I have a very fussy baby!
Not all fussiness and breast refusal is due to a low milk supply, it is important to investigate all the possible causes before considering supplementation.
Reasons Why a Baby might be Fussy at the Breast:
• Baby might be ill and/or might have one or more of a few problems such as ear infection, thrush or reflux.
Baby may have physical or neurological problems such as Low/high muscle
tone, sensory problems, tongue tie or oral aversion (resistance to
anything touching the inside of the mouth). Injury during birth or
medication given during birth and pregnancy can have an effect on baby.
Latching problems such as poor positioning, bad latching technique,
tongue problems, flat or inverted nipples or other sucking
• Milk supply issues such as engorgement in the
first few days, a fast let down (milk flows to quickly for baby), a slow
let down of milk (milk flows too slowly), delayed onset of mature milk
(milk coming in), food allergy or sensitivity to something in Mom’s
milk, oversupply of milk and foremilk/hindmilk imbalance.
• Changes in the
taste of the breast milk: During menstruation, during pregnancy with
another baby, mastitis (milk tastes saltier)
• Baby is
over hungry due to: Ineffective milk transfer (can be due to many
reasons), Mom putting baby on a strict schedule or timing feeds, baby is
overly sleepy and is missing feeds.
Signs and symptoms of a fussy baby
• Baby cries often.
• Baby arches his back.
• Baby whimpers and grumbles.
• Baby wriggles often.
• Baby pushes his/her head away from the breast.
Ask yourself these Questions about your Fussy Baby:
Were you given any drugs during labor, or were there invasive
procedures that baby had to go through during delivery such as delivery
via C-section or with vacuum/forceps. Medication given during a
C-section can have an impact on baby’s alertness and ability to suck due
to prematurity (even if it is just 2 or 3 weeks)
• Does baby
keep smacking or playing with his/her ears? This could indicate an ear
infection. White spots in baby’s mouth could indicate Thrush.
• Have you started eating any new foods? Or have you started taking any new mediation or supplements?
Do you have flat or inverted nipples? Or overly large nipples or
breasts? Or tubular breasts? Read more on nipple variations.
• Is your baby getting in enough milk? Read more on how to check for signs that baby is drinking enough.
• Does baby have tongue tie? Read more here for signs.
• Is baby producing the right amount of wet and dirty diapers for his/her age? Read more here.
• Does baby have greenish, frothy, explosive stools with colic symptoms? Read more on foremilk/hindmilk imbalance.
• Does your baby seem to choke while feeding? You might have an overactive let down.
• Are you breastfeeding on demand? Cue feeding is very important. Read more on hunger signs here.
Do you like to touch baby’s face and back of baby’s head while
breastfeeding? Some baby’s find any pressure on their heads irritating.
Touching baby’s face may also confuse him/her, by making him/her root in
that direction for the breast.
• Does your baby push your finger out of his/her mouth? This could indicate an oral aversion.
• Are you going through unusual stress at the moment? Baby can pick this up and become overstimulated and fussy due to this.
• When does baby get fussy? Has he/she always been fussy? Is he/she fussy at only certain times while feeding?
baby has been fussy since birth it can indicate birth injury or medical
interventions, tongue tie, sensory problems and muscle tone issues.
baby only gets fussy after day 2-5, you can consider the problem to be
either engorgement, over active let down or delayed milk onset.
If baby is fussy just after latching you can consider overactive let down, delayed letdown, latching problems.
baby becomes fussy half way through the feed or closer to the end of
the feed, you can consider reflux, baby needs to be burped more often,
food allergy, oversupply, foremilk/hindmilk imbalance.
What to Do?
If you suspect that baby has a tongue tie or has Thrush or ear
infection, get it seen to. Tongue tie is fixed easily, with just a
little snip in the doctor’s office. A baby with ear infection or Thrush
can be made more comfortable with medications.
• Treat engorgement and mastitis.
• Eliminate any culprit foods from your diet, if you suspect an allergy.
Get a comfortable breastfeeding position and make sure your baby has a
good latch. Know about all the problems that can cause a weak latch.
Breastfeed baby frequently. Breastfeed from only one breast at a time,
alternating only every 4 hours if you suspect oversupply or
foremilk/hindmilk imbalance. This will ensure that baby gets in more of
the fatty hindmilk.
• If you suspect that you have flat or
inverted nipples, you can use techniques to draw them out and there are
ways of making breastfeeding easier.
• If you think you have a
slow let down, you can pump milk for a few minutes before feeding to get
the milk flowing before baby latches on.
• Breastfeed when baby is calm and in a dim, quiet room.
• Carrying baby in a sling in-between and during feeding can calm baby. Skin to skin contact is also helpful.
• Chiropractic treatment and cranip-sacral therapy is often used for fussy babies that have gone through birth trauma.
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Tracy Behr, CBC, CLD, (CBI)
Reference: Course information through Childbirthinternational on breastfeeding physiology / breastfeeding problems / latching problems.
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Site by BFeeding Mamma, Tracy Behr, Studying through Child birth international (CBC, CBD), Author and Mommy of two.
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