Spit up

[@llli*kae.dowdy]

Hello Mommas!! I have to say that in my last 2 threads, all the information from you all was wonderful! I don't know what I would do with out this forum!! Anyways, I have a couple questions about my DD and her spit up. She is about 7 weeks old now and spits up SOO much. In my previous threads, I was told as long as she is gaining and happy, this is fine.
Yesterday, it was unbelievable how much and often she spit up. Sometimes her spit up was completely clear. Is this normal? Also, we live in a small town and we went to the "city (bigger town with more shopping) and I was wondering if stress can affect my milk and make her spit up more? I am also having stress from a family emergency. Can that affect everything? So far today, her spit up has been very minimal. She was so exhausted from yesterday she went/slept 6 hours without eating, I had to wake her up. She only nursed on one side so I had to pump the other because I was so full.
My next question is, if she starts only nursing on one side each session, how do I deal with the engorgement on the other breast? Should I pump or wait til she is hungry again? Thank you!!!

[@llli*phi]

Stress can inhibit the letdown reflex, but there is no evidence that I've seen that it has any measurable impact on milk composition (at least not to the degree that you would observe any kind of effect on your baby). It's good to find ways to deal with stress for your own health, but I wouldn't worry about it affecting your milk.

Some babies just spit up a lot, and the amount of spit up you see on any given day can be quite variable. My son was a spitter. He would just spew all over everything and everyone all. the. time. I had a receiving blanket draped over me most of the time because a simple burp cloth was by no means even close to enough coverage to protect me from the spit up. If there is visible pain during the spit up then you should look into possible reflux, but otherwise I wouldn't worry about it. Also spit up is common if you have oversupply and/or overactive letdown.

Don't pump! Pumping just causes your body to make more milk which leads to more pumping which makes more milk and so it goes on and on. I used cold compresses for the pain. I've heard cabbage leaves work too. I also needed to massage the breast in the shower to work out plugs. Sometimes I could get some milk to spray out while I did this, which gave me a little relief. If the pain is very bad or you are having problems with plugged ducts, then you can hand express just enough milk to get comfortable again until the next feed. Give it some time, the engorgement will eventually go away.

[@llli*kae.dowdy]

Thank you very much. Somedays I feel I should have blankets instead of rags. I do notice that when she spits up right after she is done nursing, she is super upset and a bit uncomfortable. Then after a bit she will calm down and is happy. I call her the happy spit up baby cause in between feedings and during diaper changes, she will be all smiles. They aren't gas smiles, they are spit up smiles because she will spit up after she smiles and doesn't seem uncomfortable. Only when she spits up right after she nurses she seems uncomfortable. Would that be along the lines of reflux?

[@llli*phi]

It sounds like you may have a touch of oversupply given the engorgement and overactive letdown sometimes occurs with oversupply. My guess is that is causing some of the spit up and discomfort. Your baby may just be taking in too much milk, feel a bit of stuffed, and get some relief after a nice spit up. I had quite severe oversupply and overactive letdown, and my baby would do similar things. Fuss, spit up, and resume normal activities. Nursing in a reclined position and nursing on one breast per feeding helped some, but more than anything my baby just needed to grow out of it.

Reflux that requires medical attention usually causes a baby to be very unhappy. Spit ups are often yellowish and sour smelling. Babies will often resist nursing, screaming and arching their back at the breast (although mine did some of this because of overactive letdown). Other times babies will nurse constantly to try to ease the pain of the reflux. Often poor weight gain indicates problematic reflux. If you aren't experiencing these things, then I would say that you've simply been blessed with a spitter. It sounds like your baby is happy and doing very well, so I honestly wouldn't worry about it.

[@llli*lllmeg]

For all your concerns, I suggest simply to nurse very frequently, as frequently as baby will. Nurse at any cue and whenever you feel like it. This may lessen spit up (although spit up alone is nothing to worry about as pp have pointed out.) But for engorgement, nursing lots is important, and it won't matter if baby only takes one side at a time because you will be nursing again shortly.

If you are still having problematic engorgement at this point, (some engorgement after a several hours without nursing would still be normal) but if you feel painfully engorged even when baby is nursing very frequently, you may want to consider if you have oversupply (aka overabundant milk production) and if you want to take some steps to help baby handle the flow or even reduce supply, for your own comfort and for babies happiness at the breast.
http://kellymom.com/bf/got-milk/supp.../fast-letdown/

As far as stress adversely affecting mommas milk-I hear this a lot, it is a concern lots of moms have, and I am sure extreme stress can and does cause certain issues. But I try to remember that, until very recent history, breastfeeding is how ALL mothers have kept their babies alive, quite successfully, (we are, after all, an extremely successful species when it comes to survival.) Mothers have nursed their babies through all kinds of extremities. Wars, famines, natural disasters, social upheaval etc. as well as the typical types of personal or family stress. I find it highly unlikely that most stress is likely to adversely affect a mother’s milk.

[@llli*mommal]

As far as stress adversely affecting mommas milk-I hear this a lot, it is a concern lots of moms have, and I am sure extreme stress can and does cause certain issues. But I try to remember that, until very recent history, breastfeeding is how ALL mothers have kept their babies alive, quite successfully, (we are, after all, an extremely successful species when it comes to survival.) Mothers have nursed their babies through all kinds of extremities. Wars, famines, natural disasters, social upheaval etc. as well as the typical types of personal or family stress. I find it highly unlikely that most stress is likely to adversely affect a mother’s milk.

x 1000.

[@llli*kae.dowdy]

Thank you so much. The only engorgement I had recently was when she slept 6 hours through the night. When I woke up, I woke her up. I do have another questions about her spit up. When I nurse, I always alternate her position. When I start on the right, I use the football hold, and when I start on the left, the cradle hold. I notice that her spitting up is a lot worse when I start on the right side and in the football hold. I alternate to make sure all the ducts are "emptied" and to prevent plugged ducts. Since she spits up much less in the cradle hold, should I stop using the football hold???

[@llli*phi]

Do you have a problem with plugs, or is the positioning a prophylactic measure? If you are not prone to plugs, I would just use positions that lead to less spit up. I had to nurse almost exclusