Screaming at breast

[brigid]

AmyG

Hi - I could use some help. I’m trying to get my newborn to nurse. He has been bottle fed for the last month due to a host of issues. He has a tongue tie.

I can now get him to latch after he has had a bottle (yay!). He tends to just pop off and on and cry.

I know my milk lets down and it’s not too much milk at once. I don’t really hear swallowing either.

Any ideas about why he is screaming? Thank you!

[tj]

Baby is probably frustrated bc bottles are way easier than boobs. Faster flow and no waiting for a letdown.

You are absolutely right to try latching after baby had had some out of a bottle. That way LO isn’t too hungry and frustrated.

I would:
Start a bottle
Hand express until you are able to get milk flowing
Swap baby from bottle to breast once your milk is flowing

You might also check whether you have a hard let-down. If it’s choking baby (doesn’t sound like from your post) then they will scream at that too. But there is usually milk dripping out of their mouths from the letdown and it doesn’t sound like that is the case.

[tj]

Sorry. Re-read and yes probably not heavy let down.

I would still try hand expressing and swapping. It may just take some time for LO to get used to the slower flow.

When you are bottle feeding, make sure you are doing paced feedings with the slowing flow nipple you can find. Burp and switch sides every ounce. Don’t let the baby chug it down.

How old is your baby? Remember to take a deep breath. You can do this.

[brigid]

tj thank you! He is a month old.

Do you think I should just keep trying? Right now I’m latching him a few times a day (way more than before). I don’t want to make him hate nursing but I also want to give him lots of time to practice.

[tj]

It sounds like you are doing fantastic brigid! If you want baby to breastfeed, then I absolutely think you can get him there by continuing this process. You are totally right about not making it a negative experience. That’s why you don’t want to do it when baby is starving.

Maybe even try latching occasionally even when it isn’t time for a feeding. Strip baby down to a diaper, take your top off, and you two just cuddle in bed together (safely - watch pillows and blankets that could accidentally cover baby’s face.) And just make it some special time together for you two. Make it sweet snuggles and let him latch and see what happens.

I am on mobile and not a Reg on gd so I don’t know if you have other kids or are a new mom. But obv the most important thing is that baby is being fed, not how. You are doing great.

[brigid]

tj thanks. I’m not a new mom but I’m still getting really frustrated so I appreciate the advice. I’m trying not to take his screaming at me personally but it’s hard, haha.

[AmyG]

tj mostly covered everything.
my hints for you sort of everything mentioned by tj already.

make sure you are using the slowest flow bottle nipple you can find, nipple shaped kinda like your own nipple at the end of a pumping session.

I assume you've been pumping a lot of milk to maintain your supply. But if so, how much oz do you usually get? it it's a lot more than 2-3 oz you may have a bit of an oversupply but that's another subject to talk about later.

make sure you are feeding baby sort of sitting up, tilting bottle downward so baby has to suck harder to get milk, and it doesn't just flow into their mouth. that makes it harder to transition to breast because baby is used to an easy milk flow.
switch side you hold baby on every ounce, with a burp in there and make bottles take closer to 15-20 minutes to more mimic how long nursing usually takes.

Did you get tongue tie fixed? If not that will make it harder for baby to transfer milk, more likely to get frustrated at the breast.

You can continue to try nursing after a bottle, or start to try after almost a whole bottle, or a couple ounces into the bottle, or even before offering the bottle, trying to stop before actual crying, but let baby try at the breast and a little fussing is ok, try to stop before full on crying.

Spend more time with baby at the breast with ready access to try to latch on and see how they do with that. let them see the breast as a nice comfy place to hang out, take a nap, express some milk on the nipple and see if the smell will entice baby to try to latch on. try in a darkened room. an hour after a bottle, sometime baby wants to suck but it isn't "time" for feeding.

when deciding to try nursing after a bottle/part of a bottle, it's nice if you can have a change to pump just til let down, have milk on the nipple and make it more likely baby will latch on and get milk right away.

as for baby crying and you taking it personally. baby is going to cry when you make them do things they don't want to do, but you know they need to do. so diaper changes, and burping when they just want to eat, take medicine, and go to the dr for shots. So practice not taking it personally. You are working to get baby to the breast cause that's what you want, that's something that will make that breastmilk easier for them to get, keep mom from having to pump, and baby will most likely adjust just fine once they realize this is the thing they need to do.

Be patient, give them dozens of opportunities, like try 1 time at one feeding today, 2 times at 1 feedin tomorrow, maybe 2 times at 2 feedins the next day, working up in frequency as you both tolerate it. Babies are creatures of habit. eventually baby realizes that every day, every feeding they'll get some time at the breast.  they realize every feeding they'll get some milk in a bottle and some at the breast, and then you start spending less time with that bottle.
But you have to be a bit more stubborn than baby is.

Also try different positions when trying to latch on. cradle, cross cradle, laid back, side lying, just keep trying. one way will click and be the favored way for a while with the most success,then you keep trying other ways and get to where they'll latch on and nurse without so much fuss and thought.

I know it's hard.

[AmyG]

brigid,
hows it going?

[brigid]

AmyG thanks for asking!

I’ve been working all week with him and I can now get him to (with varying levels of excitement on his part) latch whenever I go to nurse him. I’m trying to nurse for around half of his feedings now, which is awesome.

I have more questions though if you don’t mind!

He doesn’t really swallow when he is nursing. He sucks for a little while and then falls asleep, rinse and repeat. I am using a nipple shield because I have inverted nipples. I usually only see a few drops of milk in the shield - with my other child I remember it being filled more, I think.

Any tips?

[brigid]

To answer more questions... I thought I responded but I must have only done it in my head, whoops.

If I pump as often as he feeds I get around 3 ounces. I usually pump a little less often and get between 5-7 ounces. All in I pump probably about 90% of what he eats; the rest is formula. My pumping goal is basically just to do it to maintain supply with the hope that we will transition to nursing.

I’m not going to get the tie fixed due to Covid.

Thanks so much!

[brigid]

I think I figured it out! I started him with the shield and then took it off and he as still able to latch. He definitely stayed on longer, popped off less, and swallowed more. His latch sucks but we will work on it.

Thank you again! We went for eight hours yesterday without bottles!

[tj]

That is an awesome update brigid! You may even be able to ditch the shield completely some day. I had inverted nipples when I first started breastfeeding my first. It sounds really weird, but if you kind of play around with your nipples a little bit before attempting a latch, you may be able to get them to stick out the right way. Once my first (also had a tie, also didn't get fixed bc wasn't diagnosed until she was 2) got the hang of latching, I was able to nurse her exclusively without using a shield. So just know that even with inverted nips, it is possible!

But mostly I just wanted to say congrats - that is amazing progress! Just keep an eye on his weight to make sure he really is transferring well, as you transition away from bottles. Keep up the great work!