refusing to nurse, weight loss and dehydration in 3 m.o.

[haleyelianasmom]

My baby will have days (or couple day stretches) where she'll refuse to eat for hours at a time.  The other day she just kept screaming and arching and refusing to nurse to the point that she actually had a small amount of brick dust in her diaper and when I weighed her, she was a few ounces LESS than what she was the week before.

Things I've noticed:

- She seems picky about where she nurses.  Quite often she won't eat at all if we're out for a couple hours.  She seems better at eating in the rocking chair and best in bed.  However, she has had exceptions to this, having a couple days in which she nursed while out and days where she won't even nurse well in her usual favorite spots.

- Some days are dramatically worse than others.  I noticed recently that the last 2 or 3 times I've had pasta have been followed by very bad days which is why I suspected it could be food related.  Also, occasionally her bad days fall on days when we're out a lot.

- Her weight gain is slow.  My first daughter was a big baby and a constant nurser, but I was small as a baby so she could be following my growth curve.  At over 3 months, she's not quite 11.5 pounds

- She will take a pacifier, but generally refuses bottles.  I do work on an extremely part-time basis (generally only gone 3-4 hours a week, though it has a couple times been more) So I will leave bottles of pumped milk when I'm out and pacifiers.  She usually does not like the bottle.  I've also tried giving her pumped milk when she is refusing to nurse just so she'll have something in her tummy.  She usually only gets pacifiers when nursing isn't an option (in the car or if we're in the middle of a grocery store) or when all else fails (like when she refuses to nurse but is very upset).

- She sleeps very well and nurses better at night.  Recently she has been nursing a couple times in the night and a couple times when falling asleep for the night.  She generally doesn't cry or fully awaken at night and with the exception of waking just enough to eat will stay asleep for a good 12 hours.

- Sometimes she stops crying when I stop trying to feed her.  And sometimes she's happier on the floor than in my arms.

- She is gassy. Especially on her bad days

- Her skin is great.  No rashes/diaper rash/eczema When she was about 1-3 weeks old she had a bad break-out on her face, probably some sort of baby acne.  Shad diaper rashes in the first month or so, but has been great since.  The only thing she has had is a small rash on her cheek, but it only lasted a day and has only happened a couple times.  I'm guessing from sleeping in a small puddle of breastmilk at night.

- She chokes on the milk regularly.  She does this when family member attempt to give her the bottle (which, like I said is maybe once or twice a week TOPS) as well as when she nurses.  Especially happens when she's fussy.

- She has been having bad days maybe 1-2 times a week.  Her better days are a bit more fussy, but she eats better and gains back the weight she lost on her bad day, so overall she is still gaining weight, just slowly.  Fow example, she was 11-7 last week, dropped to 11-3 on her bad day 2 days ago, and is now back to 11-7.  She is never perfect with eating and even on a good day will fuss a bit with some feedings.

- No vomiting. She used to projectile vomit, but infrequently and she hasn't done so in at least a month.

Things I've tried:

- I've been staying dairy-free

- She sleeps next to me and usually nurses better at night

- She has been to the chiropractor a couple times for adjustments

- She has been on probiotics (reuteri and cuturelle) for many weeks

- Swaying/rocking while nursing her occasionally help her latch on, but not always.

Edited by haleyelianasmom - 11/15/10 at 12:36pm

[Marissamom]

food-related sounds really plausible. was there anything on the pasta? tomato can be an allergy, as can wheat and dairy. I would keep a food diary, because she could also have a less common allergy. 

[haleyelianasmom]

Just a tomato sauce with onions, garlic, olives, and spices in the sauce...  Tomatoes and garlic have crossed my mind.  I'm going to try a food diary

[AE+Mama]

A food diary definitely helped me figure out my older DD's allergies.   Some things to consider:

* Often babies who can't tolerate dairy also have trouble with soy.  Tomatoes and other highly acidic foods like citrus fruits can also cause problems. 

* Is milk supply an issue?  Some babies get overwhelmed by a too fast let down.  Other babies get frustrated when the supply is too low and there is not enough milk coming out.  

*Is there some place where you have access to a good baby scale or can rent one?  If she isn't gaining weight, it may be helpful to do a pre and post nursing weight check (if she will nurse!) to see how much she is taking.

*Could she posibly silent reflux?  Not likely if she is sleeping so well at night, but a posibility. 

[haleyelianasmom]

Thanks for the ideas, AE+Mama.  We are borrowing a baby scale currently and I weighed her today.  She's back to the weight she was a week ago and seems hydrated now, but was fussy today.

Do acidic foods actually change the pH of breastmilk?  I was wondering this because then that could explain the fussiness after pasta.  I don't know whether she has an issue with dairy or not, but it was the first thing I wanted to try.  I may have to try soy, too.

I think my supply is okay.  i do think let-down has been an issue, but as far as the amount of milk... I think it seems okay.  I will notice a difference in how much she's eating, though, because she'll have a few days of eating great and then will switch to her fussy refusing to eat day and I've had to pump just because I'm so full!  So I don't think it would be undersupply nor oversupply, but it's something to watch for.  She does still choke on the milk regularly even though I feel like my let down has slowed down.

I've thought about reflux, but I am baffled by how great she does at night.  Very confusing!

