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HELPING YOUR FUSSY BREASTFED BABY
Babies cry. It’s a fact of life. It’s one of the ways they communicate with us.
I remember my husband telling me about a colleague whose new baby was crying all the time. This poor baby could cry for an eight hour stretch. Everyone was miserable.
While every baby has times that they are extra fussy there are some babies who take it to a whole different level.
Have your visions of peacefully breastfeeding your baby in a rocking chair have been replaced with a baby screaming while nursing? Or is your breastfeeding baby fussy most of the time?
If you are struggling with a really fussy baby, then you want help. And you want help fast, like yesterday fast.
There are a whole slew of things that can make a breastfed baby fussy. You will need to do a bit of detective work. Determining why your breastfeeding baby is miserable will involve some trial and error. It will be a process of elimination
The good news is that most of the time, you can find a cause for the fussy baby who is breastfeeding. And more importantly, you can find ways to comfort your fussy breastfed baby.
Fussiness can happen during breastfeeding, and there is also the experience of a baby fussy after breastfeeding.
FUSSINESS IN BREASTFED BABIES – CAUSES AND SOLUTIONS
The reason for your baby’s cranky behavior will determine what the appropriate cure is.
It is also possible that there is more than one cause for a breastfed baby to be fussy.
Keeping a fussy baby log is essential to determining what is causing your baby to be unhappy. Because it can be difficult to know what all to track I created a FUSSY BABY LOG to help you.
Check my SHOP for the fussy baby log printable.
BREASTFED BABY ALWAYS HUNGRY
New babies eat a lot. Like a whole lot. When a mom tells me that her baby eats “all of the time,” I worry there could be a problem.
When a new mom uses the words “all of the time,” the first thing I ask is how long is it between the start of one feeding until the beginning of the next feeding.
I had one mom come in to see me for a lactation consult. As she was walking through the door, she said, “This baby eats constantly.” I asked how frequently the feedings were. She answered, “She wants to eat every three hours!” This mom was appalled at how often her newborn was eating.
Newborn babies eat every two to three hours on average. Her baby’s feeding frequency was completely normal.
NOT ENOUGH BREAST MILK
Does it feel like your baby is always hungry and never satisfied? Does your baby want to breastfeed constantly?
Some babies really do eat more than the average of every two to three hours.
Newborn Breastfeeding Frequency
- 8-12 feedings, on average, in 24 hours, is within normal limits for feeding frequency.
- Periods of cluster feeding is normal. That is when a baby will eat very frequently for an hour or so.
- A cluster-feeding session is counted as one feeding.
- Up to two cluster-feeding sessions a day is considered normal.
- A baby who regularly wants to breastfeed more often than 12 times/24 hours may not be getting enough to eat.
If your baby is exclusively breastfeeding and gaining an average amount of weight, then he is getting enough breast milk.
Most moms make enough breast milk for their babies. Most, but not all.
A baby can be fussy during breastfeeding because they are not getting enough milk. Not getting enough breast milk can also make a baby fussy and unsettled between feedings.
Offering a bottle after breastfeeding to see if your baby will eat more is not a reliable way to tell if he is getting enough from breastfeeding. Babies can and do overeat.
If you think you have a low milk supply, you should contact a lactation consultant. She can help you determine if your milk supply is low. She can also help you with a plan to increase your milk supply.
There will be times when a baby is fussy from not breastfeeding frequently enough. There are usually two situations when this happens.
- Strict feeding schedules that are not compatible with the baby’s needs
- The baby who has low energy and sleeps long stretches because he is not getting enough to eat. These babies are often described as “good” babies. That is until they are put on a scale, and it’s discovered that they are not gaining enough weight.
To see if infrequent feedings are the reason your breast baby is fussy, try feeding more often. If your baby is happier, then you know what the cause of the fussiness was.
Babies want to eat more frequently when they go through a growth spurt. Their fussiness is resolved by letting them feed more frequently.
Common Times For Growth Spurts In Infants:
- 10 days – 2 weeks
- 3 weeks
- 6 weeks
- 3 months
- 4 months
- 6 months
- 9 months
I always say that babies haven’t read the books, so they may not follow that growth spurt schedule. They also may throw in an extra one here and there.
The first few growth spurts last about 24-48 hours. As a baby gets older, their growth spurts tend to last a little longer. A growth spurt can last up to a week.
TOO MUCH FOREMILK
A baby can get enough volume of breast milk and still be fussy if they are getting too much foremilk.
The composition of breast milk changes as the breast drains.
Foremilk is the first milk a baby gets when they start a feeding. It is high in water content and satisfies the baby’s thirst.
The fat content of the milk increases as the breast drains. The milk that has more fat is called the hindmilk. It gives the baby the calories they need to grow and makes them feel satisfied.
When a baby gets too much foremilk, it can make her fussy and gassy.
Getting too much foremilk can happen if a baby doesn’t drain a breast because mom is restricting the amount of time the baby is on the first breast.
Many moms have heard that the baby should feed from both breasts. They may take the baby off the first breast after a few minutes to ensure that the baby takes the second breast.
For the mom who has a lot of milk, one breast may be enough for a full feeding.
The best way to avoid a foremilk issue is to let a baby breastfeed on the first breast until they come off on their own. If they are not interested in the second breast, then offer that one at the next feeding.
Some moms have an overabundant supply of milk. They may need to down-regulate their supply. It’s best to work with a lactation consultant if you think this is your issue.
Some mamas swear by Gripe Water as a rememdy for their fussy baby.
BREAST MILK COMES OUT TOO FAST FOR BABY
Some moms have what is called a forceful let-down.
When a baby starts breastfeeding, a message is sent to the mom’s brain to release the hormone oxytocin. Oxytocin causes the milk ducts to contract. This pushes the milk down to the nipple.
Moms often feel when their milk lets down. Women describe the sensation in their breasts differently.
- Pins and needles
Not every mom feels her let-down. She may get clued in when she notices that her baby starts gulping.
Multiple let-downs can occur during a feeding.
When a mom has a forceful let-down, her baby may sputter and choke for a few seconds. The baby may pull off the breast and cry.
FORCEFUL LET-DOWN SOLUTIONS
- Positioning your baby so she is higher than the breast can help if a forceful let-down is causing your baby to be fussy when breastfeeding.
- Laid-back position
- Football hold where the baby is very upright
- Straddle position
- Taking your baby off your breast for a few seconds
- Gently compressing your breast right behind the nipple to slow down the flow of the milk
- If you try this, be careful that you don’t press too hard and slow it down too much.
Crying is a late sign of hunger. If a baby is so hungry that they are crying, they have reached a disorganized state. It can result in fussy and unsettled behavior during the feeding.
Try to feed your baby when you see her early hunger cues. Your baby is letting you know that she is hungry when:
- She smacks her lips
- She sticks out her tongue
- She sucks on her hands
- She opens her mouth when you tap on it.
REASONS FOR THE FUSSY BREASTFED BABY THAT ARE EASY TO RESOLVE
BABY NEEDS TO BURP
If a baby is happily breastfeeding and then starts to fuss, the first thing you will want to try is burping the baby.
Most babies are content with being burped when they finish a breast. Some babies will require more frequent burping.
There have been many times when I have seen a baby pull off while nursing because he is done. He is full. He has had enough to eat.
Mom thinks he hasn’t nursed for long enough and tries to bring him back to her breast. The baby will get fussy because they are finished eating, and he wants to move on to other things.
SLOW LET-DOWN CAUSING BABY TO BE FUSSY WHILE BREASTFEEDING
On the other end of the spectrum is a slow let-down.
If your baby is getting frustrated while breastfeeding, it might be because you have a slow let-down. He can become impatient if the milk doesn’t start flowing fast enough. If your baby becomes agitated and starts pulling on your nipple, it can make you feel stressed. Stress inhibits oxytocin and can make your let down take even longer.
A slow let-down can be caused by temporary things like stress, pain, or anxiety. If you are not comfortable breastfeeding in front of certain people or in public, the feelings of embarrassment could result in a slow let down.
Substances like alcohol, lots of caffeine, nicotine, and certain medications can cause a delay in let-down.
REFLUX AS A CAUSE OF A FUSSY BREASTFED BABY
If your baby gets upset while breastfeeding, it could be due to reflux.
Reflux is defined as the contents of the stomach flowing into the esophagus. It is common in babies because they have a weak esophageal sphincter.
Any time a baby spits up food, they are having a reflux episode.
Spitting up a lot is considered reflux. Not all babies who spit up are fussy. If a baby spits up a lot but is gaining weight at a normal rate and is generally happy, we call that baby a happy spitter.
