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October 6, 2008 8:25 PM

Help us figure out why our five-day-old son has been screaming for the last four hours. (Other than just being a big baby, I mean.)

So here's the pattern: baby starts making those sucking gestures that mean he's hungry; mom puts baby to breast; baby begins screaming uncontrollably as though we're putting hot pokers in his mouth and refuses to even try suckling; mom or dad picks up baby and comforts him until he calms down; return to step one. This has been going on more or less continuously since about 7 o'clock. Dad tried taking the baby into another room to calm him down and give mom a chance to dry her own tears; he promptly fell asleep for fifteen minutes and then began crying again.

He has successfully breastfed before, so it's not like he doesn't know what that nipple is for. Up till now he's sometimes been a little fussy getting started, but nothing near this bad.

Any suggestions? Are we doing something horribly wrong? Do we keep trying, or give up and start over with a new son?

posted by ook to health & fitness (27 comments total)

Maybe you should try a bottle? We had a problem because my wife's milk wasn't there in time. I realize you said he's already done it, but maybe the bottle format would be enough to get some food in him and make him happy? Just this once...
posted by SciGuy at 8:32 PM on October 6, 2008

Oh, man. I empathize with you. Our daughter was very colic-y, and there were some mechanical problems with my wife's nipples, and the first few days were pretty torturous. I agree that trying a bottle to give baby and Mom the chance to calm down is a good idea. In the morning, you can contact a lactation consultant to get some professional help.
posted by Rock Steady at 8:36 PM on October 6, 2008

Is his tongue red/irritated or coated with white? He might have thrush which is making it painful to nurse. Will he take a pacifier?

Also, stroke his cheek gently when you put him to breast--this sometimes calms and helps a baby transition to nursing.
posted by Riverine at 8:37 PM on October 6, 2008

Oy, I feel for you all. Please give Mrs. Ook an especially giant hug from me.

First, of course, call your ped. And make an appointment with a lactation consultant.

In the meantime, have the mom do a short pre-nursing pump (either manually, or if you have a breast pump in the house, mechanically) for a minute or so. Some women have an especially forceful letdown of their milk, which to the baby is like gagging on a firehose. Doing a quick pre-pump will get her to that mid-nurse smooth flow.

Another possibility is something mom is eating, the baby doesn't like. Could be taste, could be allergies, it will take time to figure out so at least the prepump will quickly prove or not prove to help.
posted by jamaro at 8:37 PM on October 6, 2008

I am not a breastfeeding mother, or even a parent, but what immediately comes to mind is a search for what is different. I.e. - did mom do ANYTHING different from the past four days - wash with a different soap, use a different towel to dry herself, use any cosmetics or moisturizers or anything else on her body? Wear a different bra (a new nursing bra, for example). Anything that baby ook may be overly sensitive to?

Good luck.
posted by birdsquared at 8:38 PM on October 6, 2008

If he tends to cry then calm down and cry again it may be Intussusception. Anyhow, check with your Doctor.
posted by zouhair at 8:42 PM on October 6, 2008

When my daughter did this, she was not latching on correctly and wasn't getting fed. (And she did fine for a couple of days, then I tried to feed her under a blanket because there were too many visitors and screwed up the latch. Then, she refused to latch on properly and we had to reteach her. IANALC (I am not a lactation consultant but I have an 8 week old), but everything they tell you basically boils down to "Put more of the boob in the baby's mouth." Do go to a consultant in the morning (Even knowing this info and having nursed 2 other children for over a year each, I ended up at the LC with my third.) Anyway, after I let her latch on wrong, she would nurse for a second, scream bloody murder, then calm down for a while (when the nurses finally came to the room.) Finally, a different LC came in and said, "Oh, she's not nursing, she's just biting you." Make sure that you hear gulping when he eats and that you can see the sucking all the way back to his ears. (Not just the jaw up and down.)

Make sure the baby is opening his mouth REALLY wide getting a lot of nipple in. If you (the dad) open baby's mouth by pulling down on the chin and sticking his head on, that can help.

HOWEVER - if breastfeeding isn't hurting, this probably isn't the right answer. But maybe it isn't hurting yet?
posted by artychoke at 8:51 PM on October 6, 2008

Nthing lactation consultant. I'm sure there are other directories but here are some listings for your state. Most will be able to help you assess for other common issues like thrush, reflux, tongue tie, and latch refusal.

In the interim, you can try finger feeding the baby simply for hydration. A four hour screaming marathon is not something to panic over but you are likely to all feel better if you can actually get something productive out of these crying marathons.

Finger feeding is also a great alternative if the "try a bottle" suggestions causes your wife to go into total emotional meltdown. There is, at five days, also less chance of nipple confusion (which you are free to think is bunkum if you like, I'm just providing data here.) Another immediate option if there is a 24 hour WalMart or CVS and you're not too tired to drive is a nipple shield. A shield can provide immediate latch correction and if it works, it should work almost immediately.
posted by DarlingBri at 8:53 PM on October 6, 2008 [1 favorite]

If it might be gas (legs drawing up to his belly) try lying him on his back and making his little legs "run" until he farts. Also, some babies like their heads kind of squished up against you. Hold baby and hold his head onto your chest with your hand. Or, lie the baby on his tummy on your arm so that he's face down with his head (turned sideways) on the palm of your hand, his body's on your arm, and his butt's in the crook of your elbow. (Legs hanging down.) Sometimes they love that.

OOH OOh - one more. When my baby was seemingly crying for no reason, it worked a couple of times to slightly wet a pacifier, and dip it in a tiny bit of sugar. We're taking four grains here. Child hates the paci otherwise.

I am not good at describing without gestures, so feel free to email if you don't know what I'm talking about.

Also, not so good at closing parentheses, above. And on preview, finger feeding is how we had to reteach the above child how to nurse. Have a syringe handy?
posted by artychoke at 9:00 PM on October 6, 2008

Also, you can always call the hospital's post-partum dept. for help.
posted by artychoke at 9:01 PM on October 6, 2008

Check diaper. Secure baby's arms and legs in a snug swaddle. Bounce upright on your shoulder, to burp up any swallowed air that might be hurting when he's laid down to nurse. Make shushing noises in his ear until he calms. Try nursing in a different position (like, laying on the bed). If he still won't take the breast, mom should pump her milk into a bottle. Stroke his cheek until he opens up, and pop in the bottle. An ounce or two will calm baby and mom. Then, bounce, shush, diaper, re-swaddle.

Breastfeeding is surprisingly frustrating (open mouth, insert boob, right? not actually so easy.) Mom should not feel like a failure if she and baby have difficulties. And don't let anyone browbeat you into thinking you 'have' to feed your baby a certain way. It is very possible to be committed to breastfeeding and have a well-fed little baby, without actually nursing--lots of moms exclusively pump.
posted by oceanmorning at 9:13 PM on October 6, 2008

Seconding DarlingBri, especially the finger feeding suggestion. You can also call a La Leche League leader in your area for free help. Here are the LLL club listings for your state. At this point I would prioritize seeing a lactation expert over a doctor, unless baby is not peeing/pooping.

Your wife's milk should have come in. But on the off chance it hasn't, express to get colostrum out or put a bit of sugar water on the nipple to tempt baby. Kids like instant gratification, but not too much (see also: firehose problem, pump to take edge off if that's the problem).

Hang in there, I remember how miserable I was. Give your wife a hug, tell her she's doing a great job, and don't pressure her on feeding.
posted by crazycanuck at 9:30 PM on October 6, 2008

check nose for congestion; our little guy was pretty similar till we got (on doctor's advice) the safe-for-infants saline nose drops and gave him a little flush.

But do call the pediatrician- this is what they're for, and they'll help you figure out what's cooking.
posted by jenkinsEar at 9:30 PM on October 6, 2008

Thanks, all, for the thoughtful replies... we'll definitely be seeing a consultant (already had a home visit scheduled for tomorrow, in fact; nice timing, eh?), and for the time being Mrs. Ook has expressed herself into a cup so I can try finger feeding him while she gets a little bit of rest. (Biology is very unfair to women.)

Right now, of course, he's snoozing peacefully on my lap. Kids. So unpredictable. I guess that's why we love them so.


zouhair: Coincidentally, I myself had surgery for an intussusception when I was an infant. And if I hadn't, and so wasn't already aware of its more prominent symptoms beyond "crying", your answer might have been that last straw which threw me into the final off-the-rails OMG my son is going to die panic. I know I'm a little on edge right now, what with the screaming and the not sleeping and all, but still: jumping immediately from "my baby is crying a lot" to "hey, maybe he has a life-threatening bowel obstruction!" is... well, please don't do that.
posted by ook at 9:39 PM on October 6, 2008 [1 favorite]

Good luck! And fwiw, my third child is now only eight weeks old and the nursing problems and lactation consultant visits already seem REALLY far behind us. She's a happy little fat thing who is nursing fine and sometimes even smiles. Once you get to two or three weeks, everything will be fine, soreness mostly gone, etc. And one day, you may even get some sleep!
posted by artychoke at 9:47 PM on October 6, 2008

All good advice above - and I'll just add, do a nervous check from top to toe. Once, within the first few weeks, a bit of thread had gotten wrapped around our daughter's finger, and it was bugging her, and it took us a bit of time to figure out that that was it; and also that yes, she was that sensitive about it and other things to come. Later, when she was much older, a similar bout of screaming was due to a kernel of corn that had been missed after a wipe and was lodged in a sensitive place.
posted by peagood at 9:50 PM on October 6, 2008

I had a similar issue with my daughter just as my milk came in. It was as if she no longer recognized the breast and would refuse to attempt to latch. She would just scream when I tried to feed her. It turned out that the breast fullness caused by my milk coming in caused the nipple to change shape slightly and made it hard for her to latch. I had to pump some milk immediately before feeding her to relieve some of the fullness and then she was able to latch normally. It only took us about 12 hours of screaming and an "emergency" lactation consultant visit to figure it out!
posted by kcoshea at 10:01 PM on October 6, 2008

ook, delighted for you on the excellent consultant timing, that's wonderful. Also, one less "OMG how the hell do I get someone here tomorrow?!" thing to freak out about. Win all around.

