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Thread: engorgement again?

  1. #1

    Default engorgement again?

    My son was born at 37 weeks. We had some latch issues and the LC was concerned about weight gain, so I've been pumping and feeding him from a bottle. She told me that once he was around his due date or I was pumping 1 oz per breast that I should work on his latch. So, he is now 2 weeks old and I am able to get an ounce from my right breast but only a 1/2 oz (if I'm lucky) from my left. My son seems interested in latching, so we are having a go at it. All day today I have been breastfeeding him and not pumping at all. He seems to latch on pretty good. It's painful at the beginning but then the pain subsides. He sucks actively for about 10 minutes and then falls asleep. I try to wake him, he'll suck a few times and then nod off again. So, I usually remove him from the breast and lay him down to sleep. I was concerned that 10 minutes wasn't enough so one time I weighed him before and after I fed him and he did gain an ounce, so I guess he's just a good efficient eater.

    Anyway, since I haven't been pumping I find that my breasts are not soft anymore after a feeding. Parts of them are hard as if I'm getting engorged again. Why is this? Is he not draining my breast? Or since he's doing the sucking as opposed to the pump, is it making my breasts produce more? Should I pump after a feeding to make my breasts soft again?

    Also, if he eats for 10 minutes and sleeps, should I just put him down to sleep? He seems to be satisfied and has plenty of wet diapers. His poops are yellowish, but he only has 1-2 a day. He's only had 1-2 a day for teh past week or so. The Dr. said some babies just dont poop as much.

    This breastfeeding thing is new to me. I was unable to breastfeed my first 2 children and I really want to succeed this time. Thanks!

  2. #2
    Join Date
    May 2006
    Posts
    20,643

    Default Re: engorgement again?

    Welcome to the forum and congratulations on baby #3!

    If I am understanding you correctly, it is only just today that you got your baby 100% on the breast. Right? If so, then I am thinking that you may not be quite ready to phase out the pumping. Here are 2 possibilities for what I think might be happening:
    Possibility #1. Because your baby falls asleep so quickly he's not emptying the breast as well as one would like. Because he's not emptying the breast, you're feeling milk backing up in the breast.
    Possibility #2. All that pumping you have been doing has created an oversupply situation. When your baby nurses, he's taking what he needs, and eaving all that extra milk behind, which is making you engorged.

    Because the 2 possibilities are so diffent, here's what I would do: I would weigh the baby after every feeding, and see how much milk he is getting on average when he nurses. Diaper output is generally enough to give you a good idea of whether or not the baby is getting enough, but when a baby has latch issues and is a bit premature and has been getting a lot of bottles, I think it pays to play it very safe. You want to see your baby taking in around 1.5-3 oz of milk at a feeding. If he is consistatly taking in smaller amounts of milk- say 1 oz or less- then you probably want to continue to pump in addition to nursing, and may want to continue supplementing with expressed milk.

    Now, if baby is feeding well, getting around 2 oz from the breast on average, then I think you can assume that your issue is possibility # 2, and you're dealing with an oversupply. If that is the case, you want to put up with the engorgement as much as possible, breaking out the pump only when the discomfort is too much to bear, at which point you want to remove the minimum amount of milk necessary to restore comfort. That will allow your supply to decrease to a level which matches your baby's needs more precisely.

    Does all that make sense?
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3

    Default Re: engorgement again?

    Yes, today is the first day that the baby is 100% on the breast. He has eaten every 2-3 hours. The past 2 feedings I weighed him before and after. The first one he gained an ounce. With that feeding he fed off my left breast which is the one that doesn't produce as much when I pump (1/2oz if I'm lucky). After 10 minutes he was asleep. I removed him from my breast, weighed him and tried to wake him up, but he was too sleepy. I let him sleep. This feeding I just did was on my right breast and lasted about 30 minutes total. He gained 2oz from this feeding. He stopped himself after 20 minutes and looked fussy. I removed him and weighed him and then shortly after he pooped. So, I changed his diaper and put him back on the same breast. He ate for another 5 minutes but my nipple was starting to hurt. Sometimes it feels like he latches on well, but as time passes, he slowly slips off (if that makes any sense). I took him off that breast and he still seemed fussy, so I put him on the left. He was on there for 3-4 min before he fell asleep.

    What you're saying makes sense, so I will continue to weigh him before and after to see how much he is taking.

    How do I know when he is done with a breast? If he falls asleep and I can't easily wake him, should I just remove him and put him down to sleep? He has yet to really remove himself from the breast.

    Also, is it normal for me to feel pain right as he latches on? I mean, it really hurts! Then after about 15-20 seconds, it's gone.

  4. #4
    Join Date
    Feb 2011
    Posts
    278

    Default Re: engorgement again?

    Ok, what I did when my son was a newborn (also born at 37 weeks) was when he fell asleep at the breast I would change his diaper to wake him up and switch sides. Because getting just 1 oz during a feed, he needs to take the other side. After a few weeks I did have an oversupply and he did only take one side per feeding. But he was very efficient by then. Some babies poop less, but most of the time before 4-6 weeks they do poop many times per day. If weight gain is an issue and you're dealin with a 37 weeker you have to err on the side of caution.
    Mama to five beautiful kids- 9, 8, 3, 2 and currently nursing our new baby girl born 1/20/2013


    "It should not be necessary to tell reasonably intelligent mammals to suckle and not dismember their neonates." ~Susan Blustein

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