Lots of normal (I think) breastfeeding issues for this first time mom. Help!

[earlyworm]

I just had a baby!  Yay!  He is six weeks old, and doing well.  He has plenty of wet diapers, yellow poops, and he has lots of happy quiet alert time throughout the day (and some screaming!).  So I *know* that he is getting enough to eat, but I am still weirded out a bit.  I've contacted local La Leche League leaders, but no one has called me back so far, so I'm hoping some of your voices of experience will chime in on this question.  :)  

Once he hit the two week mark, he quit doing long (10-20 minute) nursing sessions, and now he is all over the place.  He does a lot of 3 or 5 minute nursing sessions every hour, which is fine with me.  The problem is that he sometimes will go for as long as 6 hours without eating.  When I offer my breast, he screams and will not latch.  He also has a few sessions per day where he will fuss so much at the breast that I wonder if he is getting anything at all.  During these feeds he will latch on, suck once or twice and then pull off screaming.  He sometimes coughs or gags like he's drowning in milk too, but I don't think I have a super crazy let down.  It never sprays when he pulls off, just 'pours' sometimes.  Sometimes he pulls off and screams even when there's no milk coming out yet.  It's been like this for four weeks now, so I am pretty much ruling out a growth spurt as the cause.  

He only ever eats on one breast per feeding, and it's usually just for around 5 minutes.  It makes me nervous because everything I read says 10 to 20 minutes is more normal.  

Does this sound like reflux or heavy letdown?  Or is it just that he's fussy and that he'll grow out of it at some point?  I've had friends tell me to put him on a 'soft schedule' where I only offer every two hours.  They think that maybe he's frustrated that he's not got any 'structure' and that an every two hour mealtime will make it so that he's actually interested in eating by the time it rolls around.  I am not so hot on that idea myself, but what does anyone think?  I think his frequent snacky meals are either to do with some kind of discomfort he's having at the breast, or just a preference for frequent meals that he has.  I'm more worried about his screaming during meals.  

I have a feeling that this is all pretty run-of-the-mill stuff, but I am stressed out about it, and worried that I'm doing something (or not doing something) that is making feeding time more stressful for my baby too.  

Any words of advice are much appreciated!  

[ElliesMomma]

do you hear swallows when he nurses? there should be a pattern of sucking and swallowing -- that's how you know he's nursing. is he exclusively breastfed? if yes, and there's lots of wet / poopy diapers, then you can feel assured he is nursing well. but i don't think 5 minutes every six hours is enough probably. 

are you nursing in a quiet undistracted location? have you tried side lying with him -- and just giving him all kinds of time to nurse one side, then the other? when he's had enough that way, turn to your other side and bring baby with you, and give him both breasts in turn again, a brand new angle.

do NOT put him on any kind of a schedule. that would be the beginning of the end of on demand nursing. you want to encourage him to WANT it more often. try a nursing vacation, where you lie in bed with him ALL DAY with your shirt off. (also works on the couch). you can sleep together all day, or you can watch some TV or try to read a book or magazine. the point is to give him unfettered access to your breasts for extended hours. he's young at 6 weeks. you want him latching on every 2 hours or so and taking at least a good 20 minutes. some people only give one breast at a time, i always gave both, but mine were always low weight and slow gainers, so i was always "pushing" the milk.

from what it sounds like to me, the main thing is giving your boy lots of time to just be with you and your bare breasts, and relax. hopefully other people will have more advice.

good luck and keep at it!

[EllisH]

I can only comment on the amount of time per feeding: my baby boy (now 11,5 weeks) also only fed 5-10 minutes at a time, but quite frequently, from 2 weeks on (as of recently, he's nursing for longer stretches). I was told very early on by a lactation consultant that he was a 'snacker' and needed to nurse for 20 minutes at least.  But he was gaining weight well - very well, in fact, his growth curve was steep and way up there.  It turned out I just have abundant supply and strong let-down and he can drink very fast (we saw this with a bottle), so he just didn't need to nurse for as long.  I also never 'spray' and hardly ever even drip milk, but I can tell when pumping that my milk comes out very fast and my son also gags occasionally (it may help to hand express briefly in a cup after the initial letdown to deal with the strongest flow).  He also has some reflux, so I think his shorter, but more frequent nursing is his way of dealing with that.

