Forget dream feeds, I've got a problem with scream feeds!

My girls are almost 11 weeks adjusted. They get bottles of pumped milk while I'm at work during the day, and I BF when I'm at home. They also get a pumped bottle in the middle of the night. Occasionally in general they've had an issue with their bedtime feeding (6:30-7:30 depending on the day and how hungry they are). Lately it's been every single night. Basically either one or both of them will nurse for a couple minutes, then start screaming. If you sit her up she'll calm down, but as soon as I lay her back on the nursing pillow the screaming starts again. Sometimes I can manage to nurse for 5 mins through the screams, but usually I have to give up.

At first I assumed it just meant they weren't hungry if they did that, and it seemed that way for a while. But last night I pumped because one of them barely ate at all, and then offered her a bottle of the pumped milk, and she drank it up. They also never do this screaming behavior with bottles, only with nursing. It's really frustrating! They mostly nurse okay first thing in the morning, and on the weekends when I feed in the middle of the day they're usually okay. It's just this bedtime feed that's a disaster. I've thought about giving up on nursing at bedtime and just pumping & bottle-feeding, but then I'd only be nursing once a day during the week and I feel like they'll forget how to nurse.

I'm betting the real solution is "nurse more, bottle less," but since I work I really can't nurse during the day at all. I also need to pump at the nighttime feed because I have a better supply at night, and I need that extra milk to make up enough for when I'm at work the next day.

 

Sorry you are dealing with this! Could it be that they are over tired at night and not up for the extra effort that breast feeding requires? Or it may be that after a day of bottles they are confused or lazy over breast feeding? This is a tough situation. You can either grit through it and be persistent with the bedtime nursing session (and hope that they get with the program) or give them a bedtime bottle and continue with the morning and weekend nursing. I don't think that they will forget how to nurse at this point but they may start to prefer bottles because they are faster and easier.

Disclaimer: I exclusively pumped BM for my bottle fed twins and only worked part time when I had nursing (singleton) babies. While I did experience some trouble nursing after I had been at work, it wasn't a big problem. Hopefully another mama has had a similar experience and can give you better advice!

 

This is an excellent article from Kellymom on coaxing fussy nursers back to the breast: http://kellymom.com/bf/concerns/child/back-to-breast/

You could also try breast compression: http://www.breastfeedinginc.ca/content.php?pagename=doc-BC Babies like a fast flow of milk, which is something different altogether from supply. Breast compression is a simple way to increase your milk flow.

 

Thanks for the help and sympathy! After reading the links you posted I tried to be more zen about it last night. I got both babies to breast at the same time so that they'd both get the initial let-down, and we did breast compressions (a 2-person job when tandem feeding :lol: ) They seemed a bit more settled that way. When they started fussing we took a break to burp, then since Cecilia was screaming when we laid her down again I had my husband snuggle her while I worked with Allison, then took her back when Allison was done. After burping they were unhappy with the nipple shields, so I tried taking them off. Amazingly, they both latched on and ate! In the past I've been unable to get Cecilia to latch without a shield.

I think part of the problem maybe is that with the shields, they are latched to the shield and if they squirm around, they dislodge the shield from my nipple and milk stops flowing. When they latch directly, if they squirm around they just take the nipple with them. Maybe I need to work on weaning the shields more.

 

Ooh, maybe they are telling you they prefer nipple to skin.

 

Sigh.  I thought things were getting better after nursing all day last weekend, but this week they just devolved again.  It's mostly Cecilia at this point -- Allison only seems to have an issue if Cecilia starts screaming first.  C will basically wail at the top of her lungs as soon as she gets the nipple in her mouth.  She might suck a couple times but not enough to trigger let down, and then she just gets more and more angry and cries harder and harder and refuses to suck.  Once I managed to get her to nurse by giving her a bottle with 1oz while simultaneously pumping to let-down, then swapping out the bottle for breast super-fast so she wouldn't notice.  This last feeding was a disaster though -- I tried to feed her before she seemed super-hungry since I thought that would leave her calmer to suck to let-down, but she started crying really fast, and once she's upset then I'm upset and it takes even longer for milk to come out.  I pumped until it was coming out and tried her again but she just wouldn't eat, and then set off her sister until they were both screaming and the dog was howling and I ended up carrying both of them around on my shoulders while I warmed up bottles for them (husband was at the grocery store).
 
I just don't get it.  They nursed fine at noon.  C was only a little screamy at 6:30 this morning and A nursed like a champ.  The milk in the bottle is the same milk, it's not like it's breastmilk vs formula or something.  And this isn't like "I'm kind of hungry" screaming, this is like you'd think we were torturing her or something, it's really wailing.  I started taking fenugreek yesterday since my supply had dropped a little and I thought maybe they were mad there wasn't enough milk, but I have plenty of milk today (pumped 10oz after giving them their bottles and usually at 3pm I only pump like 7oz).
 
