posting my last thread. But I ended up having a rather frightening time.

My boy wakes up and cried for food. So I put him on my breast. He got very frustrated at sucking ( I believe my let-down is much slower then the bottle nipple). He twisted and turned and turned very red and cried. In desperation, I asked the helper to prepare 90ml formula for him. And handed him over to her for feeding.

After taking about half of the milk, I took him over and tried to feed with the bottle. He burped and threw up milk in large amount from his month and nose. It was very terrifying for me. We tried comforting him and he rested and cried for more food but still refuse to take my breast and only can give him a bottle with formula.

My question now to Sarah are--

Does this mean my baby will refuse to take my breast unless I tried weaning him off bottle?

I do pump milk. I understand is different from feeding him directly from the breast. If I fail to put him back to my breast, can I at least continue to pump and maintain my milk supply and feed him through bottle of my breast milk?

If I continue to mix feed him, Are you suggesting is better to go one meal breast milk with bottle and one meal formula?

I tried only feed him on my breast but he always root for more food and got frustrated sucking on my nipple. That's why I supplemented him with milk powder.

By the way Sarah, I live about two hours drive from HongKong. So, the LLL group in Hongkong is closest to me yet, still too far to travel to attend your meeting for the timing being.

IF I have questions regarding BF, When is a convenient time to call you? ( I thought about calling today. But It's Weekend, I am not sure if you like to take calls during holiday. )

Thank you again for lending a hand and voice during this stressful time.
 
Dear Carey,

It is very frightening when your baby cries so much he changes colour and vomits. My last child still vomits if she cries too much.

When I'm helping a mother stop supplementing with formula I usually suggest that you put the formula on a timetable. Say give 90mls 3 times a day at 10:00 am, 4:00 pm and 10:00pm and breastfeed in between. Don't worry if the baby wants to feed lots and lots - that is the quickest way to build up your supply. Because you are giving the supplements you know that the baby is getting enough so you don't have to worry about that - just that the baby is drinking when at the breast.

If you can send me your email address I will send you a video of nutritive breastfeeding so you can see if your baby is feeding like this. Basically it is with a big jaw movement. If the baby is moving the whole of the jaw in a slow rhythmic motion then he is drinking but if he is only moving his lips in quick rapid movement then he is just comfort sucking.

Then when you are happy that everything is OK slowly reduce the amount of formula you are giving. Usually by about 10mls per feed - wait a few days until you are happy again and then reduce by another 10mls per feed. Don't try to go too quickly as you are more likely to worry and increase the supplements instead of reducing them.

If the supplement can be your own breast milk - that would be great. But it is a lot of work to do all that pumping, especially when you are breastfeeding too.

[Does this mean my baby will refuse to take my breast unless I tried weaning him off bottle?

It is possible to get your baby to wean from supplements and still use the bottle. Although we usually suggest that you feed the baby with an alternative, for example, a spoon, spoon-feeder, cup, or (my favourite) a lactation aid.

There are instructions for using an at-breast supplementer or lactation aid at, http://www.breastfeedingonline.com/5pdf.pdf

There is also a video on the web page Breastfeeding Articles by Dr. Jack Newman - Breastfeeding Online
In section called At-Breast Supplementer under the title Lactation Aid. (It has a little video camera picture next to it.)

(In this video Dr Newman just uses the tube and puts it straight into the bottle. This works just as well as the Supplementer that Medela sell but it doesn't look as nice. Obviously for Medela to sell them to mothers more design had to go into it!)

As your baby is latching on then I would recommend using a lactation aid/nursing supplementer as this allows all the feeding to be done at the breast. And feeding directly at the breast will increase the speed of your flow so that the baby is happy with it.

If you want to buy a supplementer from Celki, the Medela agent in Hong Kong, ask for "Supplemental Nursing System" or a SNS. There is a picture of one at ++ Image ++

I use an infant feeding tube (similar to Infant Feeding Tube - Exporter, Importer, Manufacturer & Supplier, Ahmedabad, India) when making a lactation aid and then do it the same way Dr. Newman does on his website. I buy mine from a local hospital. The mothers usually find it easy to use and the beauty of using this method is that you don't need to pump as much to keep up your supply because the baby's sucking does this for you.

I do pump milk. I understand is different from feeding him directly from the breast. If I fail to put him back to my breast, can I at least continue to pump and maintain my milk supply and feed him through bottle of my breast milk?

Full time pumping and feeding with a bottle is a lot of hard work. And you don't get any of the pleasure of either breastfeeding or bottle feeding. You are always worried about your supply because you can measure it. And you don't have the joy of the baby going to sleep at the breast.

But it is possible. The biggest problem is that the mother usually gets fed up of pumping as time passes and so pumps less and less and then, of course, the milk supply gets less and less. I have known of mothers who have pumped their milk and given it to the baby in bottle of nearly two years but they have been very dedicated to giving their babies breast milk.

You need to pump at least eight times a day. It doesn't have to be once every three hours, although that works fine. It can be once every two hours during the day and every four hours at night. Remember that pumping three times for ten minutes and adding the milk together will give you more milk than pumping once for thirty minutes.

Pumping works in the same way breastfeeding does. The more milk you remove from the breasts the more milk you make.

If I continue to mix feed him, Are you suggesting is better to go one meal breast milk with bottle and one meal formula?

Yes I really don't like topping up because whether the baby is full or not he will always take more milk from a bottle. This makes you think you don't have enough milk and also stops you learning to mother your baby without the use of a bottle.

I tried only feed him on my breast but he always root for more food and got frustrated sucking on my nipple. That's why I supplemented him with milk powder.

When you do more breastfeeding and are trying to build up your supply the baby will want to feed a lot. This is a good thing as the quickest way to increase your supply is for the baby to suck at your breast. Usually the baby builds up the supply between three days and three weeks. During this time the baby wants to feed and feed and feed.

As you have been giving so much formula you must let the baby work to build up your supply - this means that you will need to do lots of breastfeeding for the next few days. Increasing your supply is like putting in an order - it takes a few days to deliver. Usually mothers see evidence of more milk within three to four days. If your baby is getting fussy because of the slow flow try the breast compression and swap nursing. (See my post on http://www.geobaby.com/forum/thread130181-2.html)

Please feel free to call me anytime. If I'm out leave a message on the answer machine and I'll call you back when I return home. (Please repeat your telephone number on the answer machine - it makes it easier for me to get it right!) My number is (+852) 2548-7636 and email is [email protected]

Best wishes,
SARAH
 
one more thing. I notice that if i'm trying to build up my supply, i need to drink loads of fluid, like minimum 3 litres of fluid (water, soup) each day.
 
Thank you ladies. I think I have been drinking quite a lot of fluid although I am not keeping account of how much exactly.
 
also, it actually doesn't sound like you don't have enough milk, especially if you're leaking into several breast pads a day. When you leak into the breast pads, do you feel the let-down (that's when the milk comes out in gushes). do you feel the same let down when your son nurses?

if your bb falls alseep on the breast, how long has he been feeding?

if he wakes up crying, maybe he has wind in his tummy, that's what happen to my girls. try to burp him after he wakes up from the scream. if he's still screaming, put him tummy down on your lap, & sway him side to side. if he calms down after you put him tummy-down, that means he has tummy pains. (usually wind) then sway until he calm enough for you to change position (maybe even 5 mins), pay close attention to if he has small burps. if he still cries after you change position, feel his tummy if it's cold, he has wind. then rub some olive oil (need thick oil) vigorously between your palms to heat up & put your palm on his belly button. rub your palms again if your hand not hot anymore. funnily enough, it works.

i also notice that when my bb woke up crying (she's now 3 mths old) after a feed, & then i'd think she still wants milk, so i give her breast or bottle, she'd suck for a bit & turn her head & cry & suck & cry, this means she's tired but want to suck, that's when a pacifier comes in handy.

pacifier are useful especially for baby is cries a lot. but use with precaution, make sure your bb fed, diaper changed & well burped before using.

(oops, bb wake up now. will post more suggestions later)
 
Hi Carey, I am actually wondering if your let down is too strong that your baby is not able to suck on it. I had something similar happen- my son would cry every time I put him on the breast and he would keep coming off and on again and again while getting very upset. I thought my milk supply and let down was down/ slow... and I was leaking into my breast pads quite a lot. Then my friend mentioned that she was having the same issue and she would express a little bit before feeding the baby so that the let down is more convenient for the baby. It worked wonders for me.
 
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