Fussy Baby

I have a Very Fussy Baby!

Not all fussiness and breast refusal is due to a milk supply issue, it is important to investigate all the possible causes before considering supplementation. 

When is supplementation necessary? Read more here

Reasons Why a Baby might be Fussy at the Breast

•    The baby might be ill and/or might have one or more of a few problems, such as ear infection, thrush or acid reflux.

•    The baby may have physical or neurological problems, such as low/high muscle tone, sensory problems, tongue tie or oral aversion (resistance to anything that touches the inside of the mouth). Injury during birth or medication given during birth and pregnancy can have an effect on a baby.

•    Latching problems such as poor positioning, bad latching technique, tongue problems, flat or inverted nipples or other sucking problems.

•    Milk supply issues such as engorgement in the first few days, a fast let down (milk flows to quickly for the 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 the mother’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), the mother might have put the baby on a strict schedule or is timing feeds, baby is overly sleepy and is missing feeds.

Signs and Symptoms of a Fussy Baby

•    The baby cries often.

•    The baby arches his/her back.

•    The baby whimpers and grumbles.

•    The baby wriggles often.

•    The 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 your 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 a baby’s alertness and ability to suck, due to prematurity (even if it is just 2 or 3 weeks). 

•    Does your baby keep smacking or playing with his/her ears? This could indicate an ear infection. White spots in a 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 breastsRead more on nipple variations.

•    Is your baby getting in enough milk? Check for signs that your baby is drinking enough.

•    Does your baby have tongue tie? Read more here for signs. 

•    Is your baby producing the right amount of wet and dirty diapers for his/her age? Read more here. 

• Does your 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. What are the hunger signs?

•    Do you like to touch your baby’s face and the back of your baby’s head while breastfeeding? Some baby’s find any pressure on their heads irritating. Touching your 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? A baby can pick this up and become overstimulated and fussy due to this. 

•    When does your baby get fussy? Has he/she always been fussy? Is he/she fussy at only certain times while feeding? 

If your baby has been fussy since birth it can indicate birth injury or medical interventions, tongue tiesensory problems and muscle tone issues.

If your baby only gets fussy after day 2-5, you can consider the problem to be either engorgementover active let down or delayed milk onset. 

If your baby is fussy just after latching, you can consider overactive let down, delayed letdown and latching problems.

If your baby becomes fussy half way through the feed or closer to the end of the feed, you can consider reflux;  your baby needs to be burped more often, or it could indicate a food allergyoversupply or foremilk/hindmilk imbalance. 

What to Do?

•    If you suspect that your 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 at the doctor’s office. A baby with ear infection or thrush can be made more comfortable with medications. 

•    Treat engorgement and mastitis. 

•    Get a comfortable breastfeeding position and make sure that 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 your 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 your baby latches on.

•    Breastfeed when your baby is calm and in a dim, quiet room.

•    Carrying your baby in a sling in-between and during feeding can calm him/her. 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.

•    Try Dr Harvey's Cuddle cure to calm a baby. Watch the video here.

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Tracy Behr, CBC, CLD, (CBI)

Reference: Course information through Childbirthinternational on breastfeeding physiology / breastfeeding problems / latching problems.

One Mother's Advice About Fussy Breastfeeding in Evenings

Read more about cluster feedings here. 

Read more about growth spurts here. 

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