You do want to make sure he is getting enough to eat.  Besides the diapers, you may also want to keep an eye on his weight for a while.  

Six hours without eating during the day seems a long time to me (is he refusing to latch even after such a long stretch?).

[konayossie]

I have no personal experience with heavy let-down, but major experience with a reflux-y babe, and I'm guessing it's let-down. 

What makes me think that is the coughing & sputtering and the fact that he's so quickly satisfied (and that he's gaining well). I don't know how typical I am, but my milk would never freely "run"--it was always just a trickle if it wasn't being sucked out by my baby. So, to me, "running" sounds pretty heavy, certainly heavy enough to be difficult for a newborn to swallow quickly.

My personal experience with reflux was that it made my baby feed MORE frequently than most. He wanted to be on the boob constantly as the nursing was the only thing that could soothe his burning esophagus and provided emotional comfort. He constantly spit up. He couldn't sleep, and he was almost never "happy." He spent most of his first 5 months either nursing or screaming. I have heard of babies that go the other direction--associating the nursing with pain and so refusing, but I would think those babies would tend to not gain well b/c of that.

Hope you get a call back soon from someone who can help put your mind at ease!

[anjsmama]

My oversupply/forceful letdown had DD doing VERY similar things to what you're describing when she was between 2-7 weeks (she's now 11 weeks). The quick fill up (and very fast weight gain I might add!) would have her full after 5-6 minutes or so and she'd sometimes cough, and sometimes cough and pass gas at the same time. I found that a lot of that resistance from her (fussing, pulling on and off, screaming at breast, refusing breast, etc) was caused by belly pain from gas. If the screaming is accompanied by a very tight feeling in his belly, that could be an issue. I think the gas was caused by excess foremilk and very fast swallowing. For awhile, I would burp her 4 times per feeding (yeah... 4 times per 7-minute feeding... lol!) to keep it under control. I also lifted her feet to help her pass gas. After switching to one-breast-per-feeding and cutting pumping (for us, it was just creating TOO MUCH milk!), my supply leveled and letdown became manageable, and her gas went away. 

Since then, her nursing sessions are typically 10ish minutes and every 2 or 3 hours during the day, then she sleeps 4 or 5 hours at a time at night.. but her night feedings are also more like 15 minutes. I think she just eats very quickly because that's how she learned to handle that quick letdown. It's nothing like it used to be, and I only burp her once during the feeding and once afterwards now. I haven't had anymore problems with fussing/fighting at the breast (except when she gets overstimulated... like a PP mentioned, quiet, undistracted spots for nursing are best, especially in the beginning). I also don't leak or spray anymore.

Also - try your best to avoid advice about "moving" feedings in any way - baby knows when it's time to eat! DD's pedi told me at her 2 week check that she needed to eat more often, and then at 2 months he was mad about how big she is (12 lb 8 oz) and wanted me to space out her feedings.. go figure. They call it "on demand" for a reason, and babies inherently know what their bodies need!

BTW - Congratulations! And you're doing great mama! I remember the stress/exhaustion when DD was fighting feedings all the time in the early weeks... this too shall pass. 

[earlyworm]

Thanks for all the advice!  

I did end up trying a 'nursing vacation' the other day and that seemed to work really well.  I sat in our rocker topless for a few hours, and when we were up and about, I made sure to offer him the breast every 30 minutes or so.  He seemed a lot calmer when he got to really snack through the day.  He only had one fussy feeding that day in the evening.  I don't know that we can keep that up (with real life interfering and all that!) but hopefully just offering more frequently is going to be helpful.  

I should also mention that his weight gain is right on track, and that he was 11 pounds at birth!  So he is a big guy and probably is getting plenty of milk in those short feedings he does.  I pumped the other day and in literally 2 minutes 30 seconds on each breast, I got 5 oz total.  I was told at the La Leche League meeting I went to that getting that amount of milk in so short a time is an indication that we might be dealing with heavy/fast letdown, as some of you mentioned.  

His six hour feeding strikes have only happened 3 or 4 times, so it's not an everyday thing, just a VERY long time for a baby to go without eating, so it worried me.  He hasn't done it in a few days now.  Hopefully that's over with.  

Thank you so much for the encouragement.  As my mom told me the other day, by the time I figure this out, he'll be doing something completely different!  :)