QUESTION: My baby seems to start out feeding OK, but long before he acts full he will start struggling, grunting and pull away from the nipple and cry/scream. He acts like he wants to continue sucking but will start screaming again. It becomes a wrestling match to keep him at the breast. The disturbing thing is that he will act much nicer with a bottle of expressed breast milk. I've been trying for weeks to resist the temptation of switching to a bottle full time, but with all the frustration on both sides am I really doing him a favor? There are no rashes, no fever or other signs of illness. He does not vomit or spit up excessively. He is often fussy between feedings too, but sleeps well at night (5-6 hours) and has good play times too.

Congratulation on your wonderful determination to continue nursing Zachary! You have already passed the hardest time of breastfeeding. At 6 weeks Zachary may be going through a growth spurt so don't be surprised if he seems to want to nurse more often, this will only last a couple of days and may be the reason for his increased fussiness between feedings. Offer Zachary the breast and nurse him for as long as he wants on one side. Burp or change him and then offer the other side.  If he does not take it, that is OK, simply start with that side the next time.

You say " but long before he acts full he will start struggling, grunting and pull away from the nipple and cry/scream." My question is what do you mean by long before he acts full? There are no time requirements at the breast despite what you often hear. Allow Zachary to stay at the breast for as long as he wants. You do not need to struggle with him until he is on for a certain amount of time.

It sounds like you may have an oversupply so that Zachary pulls away when you have a let down due to the fact he cannot quite handle the spray of milk. You can find out if this could be one of the reasons for his pulling away by letting the flap down from the breast that he is not feeding on and watch for leaking. Leaking will often occur when you are letting down on the side that he is nursing on. If this seems to be what is going on, nursing in the way that I mentioned above would help. I would also recommend that you nurse Zachary on the same side for at least two feedings to slow down the production. If you need to, pump the other side for comfort.

The other reason why Zachary may be pulling away is a milk allergy to dairy that you may be ingesting. So if you drink a lot of milk or milk products try eliminating these for 2-3 weeks and reintroducing it to your diet again a little at a time. Watch Zachary for any change in behavior. It usually takes 7-14 days for milk protein to disappear from your body.

Try nursing Zachary lying down or in an exaggerated football hold so that he is more upright to see if this helps. If Zachary is not happy while at the breast, calm him down before you offer him the breast again so that he does not associate the breast with crying.

Yvonne C. Bannister, B Sc, CBC, LLLL, IBCLC

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