Infant reflux usually peaks between two to six months. It resolves by the first birthday in 85% of babies.
Reflux is less common in breastfed babies.
When there are a large number of reflux episodes, the acid from the stomach can cause a breastfed baby to be fussy during feeding. They may also be fussy after breastfeeding.
When reflux causes fussiness or other problems, it is referred to as GERD – gastroesophageal reflux disease.
Keeping your baby’s head higher than the rest of his body during feeding can help minimize fussiness from reflux. Keeping baby upright for 15-20 minutes after feeding give the food time to settle.
Putting your baby in a front carrier will keep her in an upright position and frees up your hands if you want to do something.
Get a carrier like this Ergobaby Carrier 360 that allows you to vary which way your baby faces. You will want a younger baby to face in towards your chest. Older babies like to face outward.
Up to 15% of babies have symptoms that indicate a problem with the cow’s milk protein (Source). Many mothers I have worked with have seen a decrease in reflux fussiness when they have eliminated dairy from their diet.
Some babies with severe cases of reflux benefit from medication. Talk to your baby’s health care provider if you want to explore this method of reflux management.
LACTOSE INTOLERANCE IN BREASTFED BABIES
Sometimes a cow’s milk protein allergy is misinterpreted or misdiagnosed as lactose intolerance. Lactose intolerance is exceptionally rare in children younger than five years (Source).
FOOD INTOLERANCE IN BREASTFED BABY
Foods other than dairy can result in your breastmilk being the reason your baby is fussy. There are a variety of foods that can make a baby fussy while breastfeeding.
Other food eliminations have also helped (Source). Using a food elimination journal can help you keep track of what foods you have taken out of your diet and what effect it has on your baby and yourself.
Food elimination takes patience. It can take up to a full two weeks after eliminating dairy to see improvement in your baby.
Using a log to keep track of what foods you are eliminating helps with food elimination detective work.
I have spoken with many moms who found that they felt better themselves when they eliminated certain foods from their diet.
THRUSH CAN MAKE BREASTFED BABY FUSSY
Thrush is when yeast overgrows in the body. Babies can get thrush in their mouths. They can also get a diaper rash caused by yeast.
Thrush in the mouth is when there are white patches in your baby’s mouth that will not rub away. Their tongue will be very white. Because of their milk diet, babies’ tongues often look white.
To determine whether it is newborn thrush vs. milk tongue, you can see if it wipes away with a piece of gauze. Thrush will not wipe off.
If you suspect thrush in your baby, you should call your child’s health care provider. They can prescribe an anti-fungal treatment.
BABY FUSSING AT BREAST DUE TO DEVELOPMENTAL DISTRACTIONS
Babies go through phases when they are so fascinated with the world around them, and they may fuss when you are trying to breastfeed because they want to check something out. They want to get down and explore.
Moms sometimes misinterpret normal developmental distraction behavior as a sign that their baby wants to wean.
- Try to breastfeed in a quiet, dark room
- Try a nursing cover to minimize distractions
This Nursing Cover has a sewn in burp cloth. How convenient is that? It’s 5-star rating from over 600 reviews shows that moms love it.
COLIC RULE OF 3
If your baby is crying all the time, it may be colic.
It feels like we use the term colic less often today than we did thirty years ago. That may be because the word was used to cover any fussy behavior in a baby. A definite diagnosis can be missed when a breastfed baby is fussy if it is attributed to colic.
A healthy baby who is growing well is said to have colic if their crying follows the rule of three (Source):
- Baby cries more than3 hours a day
- More than 3 days a week
- For longer than 3 weeks
Colic usually resolves by three months of age.
FINAL THOUGHTS ON THE FUSSY BREASTFED BABY
If you are unable to figure out why your breastfed baby is so fussy, I encourage you to reach out to a lactation consultant for help.
There are so many things that can cause a breastfed baby to be irritable. If it feels overwhelming to consider all the different possibilities, a lactation consultant can often help you decide what to look at first.
Most of the things that cause fussiness in a baby who is breastfeeding can be resolved. The time and effort are worth it so that you can finally be that peaceful mom breastfeeding in a rocking chair with her baby.
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Andrea Tran RN, MA, IBCLC
Andrea has been working with new families as an RN for over 35 years and a Lactation Consultant for over 25 years.
She has her MA in Health and Wellness with a focus in Lactation.