A couple of questions......

My little man is 13 days today.  He was a full term, low birth weight baby, but is quickly gaining weight and doing very very well.  I am exclusively nursing and have been since he was about 5 days old.  He was in NICU the first 5 days and although I was nursing, they were formula supplementing.  I have a few questions for you if I may.  First off, he is an excellent nurser.  I do pump a bit and Daddy gives him the bottle, but his clear preference is the breast.  I know I am producing enough as he is gaining weight (really quickly actually), has regular poopy diapers and is generally doing well. He is however a cluster feeder.  He only sleeps about an hour in between feedings, and usually falls asleep on the breast.  I am dealing with the lack of sleep...amazing how you get used to it, but am concerned this might not be what's best for him?  Is there any difference health wise for a baby that feeds every 3 hours or so vs. a cluster feeder?  Should I be doing something differently?  It has been suggested to me that I should "let him cry" and he will get on a schedule.  I am not prepared to do that, so that is not an option for us.

Second question.  He latches on very very aggressively.  It's almost like he thinks he will never get to eat again..lol.  He eats so quickly he sometimes chokes himself a bit and quite frankly, it scares me.  He also typically winds up with the hiccups afterward even though I rarely have any trouble getting a good burp out of him.  Is this normal, or again, is there something I should be doing differently?

Thanks so much, your advice is truly appreciated.  I want to do what's best for him obviously, and sometimes it's hard to know what that is.  Thanks again.

[tiredbuthappy]

His feeding pattern is completely normal and healthy for a nursing newborn. I suspect those telling you to put him on a schedule were formula feeders? At this age, any attempts to put a baby on a schedule can result in failure to thrive and can affect your supply. He's cluster feeding because he is growing very rapidly, and because he is building your supply. He's doing exactly what he's supposed to do!! It's also better for baby's digestion to take small, frequent feeds. He's falling asleep because he's comfy and has a full tummy, and because he's a sleepy newborn. Also typical and to be expected. I used to change the diaper between sides to rouse her enough to feed the other side.

As for the latching aggressively... his choking and frantic swallowing can be signs of a forecful let-down. At this point in time, your body has not regulated milk flow and production yet. I googled "forceful let down" and it brought up a helpful kellymom article on the topic. It describes and has pictures of nursing positions that you can try. I had a forceful letdown too, and my littleone would get overwhelmed. I ended having to block nurse, or nurse from one side each session to regulate my supply a bit. It is very possible that this is what's happening, as it was my little one's cluster feedings that led to this. When she was non-stop cluster feeding (you know those days when you don't know where 1 feed ends and the next starts), I would keep putting her on the same side for a 2 hour period, then switch.

I do want to add that my little one was a very frantic eater, and it turned out to also be due to very severe silent reflux. She was frantically eating to soothe her throat. Hopefully, this isn't the case for you. Just wanted to mention it.

[Super_sally888]

Hi,

Sounds like everything is going exactly as it should and you are doing great.  

Be reassured it is not natural to leave babies this age to cry.  When he cries you tend to him and sooth him and don't make him wait. :)

[adgal]

Thanks so much for both the reassurance and the advice.  What you are telling me is very much in tune with what my instincts say, and he is really thriving, so I thought what was happening must be ok.  I have gotten some pretty whacky advice....I was even told that if I kept allowing him to eat whenever and how much he wanted he would have a weight problem later in life....I just don't believe that.

Tired, I am curious about the reflux situation.  In the past day or two he has started spitting up.  Now I know this is normal, but this morning when it happened he really let out a scream. It scared me.  Milk was coming out his nose and mouth and although he wasn't having trouble breathing, he sounded "mucasy" for a while afterwards.  Do you recommend I have him checked for reflux?  Are there any other symptoms I should be aware of or looking for?

I will try the feeding on one side or the other, and hope that helps the choking issue.  

Thanks again for the support and help.  It is so nice to know I am making the right decisions.  I just cannot imagine letting him just cry.  It would feel so very wrong.

