Q&A: confusion about when to nurse teething 5-month-old

Becca writes:

"I am not sure how to phrase this question but I am confused about the cues to feed my exclusively breastfed 5 month old daughter.  This was not a problem before because it was a very distinct signal of rooting around compared to other fussiness.  Yet, now, she has popped two bottom teeth and mouths everything-all the time.  So, as everyone says, "she is obviously not starving", and has no problem at the breast...I decide to feed her only if she gets FUSSY, it has been over two hours, or I just pick her up and TRY to see if she is hungry. Every time I try she will eat at least for a few minutes.

From this problem I have a few questions.  Is this common to most breastfeeding situations (this is my first child)? Can you overfeed a breastfed baby...I am afraid by "just trying" I am (or could) override her natural signals of hunger and fullness? Also, I go back and forth wondering if I am losing milk as she mouths a lot, I "try" and feed her a lot, and she eats for small periods.  Therefore, my last question is how you can tell if you are losing milk?...as long as she is gaining am I okay?

She is very healthy, so truthfully my problem is really nothing but confusion. The thing I am scared of most is messing up her natural signals."

Teething makes everything strange. That's one of the truisms of parenting (along with "if you start to feel cocky about something it'll go to crap" and "at some point the kid will puke in your mouth" and a bunch of others). So when your kid is teething you can feel like everything's all messed up and strange, and it is. You kind of just do what you have to do to get through it.

Her wanting to take a bunch of short drinks sounds very par for the course to me. Some kids refuse to nurse during teething. Others want to nurse all the time, and drink and drink and drink. Others want to nurse often, but hardly drink much at all--it seems like it's mostly just for comfort or because they can. It sounds like the last is what your daughter's doing.

I don't think you can go wrong by offering the breast to a child that age. If she's not hungry (assuming she doesn't have a metabolic disorder or feeding disorder and that you mostly feed on demand so she's used to regulating her own intake) she won't nurse. (If you haven't seen that yet, don't worry--you will. You'll offer and she'll refuse and you'll feel like chopped liver.) If she's thirsty but not hungry, she'll nurse a little but then stop. Babies are more like cats, who will stop eating when they're full, than like dogs, who will eat until they make themselves sick. By offering and giving her the choice you're actually helping her learn to distinguish her body's signals.

I also think that her going on and off and mouthing a lot is all about the teething and has nothing to do with you or your supply. The extra-annoying thing about the teething process is that it interferes with the pattern you've gotten into with nursing because it's mouth-centered. If she's still making enough diapers (both poop and pee, although the teething can change the consistency and smell of the poop) and is alert and happy and engaged, then your supply is fine. If you feel like she's never doing a full feed, you could always add a pumping session or two to make sure your supply stays up while she's in the throes of teething, but if she's still nursing a lot, just over a bunch of smaller feeds, your supply is probably fine.

Once she pops another tooth or two she'll probably go back to nursing bigger meals at longer intervals and making it more clear when she wants to nurse. In the meantime, it wouldn't hurt to work on the sign for "milk" with her. When you offer her the breast, say clearly "nurse" (or whatever word you use for it) and make the sign at the same time. She'll probably recognize the sign within a few weeks, and may start making it herself in a month or two. Then she'll be able to give you a crystal-clear signal that she wants to nurse, which will make both of you feel good. Two thumbs up for communication.

I sometimes think teething is nature's way of prepping us for what it'll be like to parent a teenager. Hang in there.