Happy Mothers Breastfed Babies
Results 1 to 4 of 4

Thread: Reflux, Oversupply, or Both?

  1. #1

    Default Reflux, Oversupply, or Both?

    My son is 6 weeks old and nursing has been his favorite activity since day one. He has been packing on the pounds and is currently 5 pounds over his birth weight. He shows signs that either I have a bit of an oversupply or he has reflux:

    -Restless and irritable and would likely cry more if he wasn't always nursing
    -Extremely gassy
    -Spits up a lot
    -Frequent explosive stools (though they are generally yellow/mustard with one green one everyday)
    -Gets the hiccups frequently

    It is hard to say if my breasts frequently feel full because he does not allow me adequate time in between feeds. They are quite engorged at night if he sleeps past 4 hours or so. When he does latch on to me at night when I am full he often pulls off and gags, milk sprays quite a distance, and he makes a clicking sound nursing. I wouldn't describe my letdowns as painful, but I do feel them quite distinctly. And my nipples are sore. All of this makes me think oversupply, but..

    About two weeks ago he started exhibiting some strange nursing behavior where he starts fussing at the breast part way into feeds (say 8 or so minutes) where he squirms and fusses at the breast and eventually pulls off just wanting to be re-latched. This continues to where he is hitting my breasts and crying. This behavior makes me think he actually likes the fast let down and gets frustrated when the let downs slow and the flow slows down. I have tried breast compressions and switching sides both of which really make no difference. The only way he knows how to soothe himself at this point is nursing and he can only fall asleep by nursing. He won't take a pacifier and will reluctantly suck on a finger in a carrier, but not under other circumstances. He is a good nighttime sleeper and does not fight the breast at night at all I am assuming because he is too tired to care. During the day is where he fusses and pops on and off and gets little sleep as he can only fall asleep by nursing currently.

    I do nurse him in a pretty upright position and have tried laid back nursing. It was helpful at the initial part of the feed, but he was still frustrated as the feed went on with him popping on and off. I have tried block feeding for a period of hours, but this just resulted in him becoming more worked up as the flow wasn't as fast. He was recently started on Prevacid for the reflux, but it is too early to tell if it is making a difference.

    I'd appreciate any thoughts you might have. If it is oversupply how do I keep him to one breast for a period of time and keep him satisfied? If he isn't happy with the flow he will get no daytime sleep and Mommy will get no rest.

  2. #2
    Join Date
    Jun 2009

    Default Re: Reflux, Oversupply, or Both?

    Definitely sounds like overproduction and fast letdown to me, especially with that incredibly fast gain. Assuming you are not pumping as well, this would typically start to improve on it's own with the frequent nursing very soon. I would suggest keep doing what you are doing with the very frequent nursing but see if baby will be happy usually nursing only one side at a time. If overproduction continues to be an real problem, you could consider block nursing, but you would have to be very careful about avoiding bad engorgement. I suggest Read dos and donts of block feeding by Nancy Morhbacher before block feeding.

    Otherwise this all sounds normal. I would not suspect slow letdown is a factor. Baby is probably a bit uncomfortable due to the fast letdown and the corresponding overabundance of high lactose 'foremilk." This will get better as your milk production starts to calm down as it normally does at this point. Plus babies are often rather fussy at this age. I suggest keep trying different nursing positions to find ones you both feel most comfortable in, day and night.

    GERD (painful reflux) could be happening as well of course. But since there is clearly overproduction, that would be the most likely culprit. That alone explains every 'symptom' you mention.

    Nursing very frequently, day and night, is how I personally have had the most success taming the issues related to overproduction. I suggest, Don't try to stretch out time between sessions, as this makes the fast letdown and foremilk issue worse. Personally I had to set my alarm so baby would nurse at least every 3 hours overnight to avoid engorgement and other issues.
    It is entirely normal and expected for babies to "only" fall asleep at the breast. Babies expect to be comforted to sleep and there is nothing as comforting as nursing. This is a great thing as even as baby gets older you will still have this mostly surefire way of getting baby to sleep peacefully. Nursing is nature's anesthesia.
    Last edited by @llli*lllmeg; March 22nd, 2014 at 12:40 AM.

