Baby crying during breastfeeding

[mikeys_mom]

One of my twins will sometimes start to nurse and then after a few minutes start to shriek. She refuses to latch on, her whole body goes stiff and she is crying as if she is in pain. Sometimes she will burp and then be ok for a few more minutes, then scream some more.
Sometimes she gets herself so hysterical, that DH or my nanny have to take her and spend 5-10 minutes calming her down so that she can finish nursing. She eventually calms down and finishes nursing, but I have no idea why she is screaming.

She usually does this in the later afternoon and early evening nursing sessions, rarely in the morning or afternoon. Also, they get formula at night and she never does this when taking the bottle.

Any ideas what could be causing this?

[mmsmom]

My first thought is that your flow may be too fast. But could be something else as well. My suggestion would be to talk to a lactation consultant. They can help figure out the problem & offer ways to correct it. You can find lactation consultants through the La Leche League or call the hospital where you delivered.

[firsttimemama]

I agree with the previous poster.. could be "overactive letdown" or too fast of a flow for her? Or.. at the same time.. could be that she's frustrated it won't come quicker - you said this usually happens late afternoon/evening - your milk takes a natural dip at that time (as in, you have more in the morning)

I just wanted to say hang in there and maybe contact LLL or a lactation consultant for support. Being fussy at the breast is not unusual. Happens to a lot of babies & mamas. Doesn't make it any easier, but you're not alone. So worth sticking it out though!

[Sweetum]

I may be wrong, but could it be reflux?

-SunshineAndMe

[LMPC]

Wouldn't it be easier if babies could talk at that age!!! My DD did something similar when she was 2-3 mo old. I thought it was that I had "run out of milk" but I soon realized that she was just more tired/cranky in the evenings. My milk was a little slower to let down at those times. I ended up lying down to nurse her and that helped. I'm not saying this is exactly what is happening with you, but I would just like to send some encouragement your way. It sounds like a normal thing that many people go through.

[mikeys_mom]

Thanks for all the advice. I will try to find a LC tomorrow. The hospital had a LC come to my house after I was discharged. I will see if she can come again.

I'm just curious, how can they tell if the flow is too slow or too fast?

Also, this would be much less nerve wracking if I was only dealing with one baby. Biggest problem is that I am tandem nursing the twins, so when one starts to scream and I try to comfort her, the other will usually pull off and get upset as well.

[goldenpig]

My daughter was doing the exact same thing at 3 months. She would latch on, nurse for a minute or two then start crying and pull off, arching her back. It was really traumatic. At first she would only do that on one breast but then it became both sides. And she would only drink 1-2 oz at most from the bottle (expressed breast milk). I could only feed/nurse her if she was sleepy. Sometimes she would wake up screaming, 1/2 hr after I put her down. Or I had to hold her upright to fall asleep because she would cry as soon as I laid her flat. She had frequent hiccups and wet burps. Her weight gain slowed and she started falling off the growth curve. Turns out these were all signs of silent reflux. It took me a while to figure this out because she was never a huge spitter/vomiter. Neither the pediatrician or lactation consultant had any idea why she was refusing the bottle/breast. I figured it out with the help of other moms from my mom's club. She was started on Zantac, then eventually seen by a pedi GI and started on Prevacid. She's doing better now although her weight remains an issue and she's still on the medication.

If any of this sounds familiar you may want to check with your pediatrician and see if she may need to be evaluated for reflux and/or started on medication. If it is reflux, you may also want to prop the head of her mattress up to elevate her head. Hope this helps and that your daughter gets better soon! Hang in there!

[twowhat?]

One easy way to tell if it's because baby is impatient for let-down:

Pump until you feel your let-down reflex. Then latch baby. Or - latch the other twin first until your let-down is stimulated, then latch the test subject. One great thing about nursing twins tandem is that if one starts getting impatient waiting for let-down, the other keeps sucking so let-down happens faster. Unless, of course, BOTH babies stop sucking and get hysterical:)

If it's because your flow is too fast, you can try nursing in an "uphill" position - how are you nursing your twins? Using the EZ-2-nurse pillow? To nurse "uphill" you can try lying back on the recliner (if that is what you use), or putting a couple of extra pillows behind you to recline back on (if you are using the EZ-2-nurse).

I will say that if it's because the flow is too fast, your baby will eventually learn how to handle it. My twins coughed, choked, and sputtered with my let-down and eventually they learned how to handle the faster flow (one baby handled it by doing the "suck-swallow-suck-swallow-suck-swallow-GASP FOR BREATH-suck-swallow, etc" and the other baby did a fast version of "suck-swallow-breathe-suck-swallow-breathe." Funny how different they are.

Good luck!!

[mikeys_mom]

I never feel the let-down reflex and never did with my other 2 DC either. I have mentioned this to several LC and some seem surprised, others say it is strange, but possible. It's never been an issue. I was able to BF DS for 6 months and DD for 9 months.

I'm pretty sure that as soon as the babies start to suck, there is milk flowing because I can hear them gulping and swallowing right away.

Yes, I am using the EZ 2 Nurse pillow. I will try the "uphill" position. I am usually nursing on my bed, so I could prop some more pillows behind me.

I have a feeling that for some reason, the problem is with the position she is in. Yesterday, for various reasons, I ended up not tandem nursing in the evening, so I was nursing each baby separately using the traditional cradle position rather than the football hold for tandem nursing. There was no crying at all.

