Expert: Sally Wendkos Olds - 6/2/2004

Question
My one month old breastfed son is spitting up and fussy within 10 minutes of most of his feedings each day.  I have been reading alot about breastfeeding and I think I have too much milk because he seems to be unable to keep up with the rapid letdown on the right side.  He gulps frantically and I can hear his tummy rumbling with air.  Sometimes he comes off crying before he is even finished.  I was told that breastfed babies usually don't take in too much air, but what else could it be?  I have tried taking dairy out of my diet for about a week now.  This seems to have helped some... or perhaps it is just that I have tried to make sure he finishes on one side before switching to another side to be sure he has enough lactase to digest all the lactose he is taking in.  Is spit up and fussiness just inevitable in some babies or is there something I can do? I hate to see him screaming so hard - and no position seems to help ease his discomfort.  I have tried infant massage - helps sometimes. I have used mylicon drops - doesn't seem to help.  
With all of your experience, I was hoping you could give me some insight.  Thanks!

Answer
Dear Krista,

First, congratulations for giving your baby the best start by breastfeeding! You and he are both lucky that you have such an abundance of milk. You just need to find out and  resolve whatever is making your little son so unhappy. Yes, some babies do spit up a lot (two of mine did, so I remember that well) and some are very fussy (one of mine had colic every day), but having tears and upset with every feeding is not that common -- and has to be so hard for both of you to go through.

First, have you had your baby's doctor examine him to rule out any problem in his mouth structure, breathing or swallowing ability, etc. This is important, since the problem may be unrelated to the amount or the speed of your milk. If you have not done this, make an immediate appointment with a pediatrician knowledgeable about these things.

If you get a clean bill of health for your baby, I would encourage you to find a good lactation consultant  right away. You can get a referral from the International Lactation Consultant Association (ILCA). Email ILCA at ilca@erols.com or phone 919-787-5181. The LC you get may be able to watch you and your son in a feeding session and see the dynamics and positioning in the nursing relationship. Solutions often come more easily when a knowledgeable person can be right on the scene.

Meanwhile, you could try one or more of the following:

* express or pump a little of your milk  first before putting the baby to your breast so the milk doesn't come so quickly. You could save the milk for later use (properly, of course -- I give guidelines in THE COMPLETE BOOK OF BREASTFEEDING for different ways of expressing & pumping milk, for safely storing it and for giving it to the baby.).

* offer only one breast at a feeding. Maybe he's overeating because the milk is there & that's what he thinks he's supposed to do.

* Be sure to burp him well after each side, either over your shuoulder, belly down on your lap or sitting up with your strong support. (I illustrate these positions in my book.)

You might take a look at THE COMPLETE BOOK OF BREASTFEEDING (Eiger & Olds, 3rd edition 1999, Workman PUblishing & Bantam Books). It is available in most public libraries, most earthbound and online book stores (sometimes at a discount for a used book) and most La Leche League chapter libraries.

The most important thing is to act quickly to resolve this problem. Most nursing problems come up in the first month, and when they're quickly taken care of, mother and baby can go on to have a long, rich nursing relationship.

Good luck!

Sally

Sally Wendkos Olds
coauthor, THE COMPLETE BOOK OF BREASTFEEDING