  3. #3

    Default Re: Reflux, Oversupply, or Both?

    Thanks for the insight. I do pump at night to relieve some of the engorgement and so that my husband can give him a bottle at night. This introduction has made our nighttime routine much easier as he is usually very sleepy after the bottle and at that point I can swaddle him and he can nurse for 5 minutes or so before he falls asleep. He has been sleeping 5 to 6 hours during his initial stretch. When he starts waking up at night it seems to be when he is really struggling with gas.

    He currently isn't happy feeding on just one side. He starts to fuss halfway or so into the feed and things can quickly spiral out of control. Whenever he pops off later into the feeds he never has milk in his mouth and judging by his sucking he is trying to elicit additional let downs. That is what makes me wonder if the subsequent let downs are slower and he gets frustrated. When I offer the other side he will sometimes settle and other times he eventually gets frustrated on that side as well 10 or so minutes into the feed. I had a midwife/lactation consultant come by and she believed he did suffer from some reflex and that he likes the fast flow as it is soothing and gets frustrated when it isn't pouring down his throat anymore. I understand there is a growth spurt at this age and expect fussiness, but he has been very fussy from day one with the popping on and off during feeds starting about 2 weeks ago.

    I do not try to stretch out the time between sessions, but if I feed him constantly like he would prefer he gets himself so worked up into feeds but wants to continue nursing. The longer we try to nurse the more upset he gets and is unable to settle or fall asleep. The longest I would say we go in between daytime feeds is 2 hours and this is only when he cannot sleep so we go for a walk as he will fall asleep in the Ergo. I love nursing him to sleep and have no problem doing it. The issue lies in the fact that when he is unsatisfied nursing he is unable to fall asleep and the vicious cycle continues.

    If I continue to feed on demand but switch sides during feedings so that he does not fuss will the oversupply eventually settle?


  4. #4
    Join Date
    Jun 2009

    Default Re: Reflux, Oversupply, or Both?

    If I continue to feed on demand but switch sides during feedings so that he does not fuss will the oversupply eventually settle?
    Yes, but it will possibly take a BIT longer than if baby was nursing one side at a time at least some of the time. But It's not like this is a hard and fast rule. What you want to avoid is insisting/overly encouraging baby switch sides every feeding. if baby will not take the same side again after baby fusses, and will only take the other side, then I would say, baby knows best.

    I am sorry if my response came across as criticism. You said baby only can sleep if nursed to sleep and I was trying to point out that this is normal. (Lots of people DO think a baby "only" nursing to sleep is a bad thing.)

    Some other thoughts: If baby is fussy after 10 minutes, maybe baby is done, at least for the moment? Also, many babies want to nurse twice or more an hour, aka cluster feeding. Growth spurt or teething or no, this is a normal nursing pattern. If baby is fussy after nursing, and refuses to nurse anymore, maybe baby is done nursing but is asking to be comforted another way? If baby is fussy during the feeding, and then wants to nurse more, then baby can nurse more. In may experience it can take some juggling and trying diferetn things to figure out what baby wants. Often baby may not know even what will soothe him, if anything! Again, there are no hard or fast rules to all this - baby knows best and you know your baby best.

    If it is reflux, nursing frequently is recommended for reflux as well. Short, frequent feedings, is good for babies (and adults for that matter) with reflux. And in any case, reflux is not a breastfeeding problem. Formula babies get reflux too and they don't get the soothing help of frequent small feedings of breastmilk. of course, true reflux responds to medication, so that is something you could consider. But reflux is notoriously over-diagnosed. I think www.askdrsears.com has a good article on reflux.
    Last edited by @llli*lllmeg; March 22nd, 2014 at 02:12 AM.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts