Q: My 3 weeks old daughter goes to sleep during breast feeding. Its very tough to wake her up. Removing her clothes, rubbing her back and changing her diapers wakes her up but she goes back to sleep within 1-2 minutes of latching. It takes me an hour to make sure that she has had 10 minutes of feeding. I get upset because she gets very rough in the process of making her drink. She keeps splitting milk. She does not burp even after I try to burp her for a long time. When I put her on her crib, the milk starts flowing from the sides of her mouth. This happens even when I elevate the head end of her bed. Many times the milk flows out from her mouth even after 1-2 hours of feeding. She cries and makes painful gestures and tries to lift her neck while this happens. She even makes strange noise like grunting and squeaking during this time. I can hear the sound of milk moving upwards from her stomach. She passes lots of gas. I eat carefully and the only possible reason for her to pass gas is due to 2 glasses of milk I consume. I am lactose intolerant and was told to consume milk to increase the milk production in me. She also has a terrible diaper rash. I am using barrier cream every time I change her diapers. But I notice that for every new diaper, she passes gas immediately resulting in small amount of excretion of stools. The process of putting on new diapers is hence continuous.

A:Regarding adequacy of feeds, if she is feeding effectively for 5-7 minutes and passing urine at least 6-7 times in 24 hours and is gaining weight adequately, she is getting enough milk. Other symptoms suggest gastroesophageal reflux, which means her milk regurgitates from the stomach and comes into her mouth and that is why she brings out milk and is uncomfortable while lying down. You should try to burp her gently and make her sleep with head end raised by about 25-30 degrees and on her right side. This sometimes helps. If she is still uncomfortable, some medications may be required under the supervision of your doctor. For diaper rash, it is better to prevent this by minimizing the use of diapers. Expose the skin to air intermittently and you can apply any anti-rash cream.