Newborn Feeding Patterns & Others (FTM)

[Perplexed]

Baby is 4 days old and I'm a bit confused about feeding patterns.

I've been picking her up to feed her whenever I see her make the sucking movement with her mouth or sometimes she sucks on her hand. That is when the matters don't reach the crying (although she does cry sometimes because I've been changing her diaper before the feed...).

So I guess I know when she's hungry, but I am confused as to knowing when she's full. Sometimes she nurses for 10 minutes and falls asleep. At the hospital they told me to keep stimulating her by rubbing behind her ear or feet to keep her awake to feed. It works sometimes but others she just falls asleep and stops nursing. Sometimes she doesn't want to nurse again for another hour, while others she would wake up 10 minutes later wanting to nurse again. Any tips on keeping baby awake? Or does it not have anything to do with her falling asleep and it's just part of a newborn's pattern?

Also wondering if I'm supposed to use both breasts at each feeding session? I've been alternating and they're quite sore. I've only ever used both breasts at a feeding session that went on for 2+ hours and kept switching whenever one nipple couldn't handle any more.

At the hospital I mainly nursed with my left breast because the right one was flat and I was advised to either pump to bring the nipple out or use a shield. I opted to use a shield before trying to pump. And now I use nipple shields for both breasts because once I started using it for the right I could no longer get LO to latch on the left without it... should I have pumped instead?

As for pain, I know some pain is normal. But when LO nurses for longer it gets really unbearable. It feels like my nipples are continuously being stabbed with needles. Then there is some soreness at the rest of the breast that is really strange- it's a mixture of both soreness and itchiness if that makes sense. Is this normal?

Thanks for taking the time to help a new breastfeeding enthusiast out, ladies.

 

[Rachel_C]

As long as your LO is weeing and pooing enough, I wouldn't worry about her falling asleep at the boob. It sounds like even though she's falling asleep she is still waking regularly to feed so she should be getting plenty. During the day, I would hope to see a very young baby feeding every 2 hours and every 3 hours over night (increasing to 3 and 4 hours in a couple of weeks). 10 minutes is a fairly short feed but if she's doing that every hour, it sounds fine as long as her nappies are okay. If she only wanted to feed for 10 minutes every 3-4 hours I'd try to keep her awake but otherwise just follow her lead.

There are no real rules about switching breasts. Ignore anything you read or hear about 10 mins on one side, 10 on the other etc. Feed baby from the left until she stops and comes off the boob, offer it her again to see if she is really done with that side, then offer her the other side. If she takes the other side, let her. If not, she's done. Next feed, start from the boob that didn't get used as much.

Have you seen Dr Jack Newman's FB page? Everything he posts is pure gold! On 25th November he posted about switching sides (it's a bit long so I've just copied the best bits!):

One sided feeding

It is not a good idea to feed the baby on just one side, to follow a rule, as many mothers are being taught. Apparently this is being done so the baby gets the higher fat containing “hind milk”, but if the baby is not drinking, the baby is not getting hind milk. Yes, making sure the baby “finishes” the first side before being offering the second can help treat poor weight gain or colic in the baby, but rules and breastfeeding do not go together well. If the baby is not drinking, actually getting milk, there is no point in just keeping the baby sucking without getting any milk for long periods of time. The mother should “finish” one side and if the baby wants more, offer the other. Furthermore, feeding one side at a feeding eventually decreases the milk supply so that what may work at 4 weeks, will no longer be appropriate when the baby is 3 months old.

How does the mother know the baby is “finished” the first side? Because the baby is no longer drinking, even with compression (see the video clip and information sheet on compression at our website). This does not mean the mother must take the baby off the breast as soon as the baby doesn’t drink at all for a minute or two (she may get another milk ejection reflex or letdown reflex, so she can give it a little time), but if it is obvious the baby is not drinking, the mother should take the baby off the breast and if the baby wants more, offer the other side. How does she know the baby is drinking or not? See the video clips at the above website—the presence or absence of the “pausing type of suck”.