[tiredbuthappy]

chances are, he's OK. Although, in my extensive reading, i have read that over-active let-down can cause some refluxing problems in baby. This can be helped by doing things like block feeding, holding him more upright while feeding, stopping to burp, etc...

you are right in that spitting up is normal. In fact, to a certain degree, reflux is normal. A large percentage of newborns reflux because their systems are immature. Reflux becomes a problem when it causes pain and interferes with feeding. I wouldn't go to a ped yet, as they wouldn't do anything other than tell you what I just said. However, watch him. at 2 weeks was when her symptoms started to get bad. Signs that reflux is causing problems is screaming when burping, arching back, getting stiff, crying after feeds (although not due to gas) or even during feeds.

as for whacky advice... ignore it all. Your baby is supposed to eat all day. According to my LC, your baby is supposed to be very chunky. She said current weight guidelines and percentiles are based on the formula fed baby and are therefore misleading and inaccurate. My first did that, and this one is following in her footsteps. She got to be a little sumo girl by 2 months. She was gaining a pound a week in the beginning. I got nervous but my LC said that's how ebf babies are supposed to gain. They pack on the pounds in the beginning, and then slim down. In the long run, breastfed babies are less likely to have weight problems. Everything she said was true in our case. My little superchunk did start to slim down, especially once she started to walk. She is now 2 1/2 and extremely healthy- 30% for weight, 50% for height. In fact, she now shares the same size diaper as her 5 month old sister. Her hiney is so tiny, she was wearing her sister's pants the other day!

[jenstam]

Yep, all normal. The cluster feeding, I'm referring to. I still have a piggy that will NOT go more than 2 hours during the day between feedings but is mostly sleeping through the night. You'll get sleep in a few weeks, I promise (: Just wanted to reassure you that it's all normal. Oh, and it does sound like forceful letdown. I have the same problem and many times I will pump a little bit before I nurse. That way baby gets the good, fatty stuff and doesn't have the forceful letdown issue. Good luck and congrats!

[jenstam]

Oh, forgot to add...NEVER put a baby on a schedule this young and comfort when he cries (: I could never let my little man cry (for long), only when I'm super busy and can't grab him right away. They need comfort and security when they are so little.

[adgal]

Thanks again for the great info and advice from all of you.  Because Ryder spent a few extra days in hospital, I did spend a bit of extra time with the LC, but there are just so many things she didn't mention.  And the crazy advice....I know people mean well, but it is obvious the way the things "used to be done' is not really what most feel is best today.  I just cannot imagine letting my 2 week old baby "cry it out".  Tired, I am going to try the block feeding today, see if that helps. Jen, I am also going to try pumping a bit before chow time...supply does not seem to be a problem for me..lol.  

Curious, how long do they cluster feed for?  We had another night of waking every hour.  Thank God for DH...a pumped bottle this morning from him meant mommy got a few extra hours sleep.  

[tiredbuthappy]

careful pumping before- if you have an oversupply, that can only make it worse! just do a little bit.

[nicole179]

my little guys name is ryder too!!  ryder patrick and we were in the hospital for 8 days!!  i too got to see the LC quite a few times while i was there, but i still ended up leaving on the 8th day have to use a shield to get him to latch!!  i kinda wish they never gave me the sheild because i came to rely on it instead of working night and day to get him to latch!  i am kicking myself now that i am exclus pumping, i still try to put him to breast now and then but he screams i think because he is not getting it fast enough. anyone got got any tips?  he will latch for a minute then shake his head and get mad he's 4 months, and really hasn't nursed for about 2 months. :(

[zazou]

I fed on demand and still do. I don't believe in scheduling a breastfed baby and your baby is still too young for that.

It's quite normal that a baby sleeps unregularly for the first month at least, waking up numerously for feeds. They have small stomachs so need to feed constantly. Medina was a fat baby and now is rather normal, I'm still BF at 8 months :-)

NEVER let such a small baby cry it out. Your baby needs you. I was also given alot of advice, even the 'let your baby cry for 20-30 min to clear her lungs' from my MIL. I didn't do it. I was told not to carry my daughter alot because then she would want it all the time. Now she just wants to play and crawl and of course, loves a cuddle as well in between. I used to vaccuum with my daughter because she would fall asleep due to the white noise. I was told that my baby would expect that each time I vacuum, she would be held. Now she hates the vacuum cleaner, she's scared of it. Babies need so much love, care and tenderness, that makes them develop really well and I am against letting them cry it out so young.

I too had a very forceful let-down and my daughter would sometimes choke. When I felt it coming, I would take her off, let the milk out a bit and then latch her back on. Your baby will end up learning what to do, Medina learnt when the let down came she would get off herself.

Medina was also agressive and my nipples were torn and almost bleeding in the beginning. I wanted to wear a shield but I ended up using Lansinoh and it was much better (no effects on baby too).

Hope that helped a bit.

[zazou]

When a baby gets used to the nipple shield, it's hard for them to get back to the nipple. That's one reason, I went through the pain of my sore nipples.

Does he still latch on the nipple shield? Or does he only want breast milk out of the bottle? If he is drinking breast milk from the bottle, that's still a great thing (that it's Mummy milk). It's also really difficult for them to getr back onto the breast if they've been away so long.

Be persistent, trying doesn't hurt and you may be rewarded for your efforts. Good luck!!