Newborn BF issues -- breathing & long time to feed

[seamonster]

I had my son on Sunday via c-section and breast-feeding has been tough on me and seems tough on him. So he's 5 days old now. He's also a big baby (10.75lbs) and I mention size and delivery only in case they have something to do with our issues. To be concise he takes a long time to feed, especially at night (3-7 hours, but usually closer to 1-2 hours during the day and 3 hours of straight sleeping in between), and when he feeds he sounds like he gets out of breath easily and takes breaks with sucking. Hoping that someone has some advice for me. I'm thinking about pumping to be able to do a bottle at night rather than spend most of the night trying not to fall asleep nursing, but I don't know how to go about it. I'm also not opposed to supplementing with formula if that's what we need to do (getting my baby fed is top priority here).

I have the standard cracked and bleeding nipples (hopefully these will resolve and I'm using methods mentioned in other threads to treat), but those aren't preventing me from feeding.

He has a good latch, at least according to the LC at the hospital. Cradle hold and side-laying work best for us -- football hold is really hard on my arms and hands (still have carpal tunnel symptoms) and he moves his head too much to get a good latch without me having to grip his head to force the breast into this mouth. He seems most efficient in the cradle hold; sometimes he just keeps spitting out the nipple in side-laying, but is happy in the cradle hold.

He did seems to grip the nipple really hard for the first few days, but today it seems to have stopped. My milk came in Day 3, but his dirty diapers still seem to be the color and texture of meconium and he does get wet diapers.

Major issues:

1) He nurses for a really long time, especially at night. It can take anywhere from 3 to 7 hours to feed him at night. Last night he nursed for 5 hours, sleeping for about 10 to 15 minutes at a time, but then waking up crying and rooting. He'll latch right away and start nursing. He seems to fall asleep while nursing, but remains latched. I let him stay on until he falls off on his own. He'll suck and then pause, and does this during the day too, but at night I have to stroke his cheek or tickle his feet to get him going again. He'll take in a big breath and then start nursing again. It's absolutely exhausting at night. 

During the day, it's about 1-2 hours for feeding and he drains both breasts. He's closer to an hour today and slept for about an hour after nursing this morning. He seems to be cluster-feeding this morning, but it's more doable during the day (with the exception that grandparents are visiting for the next 2 weeks starting tomorrow). I may be doing it wrong, but I've been trying to nurse off the breast he didn't nurse off of if he dropped off asleep. I might get 3 hours of him sleeping at a time between feedings.

I feel like I'm starving my baby because sometimes after draining both sides, he's still hungry and I go back to the first side hoping more milk came in there and massaging to get anything and everything out. 

2) This is better this morning, but usually when he nurses he sounds like he's panting. When he pauses in sucking, he's still panting, but then starts up again. It seems like he needs to catch his breath. He seems to take longer to do this at night and as I said, at night he seems to fall asleep. I was concerned at first that he might not be getting enough air due to the size of my breasts (not due to engorgement, but I'm a 42 DD without milk), but he's got a gap on both sides and will move if he doesn't. 

I was told at the hospital that this is all normal, but at least the breathing doesn't feel right. And I'm getting very little sleep at night; even when he's down for the count I keep waking up every time he stirs thinking that he's about to wake up crying and hungry. Part of the stress is knowing we have visitors coming and dealing with them at the same time as I'm still getting used to feeding my baby and adjusting to his needs. We thankfully decided we didn't have enough room to have anyone stay over and they'll all be at hotels. I'm afraid I may spend most of next week hiding in the bedroom nursing since I don't know how comfortable FIL and SMIL will be with boobs on display and I haven't even tried covering. MIL and my mom won't care when they come out for their respective weeks, and I don't care what strangers think. I was hoping that LO would be 2 weeks old before the first grandparent visit and we would've worked out any major issues, but no such luck since I failed induction at 41W+2. Part of the stress of grandparent visits is this will be the first time any of them have visited Europe or even been outside North America and the Caribbean.

Any advice? If I do start pumping to just be able to give a bottle at night to get some rest or let my husband handle a feed, how should I go about it considering that my breasts are usually drained after feeding and there's not a lot of time until the next feed? I don't want to screw up my overall supply, but I don't know how to even begin.

Thanks for reading my novel.

[firelizard8367]

this is probably over simplified, but as a ftm, this is all I've got. Have you checked his nose for boogers? I know when my guy has trouble breathing during a feeding, I can pretty much always get something out with the bulb syringe and he breathes much better.

