Breastfeeding: Nursing sleepy baby with poor attachment
Our one-week-old daughter is having problems latching on. She won't open her mouth wide and she shakes her head even though my wife holds her head. She also falls asleep in the middle of feeding and won't wake up. What can we do?
Question:Debbi Donovan
Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more
Experiencing difficulties as you are trying to get breastfeeding off to a good start can be so frustrating. I would highly recommend working with a Board Certified Lactation Consultant to get right to the cause of your baby's feeding problems. I know you and your wife would like to see these problems resolved.
Your baby seems frantic at the breast -- shaking her head back and forth, making latch-on next to impossible. Usually when babies are this frantic, it is because they are very hungry. If you think this may be the case, nurse more frequently. Newborns need to be nursed at least 8 to 12 times in a 24 hour period. Many babies nurse much more often than this. If your daughter seems ravenous, hand-express or pump for a minute or two to help get the milk flowing before you put her to your wife's breast. Express a little milk onto the nipple just before nursing and you may find she settles right down for a good feed.
Your baby could also be uncomfortable in the position she is being nursed. Is she easier to handle on one side or the other? Sometimes a baby has a sore neck after the birth, particularly if forceps or vacuum extraction has been used. They can be very uncomfortable in positions that put pressure on, or strain that area.
When positioning the baby at the breast, your wife can hold your baby's neck rather than her head. She will still maintain good control, but your baby will be less likely to shake her head back and forth. Many newborns have such sensitive rooting reflexes, that when their head is touched they turn in that direction. While breastfeeding a baby with a strong rooting reflex it can also be too distracting for them if you stroke their face or head.
It is very important to make feeding your baby your number one priority. When a baby is not getting enough calories she gets more and more tired. She may be jaundiced, and if nursing infrequently she is not clearing the bilirubin from her body efficiently. Jaundiced babies are usually sleepy babies. This is a self-perpetuating cycle. The more she sleeps, the less she feeds, the more jaundiced she becomes and the more tired she gets.
Take your baby to her Health Care Provider (HCP) and have her weight checked. It is normal for breastfed babies to lose up to 10 percent of their birth weight in the days following the birth, but by two weeks most have regained it. Let her HCP know if she is stooling less than two times a day, wetting less than six to eight diapers, or feeding less than eight times in a 24 hour period.
Sleepy babies need some stimulation during the day. Keep them in the same room you are in. Keep it bright and cool in your house during daytime hours. Heat can make babies (and adults) sleepy. Don't overdress your baby. When your baby naps, watch for signs of wakefulness, such as sucking on fingers or fist, rapid eye movement and little sounds. This is a good time to feed her. Undress her, except for her diaper, talk to her and bring her to your breast to nurse.
I recommend lots of skin-to-skin contact for sleepy babies. Your wife can cuddle up with your little one in bed and they can spend the day resting and nursing. If it is cool in the room, they can use a lightweight blanket as a cover. Skin-to-skin is stimulating for babies and will help your baby to stay awake for a good feed. Often a few good feeds makes all the difference in the world. Hoping these suggestions help!
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