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Twisting and frantic rooting, but no sucking?

post #1 of 19
Thread Starter 

Hi, just registered - I came to this forum when I was looking for answers and didn't have anyone to turn to. You've already been very helpful!

 

I am nursing a 7wo and - he's doing something odd, and I just can't figure out what exactly is going on. He is growing well, and having plenty of wet diapers, but I am just puzzled.

 

I can get him to latch on well at first, and then he sucks well. But then I have letdown, usually within thirty seconds, and it is definitely "overactive". And it kinda hurts, like charley-horse cramp sort of hurt. Sometimes he coughs and sputters when letdown happens, but lately he seems to be better at managing it. He sucks for a few more minutes, but then he starts grunting and twisting his head, usually turning his head further towards my armpit (I always do cradle hold). This hurts, a lot, so I take him off, which makes him mad, and then try to put him back on, thinking that he just needs a new position, but no matter how much jostle and try to "reset" our positions, when I get him back on he starts turning his head again. Other times, I try to put him on, and he'll open his mouth wide and move it back and forth over the nipple frantically, but won't actually start sucking. If I do get him on (usually by stuffing his mouth full) he takes up "chewing" more than sucking. That hurts as much as the twisting. So I usually take him off. But then he gets mad, and take up his "I'm hungry" dance (panting and flailing arms). If I distract him somehow he usually forgets about his hungry-dance. But, even with all this drama, he doesn't nurse for longer than 10 minutes. I "think" he is getting enough, but I worry about stopping so soon, even though he's not really sucking.

 

Sorry, I think there is couple different issues here. To recap:

1) I have overactive letdown

2) Only occasionally coughing during letdown

3) After nursing for a few minutes he twists head/doesn't latch/chews 

4) Acts like he is still hungry when I take him off - gets mad when he realizes that I've "closed up shop" - but usually gets over it.

 

 

Oh, and I sometimes nurse him with a "break" by sitting him on my lap when he starts "fooling around" and sometimes he burps, or passes gas. Sometimes not.

 

Like I said, he seems to have enough wet diapers. But I am still feeding him very often. Like, every 2 hours sometimes. All of this is taking a toll on my nipples. What is going on? Is there anything I can do make nursing simply blissful?

post #2 of 19

Is your milk still flowing when he is doing the twisting? I wonder if he is trying to get a 2nd let down? I am sorry you are going through that.

post #3 of 19

Also, every 2 hours doesn't seem too often for a 7 week old.  My 9 month old still nurses every 2-3 hours all day and night.  

post #4 of 19
Thread Starter 
Quote:
Originally Posted by Chloe'sMama View Post
 

Is your milk still flowing when he is doing the twisting? I wonder if he is trying to get a 2nd let down? I am sorry you are going through that.

 

I'm not very good at hand-expressing, but I feel empty. Sometimes some milk does come out, and then I usually can get him to nurse for a few more minutes. Just now when I was nursing him he started his twisting, and then fussed and did some frustrated crying and beating his fist on my chest while latched on. I took him off, which made him cry, and switched him to the other side. After nursing there he seems to have gotten enough - for now. I've never had a second let down I don't think.

 

Quote:
Originally Posted by Chloe'sMama View Post
 

Also, every 2 hours doesn't seem too often for a 7 week old.  My 9 month old still nurses every 2-3 hours all day and night.  

 

Sometimes at night he'll go for about 5 hours (midnight to 5am), so it seems he should be able to go for at least three hours during the day. I'm just wondering if he is used to "easy" milk because of my overactive letdown, and loses patience when it slows down. Also, a few weeks ago he was very gassy and had green poo, so I did some blocking (usually just feeding twice at the same breast each session). I'm hoping I didn't mess up my supply with that. I feed him when he's hungry, but between the crazy letdown and the twisting/chewing drama I don't comfort nurse - it's better he uses a pacifier as his chew toy when he's tired rather than my nipples, imo. But with how quickly he'll finish after letdown (sometimes it's about 5 minutes total) I'm worried about not getting enough stimulation to keep the milk going. Worry, worry, worry, ach. Please tell me I don't have to worry so much.

post #5 of 19

My 5 week old does something similar, but usually just when I put her on my left breast. I worry about my supply on that side because that breast rarely feels full like the right side gets... She seems to be gaining weight, and has lots of wet/poopy diapers, but I just don't know what's up with my left breast :-/ She will nurse contentedly on the left at least half of the time, but gets fussy on it sometimes.. Sometimes I'm aware of a letdown, and can tell she's practically chugging milk, other times I don't notice one, but she still nurses. Does it sound like a supply issue? I'm a ftm and just need to know if I'm worrying over nothing. 

post #6 of 19
Thread Starter 

Dahlia, worrying is so easy, isn't it?

 

Honestly, it may be a supply issue. My boy will cluster feed at night (which I don't mind since then he lets me sleep a good chunk of time) and sometimes when we lay down and do the one-last-side feeding nothing will happen - I don't get letdown and he'll quickly start the twisting and nibbling routine. After a few minutes of me relatching him trying to make something happen, and him banging his fist on my chest, I give up and give him his pacifier and cuddles. Sometimes then he'll sleep for his five hours, but sometimes he'll wake up an hour later asking to nurse again, and then I do get letdown and he'll eat happily.

 

This is actually my second baby, with my first I gave up BF early because of issues - which I now think was probably just because of my overactive letdown. I regret not doing more to work through my issues with #1, so my advice to you is to just keep on doing what you are doing. If your baby feeds happily from your left breast, great. If not, try to have her suckle as long as she will tolerate, and then switch her. I think even the most easy-going baby will Make It Known if they are starving. So if a baby is generally happy and wetting diapers, then there's no need to really worry. I think. But it is frustrating.

post #7 of 19
What you just described is pretty much exactly what's happening with me. She cluster feeds a LOT in the evening, which is typically when she's fussy at the breast, then after a few hours of sleep that breast will have a let down when she eats again.

I've,been trying to get my supply to pick up on that side by starting her feedings on the left and not neglecting that side. I definitely want to bf for at least a year, so hopefully this won't be a big problem. Thanks for the advice!!
post #8 of 19
My baby does this sometimes, too. The best luck I've had is by switching him to the other breast. I think I have a pretty quick let down at first, so even if there is milk remaining in my breast, he'd rather try the other side than work with a slower trickle as the breast he's on empties. On rare occasion we'll go back and forth a couple times.
post #9 of 19

A few things could be going on. Your description of overactive ejection is spot on. There's some management techniques you can try: When the baby starts nursing, try taking him off the breast during the first ejection (let down) of each feeding. Let the ejection flow into a clean cloth diapers or burp rag, when the spraying stops (20 seconds or so, depending) put him back on the breast and let him stay there as long as he likes. Then, use THAT breast for the next 3-4 hours, letting him nurse when ever he likes. When the 3-4 hour period is over, start on the other breast, make sure to take him off the breast during the first ejection, and let him use that breast as often as he wants for 3-4 hours. This helps over active ejection a LOT, even more than 'up hill feeding." Also, the time is not written in stone, if your other breast start getting hard and uncomfortable during the 4 hour block you are using the other one, go ahead and let him use it again take him off the breast during the first ejection and then go back to block feeding on the breast you were using.

 

You'll probably find the ejection is very strong in the early morning, and gets less intense in the afternoon and early evening, to become strong again in the night. This is exepected for OER. (Overactive Ejection Reflex)

 

The head shaking is something babies do to try to center the nipple, but some babies do it when they are frustrated. I see head shaking a LOT in babies who are becoming nipple confused. Is he having any bottles or pacifiers? These could be causing the problem (as well as aggravating your OER.) Or it could just be a frustrated baby because of the OER, using the management techniques should tame your ejection so it should get better if you keep the techniques up in a week or so.

 

Babies whose moms have OER are more susceptible to nipple confusion because their mothers breasts work even less like the bottle in some ways and a bit more like a bottle in others. NO woman's breast really works like a bottle does, all babies have to wait for ejection, but babies whose moms have OER get used to the fast ejection, and often start to like it, then when they are given a bottle, the milk flows easily ALL the time, so when the strong letdown he is waiting for is over, if he's had a bottle (with it's easy flow, similar but not the same as the way some bottles flow) he's going to get more frustrated waiting for the next letdown and getting mad that he has to "work" again to get milk the regular way between ejections. Pacifiers have NO flow, so he could be getting even more frustrated with every different thing put in his mouth. Again the "chewing" behavior could be due to pacifier use, as he can "chew" on it and no one gets hurt. It's different when he tries that on your breast. Don't let him chew on you, take him off when he does this. My guess is, whether he's nipple confused or not, he's frustrated between strong ejections and is trying different things to "make" your breast let down again. (I have OER and my babies always ended up under my arm, too. Wiggly babies and an OER are a difficult combination.) I've found theses babies do better when they get ALL their sucking from the breast. Pacifiers tend to reinforce negative behaviors: like chewing and expecting to be able to suck and get NO milk.

