[tmichelleking]

Hi Andrea,
My 1 month old, Isobel spits up a lot! I am breastfeeding only and no matter how long she feeds, I am garaunteed to get a lot back. Sometimes it is fresh and sometimes it is the cheesy/curdled kind. I have tried keeping her upright. I burp her between breasts and when she is finished but she still will eventually spit up even if it is an hour later. I'm always nervous about putting her down on her back to sleep or play too quickly because she soaks herself. It also causes her to hiccup. I feel so bad for her, however it doesn't seem to bother her as much as it concerns me and she is gaining weight at an incredible pace. Is there anything I can do for Isobel? Do I just have a laundry problem and nothing else?

Also, related to the spit up - I express milk for my husband to bottle feed once a day. How much should I be putting in the bottle. I have been putting 2 1/2 ounces but she gobbles it up and seems to want more. I will then give another ounce but then she spits up more. How do I know what is the right amount?

Thanks for your help
Michelle

[Deb]

Congratulations Michelle on the birth of your baby girl Isobel! Breastfeeding her, lessens your risk for certain breast cancers and surely you know all about the benefits to her!

I am sorry, it must be so upsetting to see her go through this despite the fact that she seems to be ok.

From your post it sounds like you are offering both breasts at each feeding and I suspect that since she's 'gaining weight at an incredible rate', that she may be taking in a great deal of your foremilk. Foremilk is the first milk she gets when she starts nursing, has a consistency similar to that of skim milk, and tends to,when babies fill up on it, cause this particular challenge.

My recommendation is that you offer her the same breast, after the first burp. This will give her more of the hindmilk, which is much higher in fat and in most cases, helps to ease this digestive problem.

What are her bowel movements like? If they are very watery, with no 'seedy' bits in it, maybe even having a bit of a 'acidy' or 'vinegary' smell, feeding her in this manner will again allow her to get more of that rich, creamy, fatty hindmilk.

As far as the amount for a bottle feeding, it is difficult for me to advise you based on the information given here. Try burping her at about every 1/2 ounce or so and slowing down her feeding by taking short breaks after her burp, continuing only when she begins to smack her lips and suck on her fingers. This may help her to recognize more clearly when she is physiologically full.

Babies have a strong instinct to suck, so if she seems hungry for more, try allowing her to suck on a clean finger or pacifier(now that she is over 4 weeks of age). If she rejects it after a few sucks, she probably has room for more, then offer 1/4 to 1/2 ounce.

Attend a Breastfeeding support group, La Leche League meeting or see a Lactation Consultant privately should these issues persist.

I wish you joy and happiness in your new adventure!

Much warmth,

Andrea

[tmichelleking]

Thank you so much for your quick reply. Just to be clear, should I only offer one breast per feeding? I usually let her come off one before I switch so should I let her come off- burp her- then put her back on until she comes off again. If this is the case, is it then recommended that I pump the "untouched" breast? Or , just wait until next feeding and offer that breast then? I just want to be sure I am clear.

I had read about the foremilk/hindmilk and am thankful that you cleared that up. How does the foremilk/hindmilk work itself out when feeding with a bottle?

Thanks again
Michelle