Tincture of time

When we talk about therapies that can help make the early days, weeks, and months of breastfeeding easier, one that we often overlook is tincture of time. That is, sometimes you just need to wait for improvement.

You don’t want to use this tincture when a baby is failing to gain weight, can’t transfer milk well, or is obviously not thriving physically. You don’t want to apply it when a mom has cracked, bleeding, or obviously-not-improving sore nipples; developing mastitis; or having any other obvious difficulties. But one place I encourage you to consider using it is fussiness.

It is fairly common knowledge, but not knowledge passed on to many expectant parents for some strange reason, that babies start off being fairly content. After their initial alert period after birth, they’re often quite tired and might want to sleep soundly for a day. They’ll be a little more alert after this, but will, generally speaking and with the occasional grumpy day thrown in, sleep (partly as a way to shut themselves off from external stimuli) and eat and poop. Most brand-new newborns are pretty sweet and delightful.

And then they get about two weeks old, and it’s like you have an entirely different baby on your hands. This fussiness seems to grow and grow until about 6 to 8 weeks of age*, when it starts to taper off. (Sometimes the switch is dramatic, but most babies have regained a somewhat more sweet demeanor by about 3 or 4 months of age.

Especially when you are a new parent or if you’re experience sleep deprivation, none of this fussiness feels good to you. It all feels awful and, sometimes, relentless. Babies’ cries trigger us to want to DO SOMETHING, ANYTHING, JUST STOP THAT NOISE. The baby industry booms partly on that desire to DO SOMETHING: We’ve got endless stuff we can buy to soothe our babies.

When it comes to breastfed babies, what gets blamed? Breastmilk, of course. You might not have enough breastmilk, or too much. You might have foremilk/hindmilk imbalance (a misnomer that I hope to see struck from the lexicon). Maybe it’s gas. Maybe it’s the dairy, soy, wheat, eggs, chocolate, coffee, broccoli, onions you’re eating.

Here’s a somewhat scientific chart that I made. Keep this in mind when we look at the two scenarios that follow.

  1. A two-week-old baby is growing increasingly fussy and is sometimes unhappy at the breast. His mom has been noticing that baby chokes and sputters when she gets a letdown, and baby has some green diapers occasionally. It’s decided that she has a foremilk/hindmilk imbalance and overactive letdown, meaning that her baby is getting too much foremilk and not enough fatty hindmilk. (Here’s a good blog post with eye-opening pictures that can give insight into why this is a problematic “diagnosis.”) She is told to block feed—feed on just one breast per feeding, and use just that breast for a certain period of time. She notices after some period of time that her baby is getting less fussy at the breast and happier in general. The block feeding worked! Or did it? It’s possible that it’s just time marching on and her baby maturing. In the meantime, it’s very possible that this mom’s milk supply has taken a hit because block feeding is a technique that reduces milk supply, and that is why it works.
  2. A baby, who is now 6 weeks old, has been fussy and gassy for weeks. It just keeps getting worse, despite trying things like gas drops, tummy massages, and mom cutting caffeine out of her diet. Finally, it’s decided that baby is sensitive to cow’s milk proteins in mom’s breastmilk and she stops eating cheese and milk and ice cream and all those wonderful things. It should take about two weeks for the cow’s milk proteins to clear her system and her baby to be feeling better. Sure enough, in a couple of weeks, there’s been a remarkable improvement in baby’s behavior. She’s not a total sweet angel baby, but it’s almost as if there is improvement every day.

Of course, it is possible that these scenarios needed intervention of some sort. We don’t have a full history, and every breastfeeding dyad is different, with its own circumstances. These scenarios play out often, though, where intervention is applied at a peak time of fussiness, and the subsequent decrease in fussiness is attributed to the intervention***. What could really be happening is that a baby is going through a normal fussy period and coming out of the normal fussy period.

Also, when we’re adjusting to the newness of having a baby and learning to integrate this new little one into our lives, we’re on edge. It is not easy to adjust to a new little person, learning his or her cries, preferences, and personality. We likely aren’t sleeping well, and even when breastfeeding goes well, it takes time for us and our babies to learn how to do it, even when this isn’t a first baby. Then, when relief comes in the form of less fussiness, that relief hits us like a ton of bricks. Maybe the baby who had been waking every two hours finally slept four—how amazing do you feel the next day?

My point is not that problems do not exist. They do, and it is important to listen to your instincts as a parent (or care provider) and intervene in small or big ways when necessary. However, we don’t talk about this normal fussiness often enough, nor do we talk about it early enough. It is hard to believe that the crying that tears at your soul (and sanity) so is normal when you’re living it, but might be easier to understand if you’re prepared before it happens.

In the absence of an obviously serious problem, when the intervention (like block feeding or elimination diets) might cause more harm or trouble than waiting, try waiting first.

*I have a theory that babies start smiling about this age so that they are able to redeem themselves, if only for a few minutes at a time.

**To be fair, parents, caregivers, and doctors might blame formula, too. Why do you think there are so many different kinds?

***Likewise, when babies and children continue to have their occasional periods of fussiness, as they do when they are growing physically or mentally, we might intervene in some way and, when the fusiness abates, we believe our treatment, whatever it was, worked.