Breastfeeding issues at 4 months

S

Suv

Registered User
Hi
My issues are not very drastic but they are just annoying. I am hoping someone can shed some light on them. LLL Sarah?

1. I have lopsided milk production. I have been trying suggestions from kellymom. I think the production has increased significantly(baby's mouth is full of milk and is gulping) in the right breast (the one with low production, bad latch and a nipple crack) but the baby has become extremely fussy and keeps pulling off at the breast for the past 3 days (earlier, he would just suck at it patiently). So now I have started getting lumps in this breast again. I have tried expressing and hardly anything comes out, Like 0.5 oz or sometimes nothing. My other left breast used to have oversupply but now it has subsided and the baby has also become efficient. And now I am having trouble expressing from this one too.

About the bad latch.... when I get him to latch on well, he pulls and pulls till the latch becomes bad. So I have resorted to the uncomfortable football hold, where he latches on pretty well but is still fussy and my back is shot!

2. Baby has a good feed at 3:30am but hardly has any feed at 7am. Sucks for 5 min. and then gets interested in other things like smiling at me and looking around. Yesterday at his next feed at 11am, he only had 3oz. The only good feeds (over 20min) he has are his dream feed and 3:30am feed. These are the times when he goes right back to sleep, no problem there. He is put down at 7pm and I wake him up at 7am and he normally sleeps pretty well.

Thanks.

Suv
 
Try massaging the lumps with a cold coke can and then expressing. It worked wonders for me even though it hurts to do.
 
My baby is 4 months old too. She NEVER feeds for 20 minutes! Usually only 10-15 min every 3 hrs or so. But apparently, babies eat at different paces - so LLL usually tell you to count the wet and dirty diapers and also to make sure that the baby is putting on weight. And if those two things are ok, then it doesn't really matter how often and how long your baby eats for, because they are getting everything that they need!

I had a blocked duct for the first time today and I read that heat pads help to "dissolve" the lumps or something - so I improvised and put one on the lump for half an hour, then tried pumping, and I was amazed at how quickly it got rid of the lump!! (too much information, I know! Sorry!!)
 
Dear Suv,

It would be much easier for us to talk on the telephone, my number is 2548-7636.

It is actually quite difficult to understand what is happening with your baby and I need to ask loads of questions to do so. Doing this on the forum will sound like 20 questions!

But can you explain to me why you think the latch is bad? Are you still in pain when the baby feeds? Do you still have sore nipples or have they healed now?

For breastfeeding to work both the mother and the baby need to be comfortable. If the mother is uncomfortable, say with sore nipples, then it is she who initiates a change of position. If the baby is uncomfortable then he initiates a change of position and usually he does this by pulling off.

As you baby is now four months old he should know how to breastfeed. Try lying on your back, reclining on pillows with the baby lying on top of you and let the baby do all the work of latching. This is actually the most natural way to breastfeed and usually the baby will get into a position where both you and he are comfortable.

It is really common for one breast to have more milk than the other. For most mothers this is the right breast but for about 10% of mothers it is the left breast. Unless you are very upset about looking lopsided it doesn't really matter.

Don't worry about how much milk you can pump - it is always less than the amount the baby will drink when he directly breastfeeding. Kellymom.com will have suggestions on how to increase the amount you can pump if you need to be separated from the baby.

As Nicolejoy mentioned it is really common for babies to reduce their feeding time down to 5 to 10 minutes by four months. And also very normal for babies to get very distracted around this time. It is a time when breastfeeding in public can be very trying because the baby wants to watch everyone else more than he wants to feed - even if your breasts are saying that the baby needs to feed now! I found churches a good place to feed when out and about - dark and quiet and nothing for the baby to get interested in.

Best wishes,
SARAH
 
Hi Suv,
My baby is 4 months too. I'm going to leave the first part of your question to the lactation experts but I am very interested in the second part of your question because my guy is doing the same thing!

I think this is because he has gotten into a bad pattern where his big feeding gap is between 4am and 10:30/11am and not between 11pm and 6/7am when it should be. My problem is that I have identified this problem but am at a loss for what to do about it. I have tried feeding him less at 4am but then he just cries and cries because he is so hungry so I HAVE TO feed him. This puts him off his 7am feed and so the vicious circle never ends. Anybody have any suggestions for how to break this cycle?

Thanks!
 
Thanks, Nicolejoy and everyone! Yes, the baby has become quite efficient but there are feeds (generally night ones) where I feel he is sucking full on and both breasts together are about 15-20min. Agreed he is sleepy but I can feel the milk being drawn out. Perhaps at night there are no distractions. LLL Sarah, Yvonne Heavyside is coming to weigh the baby and she will see the baby feed as well. My nipple has healed but it gets white on one side and having read kellymom, it is called blanching- an indication of poor latch? Thats why I have been trying the football hold and he latches on great, but still keeps pulling off and my back has started to hurt in the process. I will give you a call later today.

On my mother and grandmother's suggestion- this is normal practice back home.... 2 days in a row I have given him cooled boiled water for the middle of the night feed, Alicat. He was not happy and till 5am (my deadline and about 7hrs from last 20 min good feed at 10:30pm) was either crying or drifting in and out of sleep. He had a pretty good feed at 5am and at 7am, there is a change between the 2 days. It is a tough thing to do to see them cry and for someone who has been against CIO till now, I feel like a closet CIO fan. I decided the 7hr gap is because normally he feeds at 6pm and wakes up again around 1:30am. I will keep you posted on what YH says too.
 
Hi Suv,
I've tried the bolied water thing too but he screams blue murder! The last couple of nights, my husband has been rocking him to sleep so he doesn't smell me. He's now eating better at 6 / 7am but still waking up at 4am. Will give it a couple more days to see if he fills up in the day or decides that it's not worth waking up at 4. Will keep you posted too.
 
Hi Alicat,
YH said offering water is no problem as they should be able to sleep through once over 5kgs. However, babies who are on a lower percentile which my son is(>25%), they might need a middle of the night feed till they are about 6 months. Its too bad that your son is not taking to water. It took mine a couple of days but now he is fine with it. My son is still waking up a lot- it has left me wondering if it is due to a growth spurt. The moment I feel I might have figured it out, it changes. Sigh.....
6pm last evening Great feed
9:15pm up screaming and wouldn't be calmed down till I fed him, he had a great feed
12:15am. I offered him water, so he settled a bit; but within the next 15-20 min he had woken up twice so I figured he was hungry and he again had a pretty good feed.
3:45am Offered water. Settled after 20 min of rocking.
5:15am rocked to sleep, no water offered.
7:00am Fantastic feed!
He is feeding much better during the day, so having read whatever there is out to read, that he is still getting up due to habit.

LLLSarah, in front of YH he showed her a perfect latch on the boob that I had been complaining about- Of course!! Since his feeds during the day became better, his latch has magically improved!
 
While it is true that many babies are able to sleep through the night once they reach 12 lbs or are six months old this isn't true for all babies. Rather than taking a general rule and assuming that your baby is capable of something because most babies are at that age it is better to look at your own baby and see what he can manage.

Research shows that babies actually wake up for many months. It was found that around 50% of babies are still waking up at 6 months. And at 12 months - but it isn't exactly the same 50%. Some who were waking have started sleeping through and some that were sleeping through have started to wake!

If there is any issue with weight gain then night feeds shouldn't be stopped as this is the best way to get more food into your baby. Often babies feed with much less distractions at night so although you are waken up to feed the baby it is only a ten minute job before you are both back to sleep again.

Remember that it is only our western culture that demands babies to sleep for such long stretches of time without feeding. Some babies can manage this and some can't. It is actually healthy for babies to wake up and feed in the middle of the night!

I'm not writing this to tell everyone to wake their babies to feed in the middle of the night but rather suugesting you not to get upset if your baby can't manage the long stretches of sleep our culture expects. It doesn't mean that there is something wrong with your baby or with the way you are parenting him. It is just nature. He will manage to sleep longer as he grows.

Best wishes and sleep well,
SARAH
 
LLLSarah, Why is it healthy to eat in the middle of the night? I don't quite get it.

Frankly, I have no problem feeding at night because from the time he wakes up to the time I am back in bed is 15min, max 20 min and we both go to sleep fairly quickly. I was thinking more on the lines of that- I would like him to feed well during the day and get full night's rest instead of having to wake up with a growling stomach.
 
Dear Suv,

Maybe I should say it is not unhealthy for a baby to wake up. I know mothers worry if they baby will get enough sleep but babies are great at cat napping - it is very unlikely he won't get enough sleep - just that he gets it when you aren't able to benefit by getting sleep too.

When a baby is still inside you he is getting food constantly. At birth the baby needs to change from getting his food constantly to getting it in fits and starts. Our culture tells us that large feeds with large gaps is the right way to do this. Other cultures (and I might add cultures that don't have so many problems breastfeeding) let the baby have lots of small feeds. Studies on the Kung! have shown that their babies feed for about 20 seconds on average every 11 minutes, day and night. There is no right or wrong way to breastfeed - so long as your baby is gaining well and is happy and healthy.

Many babies, however, are not able to manage the long gaps between feeds that our culture expects of them. There is a very good article by Dr. Katherine Dettwyler
at http://www.kathydettwyler.org/detsleepthrough.html

Generally as a baby grows he is able to drink more at each feed and thus requires less feeds in every 24 hours. Some babies, however, prefer to continue with lots of small feeds and still grow well.

There is another lovely article called Wakeful 4 Month Olds by Jan Barger RN, IBCLC at http://www.kellymom.com/parenting/sleep/4mo-sleep.html which explains well why many four month old need to feed at night.

Likewise many mothers body's are not all able to cope with the long gaps either. One very important factor on the mother's side is something called breast capacity. This is the amount of milk a mother can hold in her breasts at any one time. Some mothers have a large capacity and others have a small capacity. The size of your breast capacity makes no difference to the amount of milk you can make but it does make a difference to the amount the baby can eat at one time.

A mother with a large capacity, say over 4oz, will only need to feed her baby 7 times to get the required 28 ozs. Whereas a mother will a smaller capacity, of say, 2.5 oz, will need to feed her baby 11 times to get the same amount of milk into the baby. For this baby he will still need to have 11 feeds every day until he is quite old and eating lots of solids. It can be difficult to get all the 11 feeds in during the day and so this baby is likely to continue to wake up for feeds at night. This waking up is more than healthy as without it the baby wouldn't get enough milk.

It is estimated that over 50% of babies at 12 months still wake up at night. I know that there can be many reasons for waking up at night but I don't think we should rule out hunger. If the baby is really drinking in the middle of the night it shows that food was needed. As a baby who isn't hungry will play with the mother and nipple, might even bite, but is unlikely to feed well. You can see this in babies that are weaning - they will have a couple of mouthfuls and then turn over and go back to sleep.

I'd also like to add a comment about fore milk and hind milk. Many mothers in our culture worry about this and want their babies to feed for at least 30 minutes in order to get the hind milk. But studies show that babies that feed with lots of small feeds actually get more fat in the milk than babies which feed with long intervals.

This is because it is not the length of the feed that indicates the amount of hind milk but rather how full your breasts are. When your breasts are full you have lots of fore milk, when they are emptying (notice that the breast can never be empty - it is a manufacturing unit not a storage unit!) then there is more hind milk. So for the mothers who are worried that they don't have much milk in the afternoon remember that every mouthful the baby takes when your breasts are emptying has more calories than when you feel full.

Best wishes,
SARAH
 
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Wow Sarah, thank you so much for your detailed post. You have provided answers to many questions I have been pondering like breast capacity and fore and hind milk. Like the moms you mention, I always think my baby is getting more to eat when my breasts are full. How interesting to read that this is not necessarily true.

Suv, I think I might have cracked it. Famous last words? Last Thursday, I started to not feed at 4am when my baby woke up and my husband held him until he fell asleep. We were going to give it until after the weekend and if it didn't work we would go back to feeding at 4am because there was no way poor hubby could hold bubs for an hour every night indefinitely. Then a major breakthrough -- on Saturday night, bubs woke up at 4 as usual, but before we got to him, he had put himself back to sleep! On Sunday night, he didn't even stir and now, he has been sleeping through until 7am all week. He is still not eating great first thing in the morning which I find strange because the last time he ate was between 10:30 and 11:30pm the night before. Surely he must be hungry? Sarah? Any thoughts?
 
Dear Alicat,

Your baby is four months old and I'm assuming growing well a you haven't mentioned that you are worried about this. He knows how to breastfeed and he knows how to ask you for a feed and all you have to do is trust him.

You can leave him to tell you when he is hungry and wants food and when he isn't and doesn't (sleeping contentedly is him telling you he is fine and doesn't need food at this moment.)

The only thing I'd caution is that just because he isn't hungry today in the middle of the night doesn't mean that when he wakes up tomorrow that he isn't hungry. Think about it in adult terms. If you made dinner for your husband and he ate it and went to bed happy one day would you tell the next day when he suggests a bit of supper after dinner that he managed without it yesterday so he can mange without it today?

Best wishes,
SARAH
 
Thanks Sarah. Sorry, I think I was unclear in my last post -- bubs is CONSISTENTLY not hungry at 7am. In fact, he only drinks from one breast most feeds(around 120mls) and even then it takes a fair amount of coaxing. He seems to feed much better when he is sleepy. His best feeds are 6pm before he goes to bed at 7pm and the 10:30pm dream feed.

His weight gain is fine (1kg per month) and I am not worried as he is generally a very happy baby, just curious.
 
Alicat, I just started sleep training my son a week and a half ago as I was rocking him to sleep on my lap. Putting him to sleep was killing my back and I was really really sleep deprived and succumbed to flu. It was taking me anywhere from 0.5-2 hrs to transfer him to his crib.

First day of sleep training, l and behold...... he never woke up for the middle of the night feed. 2 days later he was up at 4am, whined for 8 min and went back to sleep till 7:15am, again ready for a full feed!

I have become so used to responding to every peep out of him and getting up in the middle of the night, I am still a little sleep deprived... now I need sleep training!! LOL!!
 
LOL.....I am also training myself to sleep as I would immediatly respond to every peep and realized that if I waited, most of the time, my baby would fall back to sleep. The wake ups went from about 5 to 6 a night down to 1 to 2.
 
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