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Hello,

My 5 week old son is breast fed exclusively, he feeds well and is gaining weight however, after his feeds, particularly at night, he writhes around and seems to be uncomfortable and sometimes in pain, for up to half an hour. He often drops off for a few minutes and then starts to writhe around and wake up again. This has been happening for a few weeks but seems to be getting worse with it happening for more feeds and taking longer to pass. I am careful to make sure that he has been burped before I put him back down so I don’t think it’s wind. It seems to get worse as the night progresses with it taking longer to pass after each feed. He feeds for ten minutes on one breast (and rarely takes the second breast) and I have checked and he seems to empty the breast in that time. He feeds every two hours and cluster feeds in the evening usually between 4/5 and 8/9pm. I asked my health visitor about this but she couldn’t come up with any reason why this was happening and suggested I get in touch with a breast feeding expert.

Thanks for any help you can offer

Josie

Hi, Josie. I am sorry to read about your little boy's apparent discomfort - though it's good your health visitor seems confident there is nothing seriously wrong, and that he is thriving.

I wonder if his writhing and wriggling is normal, even so? If he was in pain he would be obviously distressed and would  cry. Some babies are very wriggly and seem to do this as a regular part of setting themselves to sleep. It honestly doesn't sound like a feeding issue to me....though you could speak to a breastfeeding counsellor properly by calling the breastfeeding line 0300 330 0771. You can describe in more detail exactly what happens and she can ask your questions. Babies' behaviours can be mysterious at times! 

 

His feeding pattern sounds normal. Most mothers don't need to work hard to wind their babies, and makig sure he has burped is probably not necessary , and it is not necessary to empty the breast, either. The breastfeeding counsellor can talk about this a bit more with you. 

 

I hope you find some suppprt and help soon. 

 

Heather Neil

I am having problems with green poo and lack of weight gain. I have decide to email instead of calling so that I can make sure you know everything that is going on, I am sure it is all connected!

I have a 17 week old baby girl who is totally breastfed and since June time she has been experiencing green poo. To begin with it was occassional but for a while now it has been every poo, roughly once a day. The consistancy and smell was the same as "normal" poo. I spoke to a number of health professionals who told me not to worry about as it is "one of those things".

However for the past 6 weeks, she has not gained as much weight as normal. She was gaining about 1lb every 2 weeks, but at her last weigh in she had only gained 3.5 oz and two weeks before that it was only 8oz. Furthermore the poo has also changed. It is now very watery and almost happens after every feed. It is also causing nappy nash.

I was expressing in the morning and the evening to enable my husband to give her a feed at 1030, but suddenly it was taking over a hr each time to express the amount I needed. I read that fenugreek would help me express more so started to take it about 2 weeks ago and gradually upped my dose, as I wasn't seeing/feeling any results. I then read that watery green poo could be a side effect of too much foremilk, and thus a side effect of taking fenugreek. I therefore stopped taking fengreek about a week ago and then on monday i changed my feeding habits to only feeding one breast per feed. Roughly 730am, 11am, 230pm, 5&6pm, 1030pm, ~2am and ~5am. Although I am not sure that this is the right thing to do: by the time the feed comes round my breast still feel very full and worry that this is still too much for milk.

Olivia has also been bobbing on breast at the beginning of the feed. I am assuming that this is due to a powerful let down, as she didn't always do this, apart from previuos growth spurts. I also think that I get more than one let down per feed, I guess this is the case because Olivia will sunddenly starts to gulp and swallow for a minute or two. Is this good or bad with regard to foremilk?

I hope to hear from you soon
regards
Helen Cholmeley

Hi, Helen. Thanks for posting to NCT.

I can understand your concern, as green poo looks unusual! Your health care professionals are telling it like it is, though - in a normal, healthy baby there is no reason to link it with any problem at all. It really is on the normal spectrum. Wateriness is on the normal spectrum, too - usual measures with barrier cream should be enough to combat the nappy rash. 

The weight gain question you outline describes a normal pattern, too. Current guidance on best practice is to weigh healthy babies no more often than once a month in the first  six months after the baby has regained birthweight (no more often than every two months in the following 6 mths).  The reason for this is that the information garnered is not useful. As it happens, it is well within normal for a healthy baby to slow down their weight gain after 10-12 weeks   - a 1 lb weight gain every 2 weeks would be really, really unusual in a baby of this age. You don't say what Olivia's weight is doing on the chart, but healthy babies can drop up to 2 centiles without any problem, and the majority of the ones who drop more than that are ok. 

It's also normal for 'production' with expressing to slow down with very well established breastfeeding.  You probably are making less milk than before - that's fine! Most women over-produce in the first weeks - under the influence of prolactin, milk supply is generous. Later, prolactin levels fall and milk supply is tailored much more neatly to demand, and many women find they respond less well to the pump.

