Wow! Thanks to all of you who responded to my plea!
I should have mentioned a couple of additional details in my original post.
OALD-Mom claims to have fuller breasts at night!
My original thought when she called was exactly what many of you came up
with-typically the breasts are less full at night and this would certainly go hand
in hand with the OALD-overproduction idea.
Positioning-Mom didn't feed sidelying at all until my second consult thus
the nighttime position is EXACTLY the same as day.
I did encourage sidelying as my experience is the same as many of
you-sidelying is often more comfie for these high need babies! She unfortunately sees no
change with its use.
Reflux-I really believe that this plays a role here but why only during the
day? Is he just so tired by day's end that he sleeps regardless? Nothing else
seems to be different other than the feeding frequency which leads me to stick
with the longer intervals between feeds idea (although this is in stark
contrast to typical reflux management!)
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts
>>Hi all,
I'm close to the end of my rope with this case!
Baby is now 6-7 weeks old. First consult was done at 5-6 days of age d/t
inability to latch-resolved w/o much trouble.
Mom called a couple of times @2-4 wks of age with ??s surrounding "irritable"
baby ie. he pulls off of breast after a few minutes and cries, refusing to
reattach, has very fussy periods in eve etc. Mom had already spoken to pedi who
advised give up dairy (she did)and feed a bottle when baby refuses. I, of
course, discouraged the bottle-reiterating baby will not starve himself at this
age-wt gain has been great. We also discussed possibility of OALD,
overproduction issues -some evidence of each.
Second consult done last week, pulling off breast has persisted. Mom has
learned to cope with fussy periods (she is great-plays soothing music, very calm
manner at breast etc) but the unhappiness at breast is driving her crazy. The
complicating fact is that baby is very comfortable at night- feeds both breasts
for 10 min each then sleeps (flat) 3-4 hrs, happy, happy, happy! At the time
of my consult (afternoon) he fed well (he had been all day-that day :), but
became fussy toward feed end-o?verfed with reflux was my take at the time . Mom
does have more milk then she needs (not huge) though) but it is difficult to
manage this with the current feeding pattern ie. tends to snack all day. Baby
is very active, moves his arms and legs so much that he overstims himself and
usual calming techniques ie. sling, holding, wrapping etc. are difficult to
implement in current summer heat wave.
I currently have her nursing on one breast per feed, offer breast no more
frequently than every 2 hours-still the same!<<
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