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Thread: Poor suck and overactive letdown?

  1. #1
    Join Date
    Oct 2011

    Default Poor suck and overactive letdown?

    Ok so you would think after succesfully bfding my other two children the third would be a breeze. Not so! It appears that every child is different, as many say...and I had to meet with an LC last week but am still having issues and can't afford to keep going back to her and paying a consultation fee. SIGH

    So here's the deal. LO is almost 4 weeks old now and from the beginning has had poor milk transfer. The consultant feels this is due to his recessed chin resulting in poor ability to compress my areola and transfer milk well. His weight gain was adequate but not great at 1 and 2 week checkups and I was having to pump after each feeding because I could tell right away that he was not emptying my breasts well. I am producing milk great which is a relief since I also have hypothyroidism (corrected with meds but it can still affect milk production) and am pumping 3-4 ounces after each feeding. The LC did a weigh and feed measurement last week and after 20 or so minutes of him nursing and using breast compression he got less than an ounce of milk. No wonder he wanted to eat every 60 minutes!! So now he is getting 2-3oz of pumped milk after each feeding using an avent bottle. I am probably going to buy an SNS tomorrow because he is starting to refuse the breast altogether...or put very little effort into it.

    My concern with the overactive letdown is that although he is angry and wants letdown to happen quickly (partially due to getting used to bottles now)...when I do have letdown he chokes and pulls off the breast. He also does this when I try to use breast compression to keep him sucking or wake him up at the breast. Sometimes after letdown he will take a few big gulps and then stay latched on but stop sucking- as if he is afraid to try to keep eating or whatever. He kind of just freezes in place, waits for a minute and then will do some weak suckling. THEN he will get mad that the letdown is "over". Probably because he is starving but doesn't want to be choked to death. I don't think I have an oversupply and with the hypothyroidism and milk transfer issues I am weary of reducing my supply on purpose just to reduce letdown. Should I perhaps pump before each feeding for a few minutes? He gets so impatient for letdown to happen I'm afraid if I pump beforehand it will take forever and he will not wait for it. I guess it's worth a try though.

    Another problem I wouldn't mind advice for is how to do the prescribed pumping after feedings when your baby doesn't settle right away. If I do not do the pumping IMMEDIATELY after the feeding then it will affect the milk supply for the next feeding. Due to his poor suck I need to be as full as possible for the next feeding but to maintain my supply I also need to pump after each feed. So I try to do it right after I feed him. Or I use a bottle propper to give him his supplement in a bottle while I pump- but he is little and swallows air with the bottle unless I hold him and give him cheek support. If I sit with him and feed him his bottle and then put him down to pump, he starts to fuss and by the time I am done pumping he is in hysterics. Not to mention my two year old is climbing on me and trying to "help" the baby or me as I sit on the floor trying to hold both pumps with one arm and give him a pacifier with the other hand.

    I am really really hoping he gets big enough and strong enough to compensate for his recessed chin and nurse more effectively in the next few weeks. I want to get a lact-aid supplementer but need one immediately and of course they can't be bought locally. I might settle for a medela SNS even though I keep reading they are more difficult to use and not as ideal for correcting suck problems.

    Agh. Any advice?? In case I have babbled too much here are the main issues:

    1. Poor milk transfer resulting in need for supplementing. Starting to favor bottle over breast.
    2. Strong letdown resulting in baby choking and pulling off breast.
    3. Difficulty pumping after feeds due to baby freaking out :boggle

    I know it's somewhat rude to join just so I can post for help...but I will probably come back to offer my own advice/experience to others here once things have settled down. Thanks in advance!!

  2. #2
    Join Date
    Sep 2011
    Boring ole Michigan

    Default Re: Poor suck and overactive letdown?

    Hi and welcome!

    If baby is preferring bottle over breast and therefore is causing you to have to pump then the best thing is to get baby back on the breast! This CAN be done. I have found that the nipple shield worked wonders with me. It has a hard silcone cover over the nipple to make your breast feel more like a bottle nipple that the baby prefers. I have the medela contact nipple shield which I really like. With him nursing you can stop the pumping after feeding and stop the supplements. The pumping is making your overactive letdown worse and the more you continue to pump, the stronger your let down is going to be. The shield also blocks any heavy sprays that might come out that is making your baby choke.

    I have overactive letdown as well and my baby still will choke like he is getting too much at first. I just pull him away and let him breath a little and then put him back on. Once the letdown has weakened he feeds just fine. You can help your baby not choke as much my sitting him in an upright position while nursing. This can be a little hard at first but you can experiment and find a comfortable way. You can also nurse while you are reclined back and gravity will help the milk not drain out so fast.

    I hope it works out for you! It just takes determination and support
    July 27 2011

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