 

If he is a breast only baby, my guess is he is frustrated between ejections and the block feedings will help tame the ejections and also help him learn to use the breast during and between ejections.

 

Good luck. The taking him off during first let downs and block feeding should help a lot.


Edited by MaggieLC - 11/24/13 at 9:33am
post #10 of 19

I did want to add that the Cluster Feeding is  completely normal for a baby this age. How long he goes at night doesn't dictate "how long he can go" without needing the breast during the day. Many babies this age can sleep 4-6 hours at a time during the night and are still need the breast every hour or two during the day, and then still Cluster Feed in the evening. Let him set the timing of how often he wants to nurse.

 

You are having ejections even when you don't feel them. The ejection is less strong in the afternoon and early evening, and most women never feel their 2nd and 3rd and 4th let downs during each feeding. I've worked with women and I can tell when they are letting down, from the way the breast swells slightly, the baby's breathing speeds up, the mom's breast flushes slightly and the "suck swallow breath" pattern picks up and speeds up, but 99% of the time, the Mama didn't realize she was having a second or third let down unless she was notified of it. It's perfectly fine if you don't realize every let down. You feel your first one as you have OER, but the secondary ejections are rarely felt by mothers, even those with strong ejections.

 

As long as he's having at least 5-6 really wet disposable diapers, or 6 or more really wet cloth diapers and regular stools (how often and how big is up for grabs at this age, he could be stooling at every feeding, or having one blow out every few days) and growing well he's getting enough milk.

post #11 of 19
Quote:
Originally Posted by dahlia810 View Post

What you just described is pretty much exactly what's happening with me. She cluster feeds a LOT in the evening, which is typically when she's fussy at the breast, then after a few hours of sleep that breast will have a let down when she eats again.

I've,been trying to get my supply to pick up on that side by starting her feedings on the left and not neglecting that side. I definitely want to bf for at least a year, so hopefully this won't be a big problem. Thanks for the advice!!

 

@dalia810   one breast is always going to make more milk than the other. I'm guessing you may be left handed? (Just guessing) Most right handed women have a larger supply on their left breasts and some left handed women have a larger supply on the right side. But, some left handed or ambidextrous women don't conform to this pattern.

 

There's no reason to try to "even up" your breasts. One will always make more. Just feed normally, you are having let downs at every feeding, but you may not feel the let downs in the late afternoon or early evenings. But, you'll drive yourself crazy trying to "even up" your breasts. One always makes more. I've worked with some women whose breasts make 60% on one side 40% on the other, and other women whose bodies make 90% of the milk on one side and 10% on the other. They all make enough for their babies, it's just the way some women's bodies work.

post #12 of 19

MaggieLC, thanks for the info, it's really helpful! I'm actually right handed, so I guess I'm one of those women who don't conform to that! It's good to know that the disparity between breasts milk production can be so drastic. My right side gets hard and full feeling pretty much between every feeding, while the left side is always really soft in comparison. Sometimes first thing in the morning the left is a little hard, but nothing like the right side. Very interesting how our bodies work!

 

So I guess if we assume that my left breast just produces less milk, it's totally logical for my baby to lose interest in that side much more quickly than the right side. She'll happily nurse the right side for an hour, but gets irritated and fussy (tugs hard on nipple, fusses) on the left after maybe 15 mins. 

post #13 of 19
Quote:
Originally Posted by dahlia810 View Post
 

MaggieLC, thanks for the info, it's really helpful! I'm actually right handed, so I guess I'm one of those women who don't conform to that! It's good to know that the disparity between breasts milk production can be so drastic. My right side gets hard and full feeling pretty much between every feeding, while the left side is always really soft in comparison. Sometimes first thing in the morning the left is a little hard, but nothing like the right side. Very interesting how our bodies work!

 

So I guess if we assume that my left breast just produces less milk, it's totally logical for my baby to lose interest in that side much more quickly than the right side. She'll happily nurse the right side for an hour, but gets irritated and fussy (tugs hard on nipple, fusses) on the left after maybe 15 mins. 