I want to nurse these babies but I can't deal with this happening every day.  It's really stressful and I think it's why my supply started to drop.  I know they can nurse, they do it at some of their feedings, but I don't understand what's wrong here.  Help please!  If this goes on much longer I'm afraid I'll have to give up on nursing and just pump everything.

 

Sorry things are so rough.
 
here are my brainstorm ideas:
-try nursing Allison first until let down and then switch her over to the other breast and put Cecilia on the 'already going' breast. 
-OR feed them one at a time for a little while.  Start with Allison and let her get the milk flowing. (the goal is to eventually go back to tandem. when you are ready to try tandem again, still give Allison a slight head start so the second breast will let down easier/faster)
-have you seen this article on bottle feeding tricks for the breastfed baby? Make sure everyone who bottle feeds is doing these things, especially pausing to mimic let down
-can you breastfeed one and bottle feed the other (even switching who gets which) for a while until things feel more stable?  Maybe divide the bottle fed baby's portion in two bottle just in case breastfed baby looses it.  You will be able to at least get both started.  Hopefully have a back up plan will help you relax which will be good for let down.
-after Cecilia is satisfied will she stay calmly at your breast?  a little quiet, no stress bonding might be good for everyone.
 
It sounds to me like Cecilia is mad.  NOT hurt, NOT starving, MAD.  (My DD angry cries are far worse than for any other reason.. including real pain!)  So when it all starts to deteriorate take a deep breath and remind yourself you are doing everything right and patience is hard to learn.  She will be okay.
 
some people might be shocked. i had ear plugs that i would put in, when i was in that situation where the babies were unhappy and i was already doing everything i could as fast as i could.  I was already holding them so it wasn't like i wasn't going to notice if there was a problem.  Decreasing the noise level decreased my anxiety.  i think i handled things better, calmer, more efficiently because i was not quite so stressed.
 
You are right. Stress will decrease your supply and delay your let down.  It is a vicious circle.  
I hope you will keep trying.  Back up and find ways to ease back into it. Baby steps
Hang in there mama. you are doing a good job.
 
Edited for typo and for 
PS - fenugreek was helpful to me also, and oatmeal.

 

Amy has given you great advice. 
 
I was thinking of back to back feeds or using your happier baby to bring the milk down as well just until you get the screaming down. A friend of mine went through this with her singleton- the baby was lazy and just wanted the milk NOW and would scream to get it. My own son did this at first- I pumped and would give him just a suck or two to get started and then would put him on the breast after my non-lazy boy would bring the milk down.
 
I completely agree that she sounds mad that it's not happening as fast as she'd like. I never did earplugs but I often put on some music that calmed me down and turned it up. I found that easing my anxiety while tough- was necessary. Remember to breathe when you are starting to get amped up- it sounds so simple but when your anxiety goes up people don't breathe as much. 
 
You are doing a great job with these two little girls. :hug:

 

Thanks for the advice!  I sent along that link about bottle feeding to my husband, since he's the one who gives them most of their bottles.  We had a successful feed at 5:30 yesterday afternoon and another successful one at 6:30 this morning.  At 5:30 Cecilia was still asleep and Allison was hungry, so I got Allison ready to go and put Cecilia on my nursing pillow still mostly asleep.  She was more relaxed and was able to latch on and nurse with minimal fuss.  Usually in the morning I change their diapers and clothes and then feed them, but this morning C was starting to fuss and A was still asleep, and after my shower milk was pretty much pouring out, so I skipped the diaper and clothing change and just took their arms out of their swaddles and put them straight to breast, and they nursed really well.  I was so happy!!!  We'll see how it goes tonight.
 
I've thought about doing them one at a time but it would definitely require the other one to get a bottle and me to pump afterward, which seems like a big pain.  They are on the same schedule so they get hungry at the same time -- they get frustrated enough waiting just long enough for me to change the other one's diaper.  If C is already starting to cry then A doesn't nurse well.  Also once my milk lets down it pretty much pours out of both breasts even if only one side was being stimulated, so I worry that if I don't get both babies on for the let down then one of them is going to miss out on a good once of milk that would just get lost in a cloth.  Also after the initial let-down it's slower to come out and they get angry with slower flow.

 

Just wanted to let you all know that the nursing strike appears to be over!!!  Woohoo!  We've now gone about 3-4 days with NO SCREAMING.  My supply is up thanks to fenugreek and adding an extra pump session, and my babies are calm and have been nursing well, even at their usually fussy times of day. I am soooo relieved.  Thanks everyone for your support and advice!

 

That's great to hear! Thank you for the update.

 

So glad to hear your good news!  Great job!

 

Yay!

 

:woohoo: I am so happy for you all!

 

I can't win!  They were nursing well, but they started having terrible gas at night that was keeping us all awake.  Apparently fenugreek can cause tummy upset for babies.  So I didn't take it at bedtime last night, and this morning they were back to their nursing strike screaming behavior.  I just don't know what to do with these babies!