[tomorrowisanotherday]

Paging @amyg to get you some wonderful advice, but I will tell you don't give up, it does get easier! Keep putting LO to the breast, he is much more efficient than a pump. Have someone else take care of all baby duties except for nursing (changing, burping, soothing to sleep) so you might get some rest in between. And talk to an LC again to help your peace of mind.
Also, please do not hide yourself away during this upcoming visit. It is your house and you are just feeding your baby! If they don't like it, they should cover up or go to another room, especially if they are family. You are still learning your LO and don't need any additional stress or steps added to your nursing routine.

[saraml13]

Babies are weird/noisy breathers, but if you are really concerned about his breathing, talk to his doctor.

The rest of it sounds like normal newborn behavior. It does get better. Don't be afraid to take a break during the long cluster feeds. Swaddle LO and hand him off to DH to rock and soothe for 30 minutes. I also found that if I was holding DS he would continue to root and fuss, but that if I mixed things up by packing him up and taking him out if the house for a walk or quick trip to Target it would break him out if the cluster feeding cycle for awhile.

[Deleted]

The first thing that comes to mind is you mention several times that you might get three hours of sleep between feeds. With really long feedings and kinda long (for a newborn) sleeps in between I would recommend rousing baby fully awake to nurse closer to every two hours than three. You also say you are letting him stay on til he comes off on his own but seems you aren't getting very long active sucking.

He sounds like a really sleepy newborn and again use way more techniques than stroking cheek to get baby fully awake and nursing strongly thru better feeds. Sit up at the waist Unswaddle tickle toes cold washcloth on the toes and back if neck rub ear and bridge if nose stroke palm
Of hand. Make the time at the breast more active sucking and less hanging out. Some babies struggle to feed well and dirt if think if they are latched on they'll get automatic food like thru the placenta and they sleep at the breast rather than actually eating.

That plus the darker poo at five days out I would advise a trip to an ibclc to evaluate latch and effectiveness at nursing, milk intake and tips in person for positioning and waking him.

[mully626]

@amyg gave great advice as usual.

I would suggest in the MOTN, after he stops active sucking and you can't get him to start again by the usual stuff (the cheek/jaw rub, tickling feet), go and change his diaper or something like that. Basically try to get him a bit riled up then relatch and see if he will finish the feed. BFing a newborn can take an hour plus but 3-7 hours of just being on the breast is for comfort, not because he's THAT hungry. If he's really wearing you out and won't calm down off the breast, a paci might be something good to try to give your nips a break.

I also agree with AmyG that you should be starting to see more yellowish poops, not the black (meconium) or green (usually too much foremilk) poops. May be worth a visit to the LC.

For the breathing stuff, C/S babies tend to be more congested sounding. DD2 had that for a while. DD1 was a vaginal birth and was a noisey newborn (they're just LOUD!) but DD2 was much worse because she was a c/s and the junk in their lungs isn't pressed out with a c/s like it is if they are passed through the vaginal canal. I'd say it's likely normal stuff and as long as his lips aren't getting tinged blue at all, he's getting enough oxygen. You can try some saline spray, a bulb syringe or nose frida, and running a humidifier near his bed.

Has he had a weigh check lately? Is he back to birth weight or are they concerned with his weight loss? If the doctor isn't concerned with how he's gaining, then I wouldn't be concerned with your supply at this point. Also, even if it doesn't really feel like it, there is always milk there. You aren't ever truly "drained".

[jesster88]

When ds was that age he would only spend a few minutes at a time actively sucking. Waking him up enough to eat was very challenging. I would change diaper first and have a cool washcloth handy to wake him up a bit. When he was really really sleepy I would undress him down to his diaper and that seemed to keep him awake enough to eat. He just really liked to sleep cuddled next to my boobs

This was one of the early issues that felt like it would never end...and after a few weeks he became more alert and could stay awake long enough to eat (or at least eat an doze at the same time).

And on family - you just have to set boundaries. DS is overstimulated easily so I use nursing as an excuse to go to his room and rock and give both of us a break from visitors. People usually understand and if they dont, they'll get over it. You are the mom and you are intuitive to lo's needs.

[judyblume14]

First off - you and you baby are right in the thick of getting to know one another. You're learning how to feed him, and he's learning how to eat. It's exhausting, hang in there!

My pediatrician told me that the one of the scariest things a new parent can do it listen to a newborn baby breathing! They're loud, inconsistent, etc. As long as their lips aren't turning blue and they don't seem perpetually labored, they're probably fine. Like others said - make sure he doesn't have too many boogies or too much snot blocking his nostrils.

