My baby constantly vomitting - not sure what to do.
Hi - I'm a first time mother and my daughter is currently 7 weeks old and we are exclusively breastfeeding. She was 6lbs 7oz at birth and upon leaving the hospital she was 6lbs 1oz. We initially had very sever latching problems causing my nipples to crack and bleed, but she had no trouble regaining her birth weight by her first pediatric appointment 3 days later. 2 weeks later, she was 7lbs 6oz. I haven't had the opportunity to get her weighed since then; however, I feel like she's gaining well. I hope to get her weighed in a couple days at a local clinic.
Initially, she was having trouble lying down and would be very fussy when not being held and would be arching her back, but she always had more than enough wet diapers and BM diapers. She still does. Hearing that, her doctor recommended Zantac since I don't drink or eat dairy products as it is. In the beginning that was fine and after two weeks, I started weaning her off. Things were going well seemingly.
However, now, as of a week ago, she has started throwing up almost once a day after a long feed. Usually it is in the later morning/early afternoon this happens. She feeds for almost the whole time from 9am-1/2pm. Throughout that time (and at every other feeding) she is struggling with my fast flow as she is either choking or gasping or gulping. I do my best to take her off immediately, burp her then put her back on, but I see that it gets frustrating for her. I've also started trying to finish one side before going to to the next - but I find that my breasts are extremely engorged with that approach. I try to catch my initial spray, but it seems that my release is constantly fast, rarely slowing down. I try expressing it out til it slows, but again, it is constantly spraying.
Just today, she just kept drinking and then at one point everything just came gushing out. Only the very last bit was curdled looking, the rest looked like undigested breast milk. It feels like she is overfeeding and then instead of releasing just the excess, everything just comes out. The only thing is that she almost NEVER cries after, but rather is in a happy and playful mood. Usually, she'll play a bit and then fall asleep for 30-60mins. Once she gets up, she does want to eat. I'm currently abroad travelling and am not sure what to do.
This is my first time at any forum or anything, so apologies on the length of the post, but I'm extremely worried about her.
Re: My baby constantly vomitting - not sure what to do.
Welcome to the forum and congratulations on the new baby, and on overcoming the hurdles you had in the first days of breastfeeding! My first baby was also 6 lbs, 7 oz when she was born 7 years ago (!!!), and I still remember how terrifying and challenging it was to hold and nurse that tiny, fragile, squalling creature...
It sounds like you have probably have some pretty significant oversupply and fast letdown issues going on, since you're frequently feeling engorgement and you're seeing baby struggle with fast flow. The first thing to try when you're dealing with oversupply/fast letdowns is reclined nursing. Using a reclined position enlists gravity to slow the flow of milk to the baby, and that can reduce the choking/gagging/coughing/gasping. And while I totally get it that the engorgement you experience when you let the baby "finish the first breasst first" is no fun, I suggest that you keep on trying that approach. When a mom has oversupply, giving each breast equal time, equal stimulation, and equal milk removal can sometimes perpetuate the problem. Allowing baby unrestricted time on the first breast, and leaving the second breast more full, is a good way to allow your body to detect the difference between what the baby takes and what you're making, and to figure out that it's making too much milk.
When a mom has high supply and fast letdowns, it's very common for the baby to get full to the brim every time she nurses and to swallow a lot of air along with her milk, and those two things can cause more frequent and more voluminous spit-ups. I know it's alarming when your baby produces a fountain of spit-up, but when the baby is not in pain when spitting and is gaining sufficient weight, spit-up is a laundry issue, not a health issue! It may help to try burping baby in between breasts, and keeping her somewhat upright after feedings, so that gravity can help keep the tummy contents down where they belong. This problem will disappear in time, as your supply adjusts, baby learns when to stop nursing, and the baby develops better muscle tone in the sphincters which keep stomach contents down where they belong.
I know a lot of moms whose babies spit up get concerned about overfeeding and overeating, and start wondering what they should do to change the baby's feeding behavior. Feed less often? Feed more often? Pump off the excess milk? Pump and bottle-feed? Switch to formula? The answer is: none of the above! Just feed on demand, and give the baby the opportunity to learn to identify her own satiation cues, and to use those cues to know when to stop nursing.
It sounds like you're doing really well! This is just a temporary hiccup in your nursing journey. :)
Re: My baby constantly vomitting - not sure what to do.
I am so glad someone referred me to this forum. I'm having the same problems (without the reflux) and the "fountain" of vomit is extremely disturbing to me. It's a relief to hear that it's normal. I kept thinking it was something I was eating that was making him puke up everything but its good to know that it's just part of the oversupply issue. Thank you mommal!