My Baby Won't Nurse!

Refusal to nurse is a common problem breastfeeding moms will face with their little ones. Babies wail or fuss at the breast. They push away or arch their backs. I've encountered it dozens of times with my little ones, and it's enough to make a mom want to throw in the towel (or burp cloth) on breastfeeding. To date, I have more than 24 months of breastfeeding experience under my belt, but only because I refused to give up. Most often, waiting it out seemed to be the key. I thought I should share some of the reasons why babies may fuss at the breast:

• Needing to burp: If baby's been nursing just fine for five minutes or so, then suddenly refuses to continue, the most common explanation is the need to burp.

• Simply not hungry: Young babies will generally need to eat every two to four hours. If you suspect your baby might not be hungry, try again in another 30 to 60 minutes. Don't wait for your baby to become overly-hungry, though.

• Indigestion: The foods a mother eats change the content and flavor of her milk. Babies may get some indigestion from certain foods or simply not like the flavor of the milk after mom had something spicy.

• A cold: If your baby has a stuffy nose, she may not be able to breathe very easily when she sucks in milk. Try a little bit of baby nasal saline solution followed by a nasal bulb before nursing.

• An ear infection or teething: If this is the case, the action of nursing can sometimes be painful for some babies. If you suspect teething, give your baby a teething toy. Wait an hour or so, and keep trying. If you suspect an ear infection, use an otoscope to check your baby's ear for redness, or see your child's pediatrician.

• Too tired to nurse: Occasionally, babies are just too tired to want to do the work of eating. Sometimes a difficult afternoon or a busy day full of new experiences makes babies overstimulated. Put baby down to nap.

• Distractions: A room full of other people or sounds can be distracting or overwhelming, especially for babies about six months old or older. Do your best to dim the lights and find someplace quiet for just the two of you.

• Bowel movement: My children would refuse to nurse if they were trying to poop, no matter how hungry I thought they must be (especially as very young babies). As soon as they were done and in a fresh diaper, everything would be fine.

• A sore shoulder or neck: There was an instance with my son when simply the act of placing him in a side-lying posture seemed to set him off. I realized I had been repeatedly holding him wrong. If you haven't been diligent about how you position your baby's spine, neck and shoulders, your baby could develop sore muscles. (Baby's ear, shoulder and hip should be aligned). Try making her as comfortable as possible, possibly placing her atop a soft pillow or nursing in a different position than usual. The problem should remedy itself in a day or so.

• Other explanations can include colic, thrush, a food sensitivity, milk flow (too fast or slow) or hyperlactation syndrome. And sometimes babies go on a nursing strike for reasons we don't understand.

Even if you cannot determine the reason your baby won't eat, there are things you can do.

• First and foremost, soothe your baby and wait for him to be calm before trying again. You don't want him to associate frustration with the breast.

• Propping baby's head and torso in a more upright position. I found this to be especially effective if I could hold the baby in such a way to nurse while walking around and gently bouncing.

• Keep trying. If you've tried a few times and aren't making progress, give it an hour. Keep trying! In the mean time, use a breast pump every two or three hours to relieve engorgement and keep your milk supply.

• Try giving a bottle, just for one or two feedings. Sometimes babies who are refusing to nurse will take a bottle. Try breastfeeding again later in the day.

• Call a support person: a lactation consultant, an experienced mom, a pediatrician, or just a friend who will help you relax.

If all else fails, be sure to see your doctor and don't feel guilty or ashamed if you aren't able to continue breastfeeding. You need to what's best for baby AND you.

Cloth Diaper Update

I said I would keep you all posted on how the cloth diapering is going, so here goes!

First, I want to talk about issues related to diaper rash:

1) I now have a stash of fleece liners that I use regularly as a wetness barrier with the econobum cloth diapers. Some of them are the Bummis brand and some are ones I made myself out of scrap fleece. I've discovered that it is best to wash these separately from the cloth diapers, since the job of the liners is not only to protect my son from rash caused by wetness, but also to protect the cloth diaper from any ointments or creams we use. (Rash creams make cloth diapers less absorbent over time. If I wash my liners with the diapers, I am essentially washing the cloth diapers with the rash cream!) I "stripped" the diapers of any rash cream with some good old Dawn, hot water and a stiff brush, so we're back to business as usual.

2) I had been having some problems with leaking that I wasn't before. This has partly been remedied by the stripping I mentioned above. At night, even the "night time Pull-ups" are not enough to hold it all, so I've ended up putting "night time" disposable diapers on him at bedtime.

3) The other thing I noticed is a higher incidence of diaper rash with the BumGenius diaper detergent than the FuzziBunz diaper detergent. I'm wondering if my son may be allergic to something in the BumGenius detergent...? These are the only types of detergent I've tried thus far. Another reason I prefer the FuzziBunz detergent is that the package says it is formulated to work with any water type (we have hard water, which can cause mineral buildup on the diapers over time).

So, between changing him often during the daytime (he's 2 and I change him 5 to 7 times), finding the right detergent, and using the fleece liners, I have noticed a significant decrease in diaper rash.

The other issue is cleaning up poop!

Bowel movements from babies who are exclusively breastfed should wash right out in the washing machine. It is ideal (for your washing cycle and the environment) to put bowel movements from solids-fed babies in the toilet. Samson has adult-like poops that plop right out of the diaper and into the toilet...most of the time. The problems arise when there are days that he has very soft stools! My best solution for this has been to keep a flushable paper liner in the diaper during the time of day I expect him to have a bowel movement (his are fairly predictable). Then, I am able to remove most--if not all--of the stools from the diaper by removing the flushable liner and flushing it. When all else fails, I use a grocery bag over my hand to remove as much of the solids as possible, then throw the grocery bag in the trash.

So that is where we are at now. I will be sure to post another update after the arrival of our newest addition. She's due to arrive any day now!

Personal Concerns about Becoming a Two-child Family

As we get closer to the big day that our family of 3 becomes a family of 4, I've been asking my friends who parent multi-child households how things are different the second or third time around. The response so far has basically been that, yes its hard, but everyone will adjust soon enough. The main concern on my mind is how will my 2 year old deal with my need to spend such a great amount of time nursing a newborn? How will we keep from getting really upset with each other? He's not an especially needy or obnoxious child by any means, but he's still a 2 year old. I like this response from an interview with Elyse Eberstein, MSW, LE by Heather Turgeon of Babble.com :

Talk out loud about needing to divide your attention. When you’re helping your older child use the bathroom, say to the newborn (who doesn’t have a clue what you’re talking about, but it’s okay — this is for the benefit of the toddler), “I’m helping Emma right now, so I can’t nurse you until we come back from the bathroom.” That way, when you say it in reverse — telling your toddler she has to wait while you help the newborn, it feels like equal treatment.

My grandmother-in-law told me that she was very worried while expecting her second child, about how she would find the love in her heart for two children. She loved her first so much, how could she give that much love to another baby? She said, "It comes. The love comes." She eventually raised seven children and found her heart loving all of them.

Whether you're a parent of a full house, or just working on number 2, what kinds of concerns were on your mind during pregnancy? How did your older child(ren) react to a new baby in the house? How did the spacing of your children's ages affect those worries? How did you cope? I welcome your comments!

Marcia's Nursing-moms-to-be Toolkit

For all those mommies-to-be out there and those who are already nursing, here is my best advice:

1. Buy a copy of "The Nursing Mother's Companion". This has nearly everything you need to know about breastfeeding, pumping, weaning etc.

2. Let those babies air-dry for a few minutes after each feeding to prevent soreness.

3. Buy Lansinoh lanolin and put it on (after drying) after each feeding.

4. Early on, you'll need to switch positions from feeding to feeding to prevent soreness.

5. Buy LOTS of burp cloths. Cloth diapers make amazing burp cloths.

6. Buy NURSING TANKS instead of nursing bras. They hide the tummy and back when you pull up your shirt, or you can wear them without a shirt. You could also use the bella band you wore during pregnancy to hide your tummy, or buy clothes that can be pulled to the side to nurse. (lots of cute stuff for this purpose at maternity stores.)

7. Use Johnson's brand or Avent brand nursing pads. The liners aren't made of itchy, non-breathing plastic. Re-usable cloth nursing pads work if you don't leak a lot and can find time to wash them!

8. If you can stay awake without it, don't watch TV while nursing once the baby starts sleeping through the night. The noise and distraction will keep baby awake.

9. Keep baby from having painful gas by burping every 10 minutes during a feeding and immediately after.

10. Create a "Nursing Tote" for around the house so you can easily move from room to room. Fill it with burp cloths, a bottle of drinking water, nursing pads, wipes (for keeping your hands clean), a watch, your prenatal vitamins (so you remember to take them), the TV remote, and a book to read. Trust me, you don't want to ask hubby to bring you every little thing once you get sat down. Refill often.

11. Don't start bottles until baby is at least 4 weeks old (to establish good breastfeeding bond and prevent confusion). You can still use the pump in the meantime to boost milk production (though I never felt the need) and freeze or throw out the milk.

12. Hold baby in proper position so you don't make his neck or back sore over time!

13. If baby is very fussy at the breast, try to figure out why and try again in 20 minutes.

14. Enjoy your baby!