So, all those aspects you raise are normal, and signify nothing, really.

Foremilk and hindmilk are often misunderstood. You don't normally need to engineer them. A few women over-produce massively, and they have problems (long before 17 weeks, though). Their babies splutter and fight and gain weight hugely. They have colicky symptoms. The solution for these mothers  is to deliberately reduce *volume* of milk made by reducing stimulation - so they feed on one side only often sticking to one side for a few hours. This also reduces the lactose, and the breasts in time feel less full.

From what you say, you are not in this category of needing to do anything about your supply or its constituents. Feeding Olivia in accordance with what she seems to 'ask' for is fine - deliberately using one side only is not necessary. Just offer her the second side when she seems to have lost interest in side one. Can't see the need for fenugreek, either.  

Everyone has several let downs per feed - sometimes you notice them, sometimes not! Guping and swallowing may well be what babies do in response to them, but some babies don't show much visible reaction. 

Helen, forgive me, is it possible you have been made a bit anxious about the poo and the weight, and you are over-thinking the whole thing???  You're trying to find a link between disparate aspects of feeding, all of which are normal, and then trying to 'treat' something that isn't actually wrong? Sound from what you say that breastfeeding is going just fine, Olivia is a healthy, thriving, growing, happy baby.  When you read over this, is this something you need to do anything about, or would it just be ok to continue feeding Olivia responsively,and regain your confidence in the whole process....'cos it sounds like nature has it well in hand, honestly! 

Feel free to respond to this - you can contact me direct at h_neil@nct.org.uk if you want to share any other info or ask more questions. 

 

all the best

 

Heather Neil 

bfc

 

Hi,
I am planning to try for another baby shortly and wondered if taking folic acid affects breastmilk? I am only feeding my baby once a day in the morning and plan to stop that shortly but obviously want to take folic acid for my next pregnancy.
Many thanks,

Hi, Donna.

 

Thanks for posting to NCT.

 

Folic acid is considered perfectly fine while breastfeeding. It is a food supplement - nothing in it would not be found in food, and it not considered to be a medication or drug. 

 

You can find further reassurance on the product pack - most manufacturers have a telephone line for consumer queries.  Your midwife or doctor should also reassure you about this. 

 

all best wishes

 

Heather Neil

 

I have to return to university 4 weeks after the birth of my baby however I would like to continue breastfeeding, legally can I take the baby in or do they have to provide a room for expressing?

Hi, Abigail. Thanks for posting. The law as we understand it is unclear - there is health and safety at work protection for employees, and employers have to supply a clean, safe place for expressing and storing milk, but this may not apply to students. I don't think you can claim a right to have your baby with you. I think your best course of action is to see your student welfare officer (part of NUS) and see if there is a policy for support of breastfeeding mothers - there may well be one in place, and you may find it goes beyond what the letter of the law might say about things.

 Sorry we're not able to help more -  http://www.maternityaction.org.uk/ is usually a good source of help on legal issues. I hope things work out and you are able to continue breastfeeding for however long you want.

 

Heather Neil

Sadly I was hospitalised when my second child was 3 months old & I was unable to see her or use my express milk for 3 weeks. She is now 10 months old & I have managed to breastfeed her in the morning & during the night, however she is reluctant to take the breast during the day.
I was curious (as I was planning on feeding her up to 18months), that the boost to there antibodies via BF around 14months would be little or none beneficial as I'm part bottle feeding, (like wise if I change from day formula to normal whole cow milk)? Or would she still receive the full benefits from breastfeeding?

Hi, Jenny. Thanks for posting to NCT. I am really sorry you have had to wait for a reply.It's great t read you were able to overcome the challenge to your breastfeeding when your baby was younger.

Breastfeeding is always a nutritious and healthy food/drink, and antibodies are made dynamically (that is, they are made as they are needed) as well as being present all the time.   A baby who's breastfed a lot, gets lots of antibodies, but giving formula or cows milk does not wipe out the health effects of breastfeeding to the immune system. Your baby will get plenty of positive boosts from her continued breastfeeding, whatever the rest of her diet.

I hope this helps you, Jenny. 

 

Heather Neil

 

I was wondering if it were possible to see a breastfeeding counsellor once I have given birth? I followed NCT antenatal classes, but the breastfeeding counsellor was unwell and thus we didn't get the opportunity to have that particular session. If I have problems, is there someone who could visit me or is there somewhere to go? I live near Watford.
Thanks

Dear Elinor,

Were you given the class Breastfeeding Counsellor's contact details on your class contacts list?  Assuming she is recovered from her illness then I'm sure she'd be happy for you to phone or email her, and she can tell you what arrangements there are in your local area for breastfeeding support after your baby is born.  Your teacher can probably give you the Counsellor's contact details if you don't have them.