I had a super sleepy baby that had to be woken up every 90 mins - 2 hours to feed because she was slow to regain birth weight. We always stated with a diaper change to wake her, fed her in just her diaper, and did everything we could to annoy her and wake her up (PPs have mentioned the tickling, cold wash clothes, rubbing under the chin, etc).

I'd say that waiting for him o unlatch on his own even though he isn't actively nursing is robbing you of sleep. Either wake him up and make him eat, or put him down and take a break.

When your in-laws come to visit, let them know that you are breastfeeding, and if they aren't comfortable with it, would they mind excusing themselves for however long it takes? You should not feel banished in your own home. Maybe while you're nursing, they can throw in a load of laundry for you, or go on a lunch run

[seamonster]

Thanks! I'll contact a LC and maybe one not associated with the hospital. He's breathing better today and not panting as much. Every time he's nursed today I haven't had to keep prodding him to wake up. The Public Health Center near our apartment has a breastfeeding support group on Monday with a LC so I'll hit that up. Still having the dark poo, but it's thinning out.

I'll try waking him to feed more often. I've been wary about waking a sleeping baby, but if that's what he needs I'd rather do that. He's been awake more today and feeding more often. I'm starting to wonder if part of it is the drugs I was on for recovery since I had my last dose of anything but some ibuprofen Wednesday night (I'm down to 200mg ibuprofen every 6-8 hours). He wasn't happy in side-lying this morning when I wanted to get a bit more rest, but nursed great once I switched to cradle hold.

He's not at birth weight. He only lost 8%, but hasn't fully recovered. The Public Health Nurse is visiting us on Monday and will weigh him then.

I'll also try making him less cozy at night and see if that helps. He's a pretty easy going newborn otherwise, so he'd be down for some more skin to skin once he's warmed up from taking off his clothes. And I'll see if nose suctioning helps since he's been sneezy.

Little update: As I was about to hit send he woke hungry. I changed him before nursing to try to get him more awake. Last of the tarry black poops was this morning and this afternoon it's green and foamy. He nursed for about 30 minutes without needing prompting. He's asleep now, but I'll wake him up in a couple hours to nurse again rather than waiting for him to wake up on his own.

[sgio7485]

Just on the breathing - my LO is a csection baby and sounded congested to me. dr said it was normal, I added a humidifier, saline spray and bought a nose frida (best money ever spent!), sucked the snot out and he sounds much better good luck!

[judyblume14]

I went to a weekly "New Moms" group meeting at my hospital, headed by an LC. It was a lot like a BF support group. I would never be able to put into words just how helpful the group was for me. From BFing questions, to just being in a room full of women in my shoes. It was SUCH a "safe" place for me during the "4th trimester"!

[cogdis]

I was having many of the same problems (and maybe some others concerning latching and nipples) with my LO (born on Valentine's Day, so just a day older than yours). I hired a LC and learned that he has lip and tongue tie. Did your LC check for those? Mine is a very inefficient nurser for those reasons.

Regardless of the reason for inefficiency, the solution (until we decide on surgery or not) was to do breast compressions while he nursed so that he would receive more milk (and to help with supply). So far it has made a world of difference. His feeds are much shorter and there is actually a break between them (previous to the LC I was nursing practically 24/7 and bawling like a baby myself).

www.youtube.com/watch?v=Oh-nnTps1Ls

[seamonster]

They didn't check for a lip or tongue tie. The nurse/midwives at the hospital are all trained in lactation consultation, but not certified consultants so I don't know if they even knew how to check for one. I got a lot of help with positioning and getting everything in the right place. Looking at symptoms of lip and tongue tie, he may have one. He definitely has a blister from nursing on his lips and when I asked about it, was told that was normal. And sometimes it feels like he's clamping a bit on the nipple, but not always (seems worse when he's really tired or frustrated). Looking at a couple old threads on a local board, it seems that most people had a really frustrating experience with the LC and midwives at the hospital in terms of breastfeeding and getting help (I did feel like I was the only woman on the floor breastfeeding).

I was doing breast massage and compression yesterday and they did seem to help. Waking him up every 2 hours seemed to help a bit in that he didn't nurse for 2 hours at a time and would go for about 15-20 minutes on each breast. We did end up giving him some formula last night when he nursed off each breast for 30-45 minutes each and was still hungry, going with the idea that some breastmilk is better than none, because both he and I were exhausted. At night we let him go for 3 hours of sleeping so I could get some more sleep.

I've contacted a couple lactation consultants to get some private consultation and see if there is a tongue or lip tie. My husband and I also talked last night about going to exclusive pumping sooner than we planned. I haven't started pumping yet, but had planned to do so soon and go to exclusive pumping once I went back to work due to our work schedules.