I think that I really need to have a LC come and see what the problem could be. I left her a message yesterday. Hopefully I will hear back today so that I can get this resolved.

[twowhat?]

That's interesting. I didn't feel a let-down response for the first 2 or 3 months that I nursed. Now I do. I always wondered why that was.

Good luck with this - hopefully it's all just a matter of positioning.

[Nooknookmom]

One of my twins will sometimes start to nurse and then after a few minutes start to shriek. She refuses to latch on, her whole body goes stiff and she is crying as if she is in pain. Sometimes she will burp and then be ok for a few more minutes, then scream some more.
Sometimes she gets herself so hysterical, that DH or my nanny have to take her and spend 5-10 minutes calming her down so that she can finish nursing. She eventually calms down and finishes nursing, but I have no idea why she is screaming.

She usually does this in the later afternoon and early evening nursing sessions, rarely in the morning or afternoon. Also, they get formula at night and she never does this when taking the bottle.

Any ideas what could be causing this?

It could be reflux w/ overactive letdown complicating things. I let down pretty quick and DD did have reflux. She did the exact same thing you described. Start to nurse and unlatch and just scream, like you poked her w/ a pin. It hurt me to hear her scream it was so piercing. We ended up on Prevacid and I learned how to feed her in short bursts, stop, burp and for the next feeding use the same boob. Then switch and do it all over again.

Does she fuss when placed on her back flat? Does she scream in the carseat? How is her nighttime sleep? Is she *colicky* certain times of the day? If so I would definately look into the reflux issue. Sorry for all the questions, lol but LC's may not delve deep into the reflux side of things (neither of mine did).

Check out infantreflux.org for some great resources as well.

I'm sorry your little one is in so much pain and hope it clears up soon!

[daisymommy]

I had one child with reflux (my son), and one child where I had over-active letdown (my daughter). The interesting thing is both babies acted the same way for the most part when nursing, only the reflux baby had several other symptoms on top of that.
Here are some articles on over-active letdown/over-supply that were lifesavers for me:
http://www.llli.org/NB/LVSepOct95p71NB.html
http://www.llli.org/FAQ/oversupply.html

And info on reflux:
http://www.askdrsears.com/html/10/t106000.asp

I hope that helps!

[mikeys_mom]

Thanks for all the advice and links. I have been in contact with my Dr and a LC. We have ruled out reflux since she does not have any other symptoms for reflux. I possibly have over-active letdown, but in a very mild form since she does not have many of the typical symptoms.

The overall conclusion is that the problem is positioning and the fact that one twin needs to burp more frequently. The LC gave me a different position to try but it is not really working.

I was a bit disappointed because even before she came, on the phone, she was already suggesting that I may not be able to tandem nurse. I am looking for another LC who has more experience with twins and hoping I can find a workable solution. It would be very difficult to nurse them one at a time. Well, not that the current situation is easy, but at least I can try to satisfy both girls at once.

[egoldber]

I disagree and I think it really could be reflux. Reflux is often complicated by position. My younger DD was in a lot of pain when she nursed on my left side and I had to really struggle to find a position that was comfortable for her to be able to nurse on that side.


It could be reflux w/ overactive letdown complicating things.

I think this could be it.

I would definitely try to find someone with twins experience. I would also call a local LLL leader and ask if they have any members who have nursed twins. You are more likely to find someone who has been successful at nursing twins longer term through LLL than through more conventional sources (IMO). My local LLL group has at least three moms who have currently or in the recent past nursed twins.

http://infantrefluxdisease.com/infant_acid_reflux/index.php/infant-reflux-gerd-information/14-about-infant-reflux-and-pediatric-gerd/41-symptoms-of-infant-reflux-pediatric-gerd

[L'sMommy]

What you described is the same thing that used to happen with DS. He didn't have reflux, rather there was something in my milk he was sensitive to. Took us a while to figure this out. LC suggested it may be the flow, but he used to do the same thing with we gave him a bottle of pumped milk.

[mikeys_mom]

It seems like no one can really figure out exactly what the problem is, but we seem to have found a solution.

Thanks for all the additional links on reflux. I ended up discussing reflux with my Dr in a lot more detail after reading all the links here. She had me keep a log for a week on each of the girls to track spit ups, hiccups, screaming during nursing and a few other things because until I tracked each twin, I could not remember if one was doing things "frequently". I also went to her office a few times so that she could watch me nurse and try to see what the problem was. I had to go back twice because the first times, both girls were fine and didn't cry at all.

The conclusion was that she does not think they have reflux and if they do have it, it's very mild and does not require medication. I do have a fast flow, which is different from overactive let-down. I can't remember what the difference is. Also, the twin that was crying more frequently has an extremely strong suck.

So, the possible reflux with the fast flow and the fast sucking results in her feeding really quickly and then being in a lot of discomfort. Also, I did not think that she could possibly be done nursing after barely 5 minutes, so I would continue to try and feed her after she calmed down, which just resulted in more crying because she was not hungry.

Because the girls have such different needs during nursing, I have now been feeding them one at a time so that I can focus on each one properly. I spoke to a few other twin moms who also did not tandem nurse and it was reassuring to know that it is manageable.

Over the past week we seem to have developed a pretty good routine and nursing is now much better. :yay:

Thanks again for all the help and sharing your experiences.