[hasya]

Sorry to hear about your troubles. DD did it too sometimes. Not going days, but it was very frustrating. I found her not reacting too well to pasta with tomatoes, garlic, olive oil. I think garlic may have been the culprit. She seems fine with less garlic. Also, citrus in moderation seems fine but not too much. I had started giving her tummy time before nursing her to get gas out. That seemed to help too. Massage helped. HTH.

[haleyelianasmom]

Hmmm, I'm almost tempted to go get some pH strips and see if my breastmilk is altered if I eat tomatoes or citrus...  Interesting that you noticed that.

[painefaria]

do her probiotics have a dairy base?

[haleyelianasmom]

Originally Posted by painefaria 

do her probiotics have a dairy base?

The culterelle is dairy-free.  The reuteri says it may contain traces of residual dairy and soy.  I figured the amount was probably small enough that the benefits could outweigh the risks.

[MacKinnon]

Moved to main Breastfeeding forum per guidelines

Best luck figuring everything out Mama! We're looking at reflux for similar issues.

[PatioGardener]

Haven't had time to read the replies, so this may be repeated...

sounds very much like reflux to me.  Have you read kellymom? http://www.kellymom.com/bf/supply/fast-letdown.html for overactive let down (spluttering at breast) and http://www.kellymom.com/babyconcerns/reflux.html for reflux for a start.  She talks about dairy and soy sensitivities and fast let down all as adding to reflux.

[haleyelianasmom]

Originally Posted by PatioGardener 

Haven't had time to read the replies, so this may be repeated...

sounds very much like reflux to me.  Have you read kellymom? http://www.kellymom.com/bf/supply/fast-letdown.html for overactive let down (spluttering at breast) and http://www.kellymom.com/babyconcerns/reflux.html for reflux for a start.  She talks about dairy and soy sensitivities and fast let down all as adding to reflux.

Thanks.  I've looked at their forceful letdown info and I tried block feeding, but A wasn't gaining weight as well as I expected.

The past couple days I've been soy-free and gluten-free in addition to already being dairy-free.  She's been fussy, but actually eating which is a start.  She even ate while we wereout at a friend's house a few times which is big for her.

I do notice mucous in her poop as well.  I inspected the diapers yesterday more carefully ;)

Thanks for the reflux info!

[PatioGardener]

My guy arched when eating for a week before his reflux diagnosis.  I did all the non-medication things, and still had to put him on reflux medication.  The results were astounding - totally different baby.  He takes Prevacid twice a day.

Hope you get answers soon!

[hasya]

Oh this mucous thing - I am working on only dairy I consume is home-made yogurt theory with M. Seems to be working.

[sahmmie]

Reflux babies often nurse better at night or when groggy/half asleep; probably because they are less aware of their discomfort and have less energy and resolve to fight the feedings. I had two reflux babies, so I've been there. In the "reflux world" this is referred to as "sleep feeding." In some babies it gets so bad that they never eat when awake. My son developed a full blown feeding aversion due to reflux and my daughter had to be swaddled and walked while feeding. It was a nightmare. 

Anyway, if the problem continues, I'd strongly consider reflux and maybe some meds to give her some relief. You can read lots about infant reflux at www.infantreflux.org 

[haleyelianasmom]

Thanks for all the info.  That definitely sounds like Amaryn... BUT, the part that makes me think it is related to what I'm eating is now in the past 4 or 5 days she has been eating wonderfully during the day, even while out (she ate twice while at LLL the other day and that's big for her).  I've been sticking to my gluten-free soy-free vegan diet this week.  She does have a bit of a cold, but she has been putting on weight and eating lots!  I just hope she stays this way and I will happily stay off everything :)

Possibly unrelated, but her poop looks less green now, though still mucousy ( but like I said, she's stuffy so it might be that)  AND she has been pooping a LOT.  The other night I gave her FIVE baths because she pooped in the first 4.

Reaelly hoping she stays this way as she had days that were worse and better before I made this diet change, too.

[PatioGardener]

totally off topic to say I love the name Amaryn! 

[haleyelianasmom]

Thank you!  I loved it when I first heard it, too... and used it a few years later :)
 

Originally Posted by PatioGardener 

totally off topic to say I love the name Amaryn! 

[Marissamom]

Originally Posted by haleyelianasmom 

Thanks for all the info.  That definitely sounds like Amaryn... BUT, the part that makes me think it is related to what I'm eating is now in the past 4 or 5 days she has been eating wonderfully during the day, even while out (she ate twice while at LLL the other day and that's big for her).  I've been sticking to my gluten-free soy-free vegan diet this week.  She does have a bit of a cold, but she has been putting on weight and eating lots!  I just hope she stays this way and I will happily stay off everything :)

Possibly unrelated, but her poop looks less green now, though still mucousy ( but like I said, she's stuffy so it might be that)  AND she has been pooping a LOT.  The other night I gave her FIVE baths because she pooped in the first 4.

Reaelly hoping she stays this way as she had days that were worse and better before I made this diet change, too.

if it's less green she's getting more fats, so probably nursing a little longer. and sometimes food sensitivities can mimic reflux. keeping my fingers crossed for you that things stay better with your diet changes. 

[sahmmie]

Yes, food sensitivities can mimic reflux and reflux can even be caused or exacerbated by food sensitivities. Sounds like your getting it all figured out! Glad to hear she's eating and feeling better.

I love the name Amaryn too! Very pretty!