Glad to help. As long as he is growing, reaching milestones peeing and stooling and mostly happy, I wouldn't worry too much.

post #14 of 19
Quote:
Originally Posted by MaggieLC View Post

Babies whose moms have OER are more susceptible to nipple confusion because their mothers breasts work even less like the bottle in some ways and a bit more like a bottle in others. NO woman's breast really works like a bottle does, all babies have to wait for ejection, but babies whose moms have OER get used to the fast ejection, and often start to like it, then when they are given a bottle, the milk flows easily ALL the time, so when the strong letdown he is waiting for is over, if he's had a bottle (with it's easy flow, similar but not the same as the way some bottles flow) he's going to get more frustrated waiting for the next letdown and getting mad that he has to "work" again to get milk the regular way between ejections.

Wow, this described my experience so perfectly. Did not occur to me that we might've been having nipple confusion at all until I read this. Seems like a misnomer to me, should be called flow frustration or something like that. We've been doing one bottle of pumped milk a day for about a week now at the suggestion of our LC to help DS get ready for daycare when I go back to work. After reading the above I tried out some better nipples for his bottles (we are now using the medela calma instead of regular nipples) and the improvement is so noticeable after just 24 hours! Nursing right now, going on an hour with NO frustration or panic at the breast. What a relief.
post #15 of 19
Spinxy I'm glad to help. You did the right thing if baby needs to have a bottle wait as long possible (6 weeks at the very earliest and then use a Slow Flow nipple. ALL babies who are breastfeeding will probably do better staying on a Slow Flow nipple for the duration of their breastfeeding experience. The Calma bottle works well for mamy as it's only supposed to flow when baby sucks.

I'm glad you found a solution for your baby's frustration.
post #16 of 19

A lot of people have suggested changing the name of "Nipple Confusion" but as it's been known as that for such a long time (about 50 years) we all want to be talking about the same thing. I've heard it called "Bottle Spoiled" and "Suck Confusion" but then we get into so many different terms people get more confused. (My Ped calls it "bottle spoiled" I have asked her to use a different term. Not crazy about the word "spoiled.")

 

The thing is most LCs have seen millions of cases of Nipple Confusion yet some hospital based HCPs still deny it exists. We've seen it so many times and changing the nipple or avoiding them altogether is the cure, so it does exist for some babies. The thing is some babies can go back and forth from bottle to breast all day from birth and have no visible problems, so people who haven't seen it in their babies sometimes deny it exists. @Sphinxy, you've seen it happen in your baby and found a good solution. I usually have my clients start on one bottle every other day 7-10 days before returning to work if their babies will be using bottles while they are at work. That seems like enough time and enough "practice" to get the baby OK with it.

post #17 of 19
This exact same thing is happening with my son. He feeds really well for 10 to 20 minutes, but then he starts doing this wiggle dance and acting like he thinks my nipple can stretch miles as he tilts his head back with it still in his mouth. I got this idea in my head that maybe he needed to burp when he did this a couple days ago, so I took him off the nipple and burped him. It worked! He burped hugely, and when I put him back he didn't wiggle anymore. I've done this several times since then, and it's worked every time except once.

I wanted to post, because I'm pretty sure I'm having overactive ejection, too, especially since my baby is choking during feedings, often lets the milk escape out the side of his mouth, and has started spitting up more. I've had very little luck with repositioning him, but I've heard about the technique that MaggieLC described. Unfortunately, I'm not sure how to make it work, because when I do take him off, there's nothing coming out. He usually has a huge mouthful of milk with it rolling down his chin, but nothing comes out of my nipple unless he's sucking on it or I'm expressing or pumping. There's no "spray" at all, so how can I get that out? I tried hand expressing, and I've gotten very little out; maybe a tsp at most. Have also tried pumping before a feed, but it's a lot of work with the baby screaming to eat. Are there any other moms who also seem to have an overactive letdown, but there's no milk coming out unless the baby's on the breast? If so, is there anyway to do this method without using a pump?
post #18 of 19

Maybe you need to stop more frequently to burp or take frequent breaks during feedings and bicycle his legs before resuming. Also, I haven't read the other comments so I'm not sure if it has already been mentioned, try lying down and feeding with him on top of you or sitting upright supporting his head carefully or even in a baby carrier. 

post #19 of 19

I had the exact same problem with my daughter. Major overactive letdown. It sounds like he is trying to control the flow by clamping and twisting because it slows it down. Then, breaks off to breathe, etc. etc. What helped me the most was #1 hand expressing about an ounce out of my breast before I fed her. With how fast my letdown was this only took about a minute and no parts to clean up! Also, this will help prevent baby from getting a milk imbalance. #2 breastfeeding "down under" with me laying down on my back and baby on top, so gravity helps control the flow. Hope that helps!

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