If the baby lets go of the breast on his own, does it mean that the baby has “finished” that side? Not necessarily. Babies often let go of the breast when the flow of milk slows, or sometimes when the mother gets a milk ejection reflex and the baby, surprised by the sudden rapid flow, pulls off. The mother should try him again on that side if he wants more, but if the baby is obviously not drinking even with compression, switch sides.

I think you probably should have pumped (or just tried some of the techniques to get baby to latch) instead of using a shield, but hindsight is great, isn't it? Shields are known to prevent baby learning to latch properly and can lead to LO becoming dependent on them. Are there are BF groups or advisors near you who could advise on getting LO to latch without the shields? You may find that helps with pain too, although pain is quite normal in the first couple of weeks.

 

[Perplexed]

Thanks for the response.

How many times a day should I be changing her diaper? I feel there's been maybe 8 changes so far since we officially woke up this morning.

I've been trying to re-offer the same breast to her even when she lets go or falls asleep. It's only been two times so far but she's nursed for the same amount of time that she nursed before letting go/falling asleep. But I feel she's been nursing a lot more since last night as well.

I will have to go see the video about compression on their website! I have not had the time really, I was in the middle of even responding to another topic before baby wanted to nurse again.

I do worry that I've ruined or made things more difficult for myself by using nipple shields. But I've decided to try to first latch with them, nurse for a while, then remove and latch again. It worked for the flat nipple at least (kind of forgot when we moved to the other one).

 

[snowfia]

I just let my DS fall asleep if he wants (I did with DD too). Sometimes he'll sleep for about 3 hours, other times he'll want feeding again when I un latch him and it wakes him up, then I switch sides.

I read somewhere the itchiness is caused by the blood flow increasing and it's totally normal.

From my experience though, the pain shouldn't last long and should go away within about 10-20 seconds of latching them on. If you could get her latch checked to make sure that's all ok it would probably help. DS had a shallow latch at first and it was so so painful! I was told to latch him on, count to 10, if it still hurt then to unlatch him and try again.

 

[Perplexed]

A shallow latch hurting makes sense because through the nipple shield the latch would constantly be shallow because it would always only be the nipple that's being suctioned into the shield.

I think I will try either starting with a shield to get the nipple out then try to get baby to latch without it, or pump a bit to get the nipple out.

Thanks!

 

[MommyJogger]

Definitely find a lactation consultant or bf support group to have her latch checked, but also to check the logistics of how you're nursing through the shield.
Shields come in different sizes like pump flanges do. The shield I was randomly handed in the hospital would have been waaaaay too small if I'd used it and my nipples are not very large. It's possible to really do some damage if you're using the wrong size, just like incorrectly size pump flanges can damage the nipple-- it should fit the baby's mouth properly, but it should also fit mama properly and lots of hospital nurses only check the first one if they check anything at all.
If you can, I would suggest putting the work in to get back to breast and away from the shields. They have their place, and can really help some women with very flat/inverted nipples, but imo they shouldn't be the automatic go-to when a woman has flat nipples. There are other tools on the market to help perk the flatter nipple up for feeding and if you can get baby to nurse off of it directly for a while, lots of the time they'll naturally become less flat and easier to latch onto without help.
I had a less 'perky' nipple, not what you could call flat, but one that didn't want to cooperate for feeding at first. I would latch him onto the "behaving" nipple and hand express the other one until it perked up and I got let-down, then I'd switch him to the flat-ish one. It perked up on it's own around 6 weeks and we were able to continue as if I'd never had an uncooperative nipple at all. You and I are lucky in that we've got the one "good" nipple-- makes it a lot easier on us than women who've got two stubborn ones.
Some pain is normal, but if it's persistent through a feed, it's definitely something to get checked out to be safe and before it becomes more and more unbearable to you and challenges your lovely enthusiasm. Better to correct a poor latch as early as possible, especially if artificial feeding tools have/are been/being used.
I had the soreness/itchiness, too, but not terribly so. Just in the sense of "man, that's a weird sensation that I wish would go away". It went away (for the most part) for me when my milk regulated, and it's perfectly normal. But if it becomes really uncomfortable for no apparent reason, it would be worth it to ask an IBCLC about that, too.
You've got this.

