Nursing - Why Is Baby Snoozing at the Tap?
September 18, 2017 10:45 AM   Subscribe

Little REH is a beautiful 5 week old boy. Breastfeeding is going pretty well, but there have been variations...regressions?

Notes on the situation:
- come down is a little on the fast side
- baby has tongue tie (DO says it's a light case, but we're meeting ENT soon to decide on surgery)
- early low weight means we started supplementing with formula and have continued using this for night feedings

Things we think we can rule out or have tried:
- shallow latch...latch is good, as confirmed by doctor and two nursing consultants
- prodding...jiggling, pinching, diaper changes, singing, switch nursing and exposed skin have been tried to wake up baby
- milk adequate (as experienced from pumping)

Weight gain has been pretty good, but we'd like to improve the quality of feedings and also rely less on formula.

(1) How can we get baby to perk up?
(2) How can we know how well the feeding is going? Weigh gain has been good, but sometimes it sounds and feels like he's not getting milk
(3) How can we tell if tongue tie is the culprit even tho the latch is good? (Dr's refuse to weigh in on this, saying it's hard to know)
(4) Is this a chicken<>egg with formula feeding where we should work harder to get off the bottle?

posted by Reasonably Everything Happens to Health & Fitness (20 answers total) 1 user marked this as a favorite
Are you sure this is a problem? If weight gain is good, why do you think he's not getting enough milk? As far as babies are concerned, boobs are food, pacifier, and happiness all rolled into one. I don't think a few sips and a nap is really anything to worry about, it's just sort of what they do.

When my little one was jaundiced and we needed to feed her extra, I breastfed until she quit drinking, then hand expressed another ounce or so into a bottle and fed it to her. That let my body know what baby was actually consuming, and helped keep up supply. If you're really anxious to get off formula, this is one way. But it's not mandatory!

If you have some additional concern based on feedback from your doctor, please let us know, but honestly it sounds like you have a normal baby who likes a nightcap before his naps.

As they get bigger and more alert, breastfeeding transforms more into a meal - baby will drink a lot and hurry to get back to playing. But when they're so little, this sort of chilling at the boob without doing a lot is not unusual.
posted by telepanda at 10:55 AM on September 18, 2017 [12 favorites]

Babies totally fall asleep at the boob all the time, especially when they're that new. If he's gaining weight and if he has lots of opportunity to feed, I wouldn't worry about this at all.
posted by rabbitrabbit at 11:03 AM on September 18, 2017 [8 favorites]

Also, when worrying about weight gain, look for WHO weight charts that are based on breast feeding, rather than US charts that are based mostly on formula feeding. You may find that he's doing just fine!
posted by acm at 11:40 AM on September 18, 2017

If baby is gaining and does not seem excessively hungry or fussy, I don't think you have to worry. As mentioned, newborn babies sleep and nurse for comfort all the time. You'll also likely get a growth spurt with lots of evening cluster feeding (and fussiness) in the next 2 weeks.

Unless you're concerned right now about oversupply, I would pump as many times as you supplement with formula (or more) (if you can, recognizing that pumping is a pain) - that will offset anything to do with losing supply due to formula feeding and it's helpful to have a backup freezer stash anyways (if you don't use it you can donate it). If you want to keep up with the formula, you can, but you may want to just start feeding from your supply. Whatever works best for you. You may want to rent a hospital grade pump if you haven't already.

We had an early low birth weight baby and supplemented with formula just at the very beginning but continued to do some night bottle feeds (from pumped breast milk) for the first few months - this allowed me [mom] to get some sleep and habituated baby to a bottle without causing nipple confusion.

Good luck!
posted by vunder at 11:51 AM on September 18, 2017 [1 favorite]

Response by poster: Sorry, I missed a big piece of info in the OP:

Baby gets upset after being taken off (even if in dead sleep) and remains fussy to other forms of soothing outside feeding (whether that's breast or bottle).

So the conundrum is that he's content when he's asleep at the breast, but there's no place to transition him to where he's happy afterwards. He gets noticeably fussy compared to when he has a good feed.
posted by Reasonably Everything Happens at 11:55 AM on September 18, 2017

I know it's the most difficult thing to hear, but most likely it will pass. Your baby will get past the snoozey stage shortly and if he is gaining and not generally acting fussy and inconsolable, I think the only thing you can do is just feed him on demand.

You might try a pacifier if you haven't already, though some babies are reluctant. My pediatrician said she thought there was "no downside." If he will take it, it may improve the quality of the non-comfort-feeds.
posted by vunder at 12:04 PM on September 18, 2017

This is why my son was on the boob 40 minutes of every hour at that age. It's still normal. Baby wants a little food, falls asleep because he's so warm and comfy and no longer starving.... but then when he wakes up he's like, hey! I want food now!
posted by rabbitrabbit at 12:05 PM on September 18, 2017 [4 favorites]

Have you tried the cold wet washcloth of doom? My daughter was 3.5 weeks early and as such pretty much slept for the first month of her life. Wiping her with the cold wet washcloth (fall asleep > wipe with washcloth > protest > relatch > eat, fall asleep) was the only thing that kept her awake enough to finish a meal those first few weeks.
posted by rockindata at 12:07 PM on September 18, 2017 [3 favorites]

Best answer: Congratulations, you have a 5 week old baby :)
Unfortunately, some of them are little parasites that would like to be attached to the boob at all times because it's warm and snuggly and snacks are right there and so is mom. Why would you ever leave?

The basic options are - (A) tolerate it as long as possible - I used to read, watch Netflix, play PlayStation games with a non scary soundtrack, while the baby just lay there and slept and sucked.

And when you just can't anymore, (B) start working on your baby- soothing A game. Pacifiers, swaddling, swings, bouncy chairs, carrying around in a sling or baby carrier. There are shelves and shelves of books about this.

Again, this is most intense during the first 3 months, which are essentially a larval stage. It's part of why newborns can be so draining.

Strangers on the internet can't say whether the tongue tie is or isn't an issue, but this too is standard baby behavior.
posted by telepanda at 12:09 PM on September 18, 2017 [10 favorites]

Sounds like you're doing a great job. Have you tried putting the baby in a wrap/sling after he's fallen asleep? The closeness to parent+ motion can be magic and it gives you two free hands rather than being stuck under a baby. I am not an IBCLC but this (falling asleep on the boob, being pissed off when moved from boob) sounds like totally normal newborn behaviour.

Kellymom website is a great resource on breastfeeding with lots of articles by International Board Certified Lactation Consultants. It answers some of your questions like, Is my older baby getting enough milk?, weaning from formula supplements.

You might also find Timeline of a Breastfed Baby helpful in terms of "what to expect". It's well sourced and specific.
posted by bimbam at 12:23 PM on September 18, 2017 [1 favorite]

Yep, you're a pacifier, plain and simple, lol. NUK brand pacifiers worked for me when my daughter thought she needed to be attached all the time. They come in all sizes and really do mimic breast nipple shape. Its nice to be all nice and snuggly but you have to get things done. Telepanda has the right idea.
posted by PJMoore at 12:45 PM on September 18, 2017

Have you seen a lactation consultant? Or maybe attended a La Leche League meeting with baby in tow? A lot of these questions are easier to address with someone watching/helping as baby is actually eating, especially when there is a tie involved, and particularly if you can find someone who has good experience with ties.

Memail me if you want to go chat a bit about correcting a mild TT.
posted by vignettist at 1:18 PM on September 18, 2017 [1 favorite]

Totally normal. My six month old still does this when we bring him into bed with us in the morning. Naps and feeds, naps and feeds. They just like being there. Mine keeps one hand on my breast to check it's still there. Babies are weird. They do grow out of all of these phases though, he'll be doing something different next month regardless of what you do.

Mine was a much more efficient feeder after his tongue tie was snipped, so it's worth trying that. Our ENT said it is always hard to predict how much improvement there will be, but DS went from taking 1.5hrs off and on and off again for each feed, to taking 20-30mins and being done, so from our point of view it was well worth it. The op takes under ten seconds and doesn't seem to upset them for more than a couple of minutes, so there's not really any reason not to have it done.
posted by tinkletown at 1:28 PM on September 18, 2017

Some babies are like this.

