STTN=big boobs=big spit up?

[@llli*lukes.mom]

Hi ladies, hope everyone is well!

LO is now 4 mo, 2 weeks old. He JUST started sttn--yippee! Prior to this, he would wake to nurse 1-2x/night, usually just once. It's only been 3 nights of this, so my breasts have not adjusted yet, of course, and they are huge when we all wake up. The 1st morning, I was dumb and still offered DS both breasts--which he willingly took--and then spit up a TON, gag reflex and all. Oh, right--probably more than his little tummy can hold. So yesterday morning I only offered 1 side before leaving for work. DH reported DS again spit up, maybe 20 min after finishing eating. This am I was able to manually express a little from one side before going to him when DS woke. We'll see what happens.

My question is--why the copious spit up? Is it that I've filled up with too much foremilk and it's too much sugar? Or is it that he's just taking too much because he's so hungry? DS also has a very mild cold so is that playing a role? I feel so bad because he goes through the whole heaving motion (sorry for the visual) so it's not like an easy spit up, more like vomitting.

Any ideas?

[@llli*lukes.mom]

Additional info: another spit up/upchuck this AM, maybe 15 min after stopping because he fell asleep (he's back at that same breast now) but it was a smaller amnt. DS is NOT normally a spit-upper, only rarely. And he's only been doing this these past3 AMs when he's sttn and I've been super full...

[@llli*juliet1]

It could be that he's spitting up because you're getting a forceful letdown (OALD) from being full. Since it comes out fast, he has to gulp to keep up with the flow, if not, they'll "choke" on it. Especially if he's had a cold, he may not be able to get a good latch (since he can't breathe if he's stuffed up) so he might be swallowing some air, too. All that air would make the bm come back up pretty hard between a burp and spit up combo.
You could try blockfeeding so that he gets a balance between foremilk and hindmilk. That's helped my dd in this situation (along with what I said in your other post).

[@llli*lukes.mom]

Thanks again Juliet1,

That makes perfect sense--I do see him gulping at the beginning of the feed when I'm so full...he probably is getting a ton of air. I'll be able to burp him some, but not as much as I would expect. And I guess as the bubble tried to come back up, it might bring some milk with it, leading to the gag reflex being triggered and I'll see that awful heaving motion and facial expression. Poor guy!

Would it also help if I expressed some before putting him on the breast? I tried to this AM, just manually (I'm not that skilled at that yet) so I didn't get a lot out--I was still quite large and firm--but he still gagged/spit up after he finished. Maybe if I try to get up a bit earlier and use the pump a bit, just to soften things up/relieve the back-pressure?

Re: block feeding...I still need to have him take the other side at his next feed, it's still uncomfortable after pumping since he's now napping for a while...will it still be beneficial to block feed after that? He doesn't have any trouble for the rest of the day, it's just been that first feed...so maybe I don't need to block feed at all?

Thanks a bunch! BF'ing and our bodies are truly amazing...

[@llli*zplum]

something else to consider would be the mild cold. If he has post nasal drip going into his belly throughout the night then that could be upsetting it. And the larger amount of food mixed with the faster letdown/excess foremilk could all be playing a part. It will even itself out mama.

[@llli*lukes.mom]

Thanks zplum, I hadn't thought of that. i do remember thinking the first spit up seemed more slimy than I expected Poor little guy! So much going on all at once!

[@llli*juliet1]

Originally Posted by @llli*lukes.mom

Thanks again Juliet1,

That makes perfect sense--I do see him gulping at the beginning of the feed when I'm so full...he probably is getting a ton of air. I'll be able to burp him some, but not as much as I would expect. And I guess as the bubble tried to come back up, it might bring some milk with it, leading to the gag reflex being triggered and I'll see that awful heaving motion and facial expression. Poor guy!

Would it also help if I expressed some before putting him on the breast? I tried to this AM, just manually (I'm not that skilled at that yet) so I didn't get a lot out--I was still quite large and firm--but he still gagged/spit up after he finished. Maybe if I try to get up a bit earlier and use the pump a bit, just to soften things up/relieve the back-pressure?

It really would help if you could express some before placing him on the breast. As long as you can do it before he gets too hungry and starts crying, because that'll just cause him to 1) swallow air, and 2)eat fast because he's really hungry.
When I manually express, I'll cup one hand under breast creating a "c" shape kind of squeezing, and place the other hand (all fingers and palm) on top and close hand (as if I'm trying to touch fingertips to where my palm and wrist meet). I hope this makes sense.

Originally Posted by @llli*lukes.mom

Re: block feeding...I still need to have him take the other side at his next feed, it's still uncomfortable after pumping since he's now napping for a while...will it still be beneficial to block feed after that? He doesn't have any trouble for the rest of the day, it's just been that first feed...so maybe I don't need to block feed at all?

I think it would be beneficial to blockfeed because it will let him get a better balance of hindmilk and foremilk, and it'll help your body regulate your supply so that you don't keep getting so full that you're breast get hard or lumpy. Which may lead to clogged ducts So, if you bf him 2-3 feedings on the right side, just manually express on the left in the meantime until it's time to bf him on the left. If you actually pump to get relief, and LO isn't nursing/emptying out that breast, your body will think you're telling it to make more so your breasts will keep getting full/hard. That's why I prefer to manually express. It helps if you put a warm-hot towel on your breast to help the milk flow easier. And you can do it while you bf or afterwards. It's easier if you manually express the side not be "used" while bfing with the other because you'll get the let-down flow. If you're storing the milk, you can catch it into the pump opening so that it drips into the container. When I relieve my breast after bfing, I recline the pump on towels on a counter or hold it between my knees, and just manually express the streams of milk into the pump opening. By the time I'm done and feel comfortable I have a container and a half full and ready to be stored

Originally Posted by @llli*lukes.mom

Thanks a bunch! BF'ing and our bodies are truly amazing...

They really are.

[@llli*lukes.mom]

Yup, I can visualize that technique for manual expression. I'll give it a try the next time he sttn (as I mentioned in the other thread, he woke up 2x last night to nurse...possibly because of his cold).

And I'll also try the block feeding too if it's a day I stay home with him. Today (a day off) I'm not over-full since he fed during the night. And at work, I just pump both sides. But if, when he's well, he really is starting to sttn (I suppose it all could have just been due to him being extra tired from being sick...) then I'd like things to get regulated as quickly as possible!

It is interesting, tho...even tho I wasn't particularly full this AM since he had eaten overnight, and he wasn't super hungry from going so long since his last meal, he still did have a small spit up. Makes me wonder if zplum was onto something about there being more mucous in his tummy from overnight and that's what's upsetting his tummy. He still doesn't spit up during the rest of the day. Hmmmm...

Thanks for all your help!

[@llli*juliet1]

That definitely would make sense. If he's had a lot of drainage, that could also cause diarrhea, so I could imagine how an upset tummy could easily happen.
Poor little guy I hope he gets better and you, too, mama.