Breastfeeding the Fussy Feeder

Dealing with a fussy feeder can be stressful, but there are ways to cope.

My second daughter, Breeze and I haven’t had the smoothest of nursing relationships. With my first daughter, Raine, I’d just pop her on the boob and everything went right with her world. But with Breeze, aside from those first few blissful hours in the hospital nursery—we were probably both too sleepy for anything—breastfeeding has been a struggle.

It could’ve been karma squirting me in the face. I admit to casting smug glances at the other mothers in the nursery who were complaining about not having milk yet. My milk came in on time, and abundantly. Over abundantly, in fact. Breeze would gag, choke and complain at the forceful letdown. And the leaking from the unoccupied side had me soaked in no time.

Breeze would cry most times when we’d feed. She’d cry, latch on, unlatch, gag, cry, arch her back, kick her legs, pump her arms, latch on, unlatch, cough, cry, latch on, unlatch, kick, arch back, cry then finally spit up copiously. Sometimes we’d even get Exorcist projectiles. Initially, she fed round-the-clock, almost every hour. And we’d go through that routine almost every time. Then when she got older, at about two months or so, she would go for up to six hours without feeding, and I would have to coax her to feed. There came a point that when she saw my breast, she would start wailing.

Of course it didn’t help that she was extremely gassy, high-need and colicky (American pediatrician Dr. Morris Wessel’s most widely accepted definition of a baby with colic is "one who, otherwise healthy and well-fed, had paroxysms of irritability, fussing or crying lasting for a total of three hours a day and occurring on more than three days in any one week for a period of three weeks.” Check out MedicineNet for a quick, easy-to-understand overview of colic.).  It was a vicious cycle: her fussiness would make her gassy, and that would lessen her desire to feed, which naturally would make her hungry, which made her fussy.

Breeze’s pediatrician diagnosed her with a mild version of lactose intolerance; she probably didn’t have enough enzymes to break down the milk. He prescribed a lactose-free formula to take for a week, before gradually reintroducing breast milk.

I was devastated. I may not be the most maternal of mothers. I confess that I can’t last more than 15 minutes playing peek-a-boo or hide-and-seek or tea parties or catch or whatever else kiddie games—and that’s pushing the time limit. I sometimes take the last cookie and hide from Raine while eating it. I have to work hard at making that elusive mothering instinct kick in. But by golly, I could produce milk. I was Super Cow!

To find out that milk from my breasts was not only unable to soothe Breeze, but could also partly be the cause of her misery was a blow to my already deflated Mommy ego. It also started a new vicious cycle—since Breeze wasn’t feeding from me that often, my milk production went down (though I admit I wasn’t too diligent about pumping every two hours), so when she would deign to suck from me, the letdown took too long that it frustrated her, prompting another nursing strike. Breastfeeding, which was once my bastion of confidence as a mother (and my chance to relax) stressed me out.

The pediatrician was also concerned about Breeze’s minimal weight gain, which of course, added more pressure. Long story short, we didn’t last the entire week on the formula. Breeze hated it. After two days of forcing her to take it, she got so dehydrated that we went back to the breastfeeding struggle. It was the lesser of the two evils.

Breeze is now four months old, and while our breastfeeding sessions have gotten better, it still is far from the idyllic smiling-mother-and-baby-in-rocking-chair scenario. But we are coping. Sometimes we even enjoy it. Her colic has peaked, and we’re gradually discovering the happy baby underneath all that gas. Along the way, we’ve found tricks and strategies that helped ease feeding woes.

• Try to figure out the cause of fussiness. Popular breastfeeding support site Kelly Mom has a great rundown of possible causes of feeding fussiness.
• Watch for cues. It’s best to offer Breeze the breast when she isn’t screaming hungry. Once she starts screaming, there’s no way to feed her. When that happens, I usually let her sleep and try to feed her after the nap, when she’s half awake. This also means that I wake up early mornings to attempt to feed (she can sleep 10 hours without feeding sometimes!). I also offer to feed even if she isn’t really showing signs of hunger, say, every two hours.
• Experiment with the ambiance. Breeze won’t feed if it’s too hot, no matter how hungry or thirsty she is. Much as I am against raising an aircon-dependent baby, I’d rather have that over an undernourished one any day. She also feeds better at night if the ceiling light is off and the TV volume is low.
• Minimize distractions. Any noise—Raine talking to me, The Hubby snoring—can distract Breeze from a feed. Once, The Hubby attempted to spoon-feed me my dinner while I fed Breeze hers, and I wanted to kick his sweet, well-meaning butt since Breeze stopped and refused to feed again until four hours later.
• Try to eliminate the gas. Dr. Zeka Tatad-To, founding member of breastfeeding group LATCH, advises burping when changing breasts, and after every feed. I have a hard time making Breeze burp, so if he’s available, I pass Breeze on to Daddy. We also try tummy massages during baths and diaper changes (only if she isn’t crying); aceite de manzanilla on her feet (it gives her rashes on her tummy); and carrying her upright for at least 30 minutes after a feed. Monica Manzano, one of the yummy mummies behind Indigo Baby highly recommends Woodwards Gripe Water, available at Assad Mini Mart along Jupiter Street in Makati.
• Control letdown. When I was overabundant, I’d pump and feed Breeze after letdown. Then when my production slowed, I had to pump and feed Breeze right before letdown. A good pump is your friend.
• Change scenery. I’ve tried feeding Breeze on the couch, on the bed, on a stool, standing outside in the garage (behind the car, out of passersby view, or so I hope). Sometimes it works, sometimes not. But it’s always worth a shot.
• Change positions. We’ve tried tummy-to-tummy, semi-upright, sitting on lap, sitting beside lap, carried by Daddy facing me—and like the scenery, sometimes it works, sometimes not.
• Change your diet. The usual culprits are dairy, nuts, wheat, chocolate, onions, garlic, beans, cauliflower, broccoli--the stuff that can cause you to become gassy. Experts recommend that you try eliminating one food for one week and observe if there are any changes in your baby. Keeping a food diary helps.
• Try a little restraint. And yes, I mean more than the restraint that keeps you from tossing your baby out the window. When she was tiny, I'd swaddle Breeze before feeding, as advised by Dr. Tatad-To. When she outgrew swaddling (and it was way too hot), I'd hold down her hands and wedge her feet against a pillow. Sometimes, in cooler weather, a light blanket over her would also work.
• See your doctor. Our pediatrician helped us rule out my paranoid self diagnoses, such as tongue-tie and Gastroesophageal Reflux Disease (GERD), as well as any nasal blockages.  I’m thankful that Dr. Borja has been very patient and empathetic, and really takes time to entertain my questions. But just in case there is something wrong with your baby, then early diagnosis and intervention is always best.
• Don’t sweat the small stuff, especially ounces or number of feedings in a day. According to Dr. Tatd-To, “Every baby will have his/her own feeding schedule…A baby who feeds six times a day will not necessarily get less nutrition than a baby who feeds 10 times a day since each baby's needs are different, and the amount of milk a mother is able to provide at each feeding also varies among mothers.”
• Relax. Related to the previous tip, this is one of the hardest things to do, since by nature I’m really such a worrywart. But to paraphrase Jesus (in Luke 12:25-26), by worrying can I add another day to my life (or another gram to Breeze’s weight)? I can’t. So I just do my best to feed and nurture Breeze, and I entrust her health and development to God.
• Be pragmatic. Sometimes, Breeze would rather have expressed breastmilk from a bottle than feed from me. And she’d rather take the bottle from someone else. As Dr. Borja says, I just have to accept it. So now I do my best to pump as much as I can, try to feed directly when Breeze would like to, and enjoy the sudden pockets of free time that I get when Breeze feeds with someone else.

Need more information on fussy feeding and nursing strikes? Kelly Mom gives a good overview on the topic, as well as additional reading.

Have your own fussy feeding tips? I’d be so happy to hear them.