Breastfeeding case study of Max – 11 weeks

A full history from birth

Max was born at 39 weeks gestation and was induced.

I was in labour for eight hours and he was born in just under five minutes with only three pushes so it was a very quick delivery.

He was 8lbs,7 ounces at birth. He breast-fed within the first 45 minutes of being born and latched on pretty well. The breast-feeding was going pretty well but a few weeks in he was having horrible gas, screaming a lot and generally pretty uncomfortable and miserable. He could never be put down on his back or pretty much at all. This is when we started co-sleeping as he just screamed if I laid him in the cot.

I also noticed he never opened his mouth very wide when latching onto the breast and suspected he may have a tongue-tie. I met with the lactation consultant who confirmed she didn’t think he had a tongue tie. However she thought he was latching pretty well and his weight gain has been perfect the entire time.

He has pretty much remained in the 91st percentile. I saw the paediatrician and the GP who both reluctantly suggested that he try going on Ranitidine. I put him on 100 ML three times a day. He got much better after that I would lay him on his back for short periods during the day but he still wouldn’t nap or sleep at night on his back.

He continues to nap carrier and go to sleep at night. The lactation consultant and doctor suggested I cut out dairy and soy. I did this for two weeks and tried to cut back on the reflux medicine. When I cut back his symptoms came back and he was screaming all the time and would never be put down. I put him back on the reflux medicine.

Just last week when Zantac was recalled in the U.S. we decided to switch him from ranitidine to omeprazole. He’s been on 5ml a day for 5 days and seems to be doing well so far.

My main concern is I would like to start teaching him some self-soothing techniques. He will not take a dummy and doesn’t really use his hands to soothe. However it’s very clear to me that he needs to suck and will often use my breast for this. Also I am not trying to make him sleep through the night, however I would like him to learn to sleep in his own cot next to our bed. I am happy with travel Cot, co-sleeper or bassinet. I also think it would be great if he could go to bed on his own at a set bedtime as opposed to needing to be in bed with me nursing him to sleep.

I just want to set the ground work now for healthy sleeping habits and self-soothing in the future . I also want to get him off of any kind of reflex medicine. The decision we need to put him on it had to do with the health of the whole family. His screaming and crying was taking up all of my time and it was really taking a toll on the whole family including my 2½-year-old daughter.

I take care of both kids by myself most of the time and it seemed really unfair to her that I could never put him down and really give her any attention. I also don’t want to see him in that kind of pain or him screaming crying, pulling his legs up, arching his back.

24 hour current schedule to include food, feeds, naps and timings

  • 7am wake and feed.
  • 9:30-11:30/12 nap in carrier
  • 12 feed.
  • 1:30-3 nap
  • 3 feed
  • 5pm-7pm nap
  • 8:30/9pm feed in bed till he falls asleep
  • 2am nurse in bed
  • 4am nurse In bed (sometimes he skips this one).
  • 5:30am nurse in bed
  • 7am wake and feed

I sometimes give him a short feed before his naps to help him sleep longer

Any sleep associations - ie dummies, bottles, breastfeeding, co-sleeping or other aids

I nurse him to sleep at night. He co sleeps in the bed with me. During the day he take his naps in the carrier on me and I generally use a white noise to help him fall asleep day and night.

Night waking patterns and behaviour around settling and soothing

I don’t think he knows how to self soothe at all. He wakes in the night and I nurse him back to sleep. He wakes two times to six times a night. It varies. The longest stretch is the first stretch and it get shorter as we get closer to morning. He’s very restless and uncomfortable between 4am and 7am. Usually whining, moving a lot and wanting to comfort nurse. He seems uncomfortable.

Any family/medical information that may assist the assessment

My daughter had an egg allergy which she outgrew at 2 years old. She was also in reflux medicine till she was 4 months old. I think it is possible that he could be lactose sensitive. I was lactose intolerant when I was younger and also had reflux in my teenage years which seem to go away as I got a bit older. However I am still lactose sensitive and can’t have heavy cream or milkshake type of dairy.

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