If your class Breastfeeding counsellor is unavailable you could either ask your teacher, or if you go to the NCT website homepage, check "Your local branch" and enter your postcode that should bring up details of a local contact.  One of these should be able to put you in touch with any other Breatfeeding Counsellors or tell you about drop-ins etc in your area.

The NCT also runs a Breastfeeding Helpline which is staffed from 8 a.m. to 10 p.m. seven days a week by qualified Breastfeeding Counsellors who can provide you with information and support.

 

I hope this information is helpful.

 

Best wishes

How soon after a caesarin delivery is it safe to be pregnant again?

Hi Kath,

Thank you for contacting the NCT. 

It is usually suggested to most women to wait a year before becoming pregnant again, however, this doesn't mean that some women don't become pregnant again sooner than this.  It is felt that this time period allows for the incision to heal fully before a subsequent pregnancy.

Our website, http://www.nct.org.uk/info-centre/decisions/view-40 gives information about VBAC (Vaginal Birth After Caesarean) and states "Research seems to show a small decrease in scar separation rates as the gap between pregnancies increases. However, the risks are tiny in all cases and most mothers who go on to have a small gap between pregnancies do not encounter problems."

This website may also be of use : www.caesarean.org.uk

Finally, NCT Shop stocks a book, Vaginal Birth After Caesarean which may be of interest if you are planning a vaginal birth, http://www.nctshop.co.uk/Vaginal-Birth-After-Caesarean-The-VBAC-Handbook-Helen-Churchill_Wendy-Savage/productinfo/1840/

Kath, I hope this is useful information.

Best wishes

Clare Charlton, Antenatal teacher

Hi there, I am breastfeeding my 5 week old and feeding her every four hours during the day and she goes six hours in the nights. Lately she seems to only want to feed every six to seven hours. I try to feed her at four hours but she only latches on for about 5 to 20 minutes and then falls asleep and refused to have any more (clenches mouth or cries when I try any more. I am worried that she won't be getting enough food. Any advice will be greatly appreciated. I have tried calling all the breastfeeding helplines and my health visitor but have had no answer.
Thank you,
Sarah

Hi, Sarah. Thanks for posting to NCT.

I can understand your concern about your baby's changed feeding. 

First thing is to encourage you to call the breastfeeding lines again - NCT's is always answered (bar rare technical hitches) and if you need to leave a message, you will always get a call back within an hour or so (again, bar technical hitches). I encourage  you to call your HV, too.

I'm suggesting you call, because there is more information I'd need to ask you before exploring the situation with you.  Your baby's general health, her weight, her behaviour up until now, and any breastfeeding 'history' you have had - all relevant information that would help you assess what might be going on.

 

I agree with you that this feeding pattern is unusual and concerning - it may be a short phase connected with nothing serious at all, of course, and things may be fine. On the other hand, four hourly feeds and six hours in the night for a 5 week old baby - what she was doing before this change - was unusual in itself. These feeds are quite infrequent - she was probably feeding no more than 5 times in 24 hours, which  can be normal for a baby who's piling on weight and doing well, but for some babies it's just not enough to maintain a good milk supply and a good intake. Feeding only six to seven hourly now could be a result of her trying to conserve energy - it is impossible to tell and I can only urge you to get a real-life opinion on what might be happening. 

 

I hope this helps, Sarah. 

 

Heather Neil

Do you know if there are any risks to having 3 ulransound scans within 7 days?

We are expecting twins and plan a 4D scan Tuesday 27 July. At my consultant check up today at the hostpital they did a 10 minute ultrasound scan to check the babies heartbeats and I'm due to have a 28 week scan on 29 July at the hospital.

Grateful for your advice.

Zoe

Dear Zoe,

 I do apologise for our delay in answering your query, and hope that you have not been worrying too much.  Unfortunately a glitch in our system meant that a number of queries got "locked" preventing us from getting in to answer them.

Ultrasound has been widely used for many years, and these days most babies will undergo several scans during pregnancy.  There is no evidence that these scans are associated with any specific risks, although some parents feel that it is prudent to keep them to the essential minimum.  You might like to check with your consultant about the purpose of any future scans that are suggested, and whether there is another way of checking your babies' well-being.  However it seems on the available evidence very unlikely that the scans you have already had will have done your babies any harm.

 I hope this reassures you, and wish you all the best for the rest of your pregnancy and the birth of your babies.

 

Hi
There seem to be great benefits to baby massage, but I want to know if I am to receive training in such techniques what qualifications should the instructor have? Are there any particular qualifications that are regarded as industry standard? What should I be looking for in the trainer or training? What insurance should they have?

Apologies I couldn't just ask one question. Thanks
Alex

Hi, Alex. We can't answer any of these questions, sorry. We don't run baby massage classes and we don't act as assessors or mediators for training schemes.

 

You could ask the organisation offering training how they assess, insure and otherwise quality control their trainers. 

 

all best wishes

 

Heather Neil

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