I'm sorry, though, about the finger feeding link I gave you. That particular method is a long term solution for protracted nipple refusal. You seem to have correctly assumed that I meant the much more basic and old fashioned dunk-suck-dunk-suck method, purely for hydration and not nutrition.

I'd just add that whilst the milk is in the cup, you might taste test it. Seriously. It should be watery and sweet and if it tastes funky, this could be a reason for rejection.

If that's the case, or you're just desperate to try something else without having to wake your wife up, crazycanuck's sugar water suggestion is an old standby, again with finger feeding.

Good luck and let us know how you get on, we're all, umm, rooting for you!
posted by DarlingBri at 10:08 PM on October 6, 2008

When my daughter was nine days old she just lost her shit one evening. She hadn't been a crier before then, and this was completely out of the blue. I tried everything: feeding, changing diaper, burping, treating her as if she had colic, you name it. Nothing worked.

In desperation, I decided to start with just the baby and work my way through all the things that affect her, so I stripped her down to nothing. Crying stopped. She even cooed. For the next year, I was able to get her to stop crying when she was otherwise completely inconsolable just by stripping her naked and letting her roll around on a blanket (backed with something waterproof). It turns out she just needs to be nekked. Still does, at age five. When she's had a tough day at kindergarten, being naked cures all.
posted by Capri at 10:56 PM on October 6, 2008 [2 favorites]

1. Pump and bottle feed to avoid an over hungry baby, a overly frustrated and overfull mom.
2. Check the nose. I've noticed that babies who can't breathe through the nose have trouble eating sometimes.
3. Go to the doctor.
4. Take turns checking 1-2 so that somebody sleeps sometime.
posted by ewkpates at 11:17 PM on October 6, 2008

There are some good video clips on breastfeeding.com that might be helpful even after the visit with the LC.
posted by Dreama at 2:02 AM on October 7, 2008

I called these 'fuss-n-feeds' and to some extent fuss-n-feeds are normal. Over-active letdown is a possibility.

Try having Mum nurse in the tub -- with a newborn she'll probably get pooped on, but, big deal. And try to catch baby at the very first stirrings of waking, before he even knows he's hungry, to start nursing. Hand-express a bit first to soften the areola & establish but slow the flow...

Bottles and pumping are buying a lot of long-term bother; not a good solution. I wouldn't rush to a nipple shield without the guidance of a IBCLC, too. Best advice I can give is for Mummy to accept some fussing as normal, not something she needs get upset over, and to just ride it out. Eventually latching a baby is as hard as using Velcro.
posted by kmennie at 5:20 AM on October 7, 2008

And beware of 'it's something Mum's eating,' because that's very rare. Nobody eats a cheese pizza, gets a rumbly tummy, and decides the cow responsible for the cheese must've eaten something odd. Useful info on Mom's diet here.
posted by kmennie at 5:31 AM on October 7, 2008

Pretty much everyone's covered any advice I've got...just wanted to say good luck and I hope things have straightened out for you all and the baby! Nothing freakier than inconsolable baby.

By the way, if you haven't purchased some infant gas drops, I advise you to do so the next time you're at a drug store. They might not fix the problem this time, but they can really be a life-saver. At least for my (10 week) baby, they can really do the trick when she's gassy. We give them to her after she's been screaming her head off, and then within like 2 minutes, she's stopped crying and is happy as a clam.
posted by leahwrenn at 6:17 AM on October 7, 2008

We had the same problem. Wife was basically drowning the baby. Wife was also having emotional problems because baby wasn't latching on. She felt disconnected. A mother is suppose to nurse right? I talked some sense into her and we decide that she pumps and I finger feed.

As a Dad, finger feed was the best thing for me. It was the best bonding time and a very unique experience. My wife could sleep and I could wake up and feed my daughter.

Give it a whirl.
posted by bleucube at 7:20 AM on October 7, 2008

Morning update (it is morning, right? :) We haven't talked to the experts yet but I'm beginning to think kcoshea was closest to the mark; her milk had just come in, and he was finally able to feed last night after we softened things up a bit...

Thanks again from both of us (er, all three of us) to everyone who offered help and advice (including zouhair; sorry I got kinda testy last night.)
posted by ook at 9:00 AM on October 7, 2008

N'thing call the doctor.

If your child has colic, please feel free to contact me. My child had severe colic and it was traumatizing for everyone. There's not much good research, but I have a couple of articles.
posted by theora55 at 1:05 PM on October 7, 2008