foremilk hindmilk imblance and overactive letdown
Please help! I am struggling with an oversupply. My daughter was 8lbs at birth. She is 5 weeks old and weighs 10lbs 4oz. She has had all the symptoms of foremilk/hindmilk imbalance. She is always hungry, fussy all the time, gassy, green explosive watery foamy poops, recently started spitting up, and this all seems to be at it's worst in the evening. In addition, she gags and chokes when I nurse. I have been block nursing since Friday last week and so far, not even the slightest improvement. She is also getting rashes from the acid in her poop from too much foremilk. She never seems satisfied after a feeding even with the oversupply. I can keep her on the same breast for like 2 straight hours and still she looks for more. I've tried putting her back on and putting her back on the same breast but no success. After a while, she gets annoyed because she's not getting what she wants out of that breast anymore. I don't want to offer the other breast because then again she will be getting too much foremilk. Tonight I broke down and gave her a supplement of formula after I gave her a 3oz bottle again. For the first time she went right to sleep. I'm considering going to exclusively pumping since I have to go back to work next month anyway. I was wondering if I switch to only pumping will that cure my milk imbalance? I don't want to pump and still have too much foremilk. Any suggestions would be greatly appreciated.
Re: foremilk hindmilk imblance and overactive letdown
Poor you and poor her! Sounds to me like you have an upset baby on your hands and that you are wondering what the best thing is for her.
It sounds like you have been trying all the usual recommendations to balance out the fore/hind milk supply issue. One other thing you could try (especially since you will need milk in the freezer when you go back to work anyway) is to pump a bit off from your breasts before you start to feed your daughter. This won't address your overall oversupply isue, but it would let her get the creamy hind milk that she needs to sooth her tummy and her bum, while still being at the breast to get comfort from you too. I would caution you to see this as a short-term measure, which you wouldn't necessarily even do at every feeding, and which you would want to reduce over the course of a few days (eg take an ounce or so for a day or so, then take less the next day, and less the day after, so that your breasts get used to producing less not more milk!).
Since she is tiny and obviously upset about things right now, you might want to be particularly observent of her least little sign of hunger, and offer her the breast right away. This way she'll be as calm as possible as she latches on. One thing that could help is to put her in a sling or swaddle her in a blanket so it is harder for her to arch and pull away from you. A frantic baby is very hard to nurse no matter what!
Does she latch well? If she is feeding often, she should be drawing out the good fatty milk, especially if you have been offering the same side for a couple of feeds. If she is latching poorly, she may not be causing the letdowns that release the fatty droplets into the milk. Is there someone close to you who could observe her feeding? A LLL Leader for instance? It is possible that simply positioning her better might solve your problems. Once she has a fully tummy with lots of creamy milk, she should be noticeably calmer.
I hope these couple of ideas are some help.