Dear Rachel!

> Rachel writes:
>>I'm seeing a mother of a two month old baby who has been gaining fine but
>>very unhappy with feeding.  Mother contacted me because breastfeeding is
>>so
>>stressful.  Some feeds go smoothly, most often at night.  Other times, he
>>seems hungry to mother, will latch on and suckle for about five minutes,
>>after which time he pulls off, though continues to behave as if hungry -
>>hands to mouth, rooting a bit.  Mother notes that milk is often spraying
>>from her breast when he lets go.  If mother offers the breast again he
>>becomes very upset, screaming and arching.  She fears that five minutes
>>isn't long enough to transfer enough milk to survive and is very worried
>>that he is getting underfed.

I would, too, think first about strong MER and too much milk after hearing a
story like this if the baby is othervise healthy. Baby is gaining weight,
how about the whole anamnesis (baby, mother)? If there is nothing else, that
stand out as a red flag, I would ask the mother to try feeding the baby
several times at the same breast and gradually lenghten the time feeding
from the same breast to 3-4 hours before switching to the other breast. I
have had several cases where this have worked things out better. I even had
one mother, who donated a tons of  milk and whose own baby was not gaining
normally in the first month. After she started to pump first some milk and
then breastfed the baby, the weight gain normalized - and was actually great
after the switching the feeding and pumping routine. (Allergies would be my
second thought.)


Best wishes,
Pia Ruohotie, RN, breastfeeding counsellor and educator, Imetyksen tuki ry
From Helsinki, Finland, Europe - we have snow here!

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