Hello from Sharon Mattes, IBCLC

[Sharon_Mattes]

Hi friends of breastfeeding. I am here to help you. :)

[Sharon_Mattes]

Dear medevry:

That question could be better answered if I ask you for more information:
How old is your baby?
Is she only breastfed?
Do you have a 'schedule' for her?
Is she gaining weight and happy much of the time?

I am going to make an assumption (I could be way off though) and assume that
your baby is only a couple of weeks old or even less. If this is the case, you may
find there are a couple of things that you can do.

First - you need to learn her 'patterns' since all people (including babies) have their own
sense of time that is most comfortable for them in eating and sleeping.
When parents feed a baby because 'it is time' sometimes they spend lots of energy in
trying to waken a baby that is in a deep sleep state. Babies feed best after they move
from that deep sleep up into a light sleep and then become drowsy, then awaken. It
is a waste of time to feed baby in a deep sleep.

Watch her. Every hour she goes through a complete cycle (look up infant sleep/wake
cycles and read more) - about every hour. After a couple of cycles - or around 2 to 2 1/2
hours, you can see her start to suck on her hands, stretch her limbs, make smacking or
sucking sounds, and begin to look around - for you! These are early feeding cues - which
are designed to draw your attention to her so she can feed. This is the best feeding time.

Now perhaps you are doing this - but when baby latches on to feed, she suckles for a
minute and then falls immediately to sleep - continuing to do 'non-nutritive' sucking (which
is similar to pacifier sucking). There are lots of pauses - and few sucking bursts.
This may mean she is not 'actively feeding' for a long enough time...and may not be
getting much milk - but she knows already that if she stays on the breast - every so
often you will have let-downs and she will get more swallows of milk. So - if she is
seeming to sleep nurse a lot of her feedings - you need to check her weight and the
number of wet and (especially) soiled diapers - to assess if she is getting enough milk.

You may need to speak in person with a Lactation Consultant, La Leche League Leader,
or your Pediatrician's breastfeeding helper to make sure she is latched well at breast. If
you have sore nipples - she probably is not. :) Sore nipples are not normal --- contrary
to popular belief. They are common, however, because many people think soreness is
normal and they just 'put up with' pain and physical damage. It is something that needs
to be checked out ASAP.

The last possibility is that you are feeding her well - she is very efficient and empties
your breast quickly (5-7 minutes) and just likes to 'hang out' at moms. :) A full baby
is also very hard to waken. So - if she has 4-8 wet diapers and 4 or more large soiled
diapers daily and is happy much of the time - I may not have any problems to help you with. This may be normal for her :)

Do write back if I have missed the mark or if you have other questions.
Sharon Mattes, IBCLC


__________________________________________________ _____________________
What should I do if my baby doesn't unlatch on her own to signal that she is done feeding? She usually falls asleep despite cold wash cloth and other attempts to awaken her during a feeding.

[medevry]

Thank you for your response. My baby is actually almost 7 weeks old. She is gaining weight but slowly, has numerous wet diapers but more infrequent soiled diapers. I take her for weekly weigh ins and I feed her non-stop. The pediatrician thinks she is not getting enough hind milk which is why i have tried to wake her up when she is at my breast. I'm not having much success with this however. Do you have any other suggestions to keep her awake? I am waiting for a call back form a local LC to assist me again with the latch. I think the latch may be part of the problem. Will the baby fall asleep if she isn't getting much milk because the latch is poor?

[Sharon_Mattes]

Dear Medevry

Yes, baby will fall asleep if the latch is not deep enough - because she is not really fully emptying the breast. This can be more important than the concern about hind milk. The hind milk comes if she is deeply latched and feeds as long as she wants on that same breast. It is only when a mother interrupts baby (at perhaps 10 minutes to move to other breast) before she has fully emptied the breast that some hind milk might be left...or when she is not effectively removing milk herself. She may have an anatomical problem that can be quickly resolved and she will do a better job. She may not be causing you to get sufficient let-downs due to her shallow latch. She may not really be drinking as much as she could - which would give her fewer calories, which would also slow her weight gain. There are many factors here that you could look at - so it is best to have someone watch a feeding.

Do see the LC because she might be able to do some very simple fine tuning of the attachment and baby will feed much better --- and your nipples will sing halleluia as well. :)

Babies at this age often have fewer soiled diapers anyhow - (sometimes only 1 per day - or 1 every several days and still are quite normal) however, those
stools would be huge ones! If she is also not gaining well - she can benefit greatly from an LC's expert advice.

Good luck.