 

[luna_19]

Looks like you have a ton of great advice already. Just wanted to add that I have one flatter nipple too and I find even now it will hurt a lot right when he latches of he doesn't open his mouth as wide as possible.

 

[Perplexed]

I feel so defeated

Been nursing for a few hours now and I've been screaming and crying throughout it. It's just too painful.

 

[luna_19]

Are your nipples actually damaged? Mine were quite raw and sore but not cracked or bleeding in the beginning despite getting a good latch. Maybe you could watch some YouTube videos on how to get a good latch. Also don't forget the tummy to mummy and nipple to nose rule every time. I know in the beginning it can be tempting to let lo get away with a bad latch because getting one at all is an accomplishment but she needs to learn how to do it properly so keep taking her off and trying again until she gets it right. If you need to don't be afraid to pump if you need to give your nips a bit of a break. You can cup or syringe feed to make sure she is getting enough to eat. Hang in there is does get better

 

[luna_19]

Oh and some good advice I got from the lc was to not let baby use you as a pacifier. It only takes about 20 minutes to drain each side at this point and you will be able to hear of she is making the swallowing sound. You don't want to restrict her too much because she is building up your supply but some babies (like mine!) Will just keep sucking away for hours if you let.them.

 

[Perplexed]

They aren't actually damaged, well the slightly perkier one is bleeding. The flat one was bleeding at some point but it's in much better condition than the other one.

It was really awful last night!! I felt I couldn't handle the pain anymore...though it probably is only a quarter of the pain we feel at labor.

Is it safe to use lanolin right before a feed? I was told at the hospital that it's fine but I thought I'd double check.

 

[MommyJogger]

Bleeding means damage and that should not be happening. Please get in contact with a lactation consultant and watch the youtube latching videos asap. Bf doesn't have to be like this.
Lanolin is safe to use right before a feed. I used to slather it on before and after.

 

[Perplexed]

I'll inquire about a LC at the hospital tomorrow when I take baby for her appointment. I actually started bleeding at the hospital on day 2, it wasn't as painful though and the nurses were checking in on me too I really thought it was just normal.

 

[snowfia]

I agree ^^
The sooner it's all sorted, the sooner you can enjoy BF!

I know it's frustrating, it would sometimes take ages to get DS latched on correctly and it was SO painful as I had blisters. But once you've both mastered it, it is worth it.

 

[snowfia]

I posted that at the same time as you haha.

Glad you're going to see the LC The nurses should really have helped you, it's definitely not normal to bleed. Big hugs.

 

[Perplexed]

I feel like the nurses aim was more to get baby to feed and not actually troubleshoot the problems I was having. At the time I was so desperate to get her to latch that I didn't realize I wasn't actually being helped.

 

[luna_19]

I found the nurses here the same, not really helpful at all

 

[MommyJogger]

Most nurses aren't trained to troubleshoot bf problems (at least in the US, I'm not sure where you're from), but it's part of the human condition for them not to want to admit that there's something they don't know about as nurses. Most of them don't actually know anything practical about breastfeeding and only go by mother-reported results to determine whether baby has fed or not (at my hospital, they didn't even talk to us if they didn't have to; they had a sheet you filled out with how many times the baby nursed and how many diapers you changed). Many hospitals don't even have real lactation consultants on staff, so make sure you confirm that your lc is IBCLC and not just a "lactation nurse" who took a 1-hour seminar on shit that doesn't actually help her help women breastfeed.

 

[Mummy Bean]

Have you got lanoish...honestly it was a life saver really soothed the nipples. Also put breast milk on your nipples and let then air dry as much as possible

Also i found holding him in a rugby ball hold (under your arm) helped him get a much latch and hurt a lot less.

From everyone i spoken to say day 3-7 the worse. So keep reminding urself it wont be long until things improve. Tackle one feed at a time.

 

[Mummy Bean]

Also youtube..there lots of guides on things to look out for....i found they really helped working out if the latch was good or not.