If the baby is hydrated and gaining weight, they are getting enough.

Try spacing out feedings a little more. Then when feeding, rub the bottoms of the baby's feet to keep them awake. You can also push the baby into your boob a little to make it hard for them to breathe for a second. I know that sounds weird but - it's what I did when my daughter would bite - and it also woke her up a bit.

Night times were just like this for us. She would have sleep half nurse for hours. Solution was growing out of it.
posted by latkes at 1:50 PM on September 18, 2017

Mine was like this because he had very inefficient milk transfer, so he was actually eating for the hours and hours he'd be sleeping. Nursing was exhausting and long and drawn out for him.

I'd say fix the tongue tie if necessary and try to work on baby's latch, to get it deeper. But if I had to go back in time I'd probably switch to bottles. He was really hungry and miserable for a lot of the time when he was breastfeeding, and so was I. He was demanding and assertive enough about it to not actually be missing out on calories. But, we were both so miserable and it would have been nice to spend that time playing, going out, bonding, or doing anything but endlessly nursing.
posted by Rock 'em Sock 'em at 2:05 PM on September 18, 2017

shallow latch...latch is good, as confirmed by doctor and two nursing consultants
- prodding...jiggling, pinching, diaper changes, singing, switch nursing and exposed skin have been tried to wake up baby
- milk adequate (as experienced from pumping)

Seriously this is like going back in time. Everyone thought his nursing was fine but he was just not transferring milk efficiently.

See if you can get a lactation consultant who will weigh your baby before and after nursing to see if he's actually transferring milk. Your strong let-down (me too!) and his persistence might be masking really inefficient nursing.
posted by Rock 'em Sock 'em at 2:10 PM on September 18, 2017 [1 favorite]

Post written over the head of my sleepy baby attached to the boob, I feel your pain!

Pumping is a terrible way to gauge supply because there's so many variables that could be affecting the way milk is getting from boob to bottle that have nothing to do with supply. its a very unreliable proxy measure.

If he's weeing and pooing and gaining enough weight, that's more reliable.

If you're concerned about low supply the low hanging fruit is making sure you're eating enough, drinking enough and not over-exerting yourself (ie no triathlon training).

Newborns tend to be very sleepy because feeding is exhausting for them. It's their only job and their entire energy production is centred around this feeding and sleeping cycle. They grow into their sleep/wake cycle over the next month or two.

More specific advice as to whether your kid is being fed enough right now really needs to be raised with the doctor, who has their growth chart and can look at bubba to see if they're appropriately alert and hydrated etc. everything you've mentioned could be part of the spectrum of normal babyhood, and there could be things that could be 'improved' like the tongue tie, but it's hard to say on the phone. Good luck!
posted by chiquitita at 3:23 PM on September 18, 2017

You absolutely need to see an IBCLC if you haven't already. They can assess your latch, asses the tie, do a weighted feed, and offer personalized guidance. Newborns are super sleepy and love to be at the breast for hours. It will pass. It will pass. It's soul crushingly exhausting and draining but it will not last forever, I promise! You can try a pacifier if you'd like, but I might wait til you resolved the tie (if you end up doing that).
posted by pecanpies at 3:40 PM on September 18, 2017 [1 favorite]

...came in to offer bimbam's links -- definitely Google Dr Jack Newman and read all his stuff, especially "Is my baby getting enough milk?" and "Breastfeeding myths."

A pump doesn't tell you much about how much milk you are making, just about how much you can pump -- it is really common to have an oversupply at the start, then level off to meet demand. And then, OMG, you can't pump nearly as much! Supply problems! But it is NORMAL.

Newman and Kellymom; just do some reading and relax.

I don't know what DO stands for but do be warned that the majority of doctors and nurses, including self-styled uncertified "consultants," have little/no/terrible training on nursing. Your primary line of help should be an IBCLC.
posted by kmennie at 7:24 PM on September 18, 2017 [1 favorite]

I worry about advice from afar but this was my oldest and what worked was letting him hang onto that nipple - but only that side for like 3-4 hrs. Then the other. This helped him get down to nice fatty hind milk. Ymmv.
posted by warriorqueen at 7:35 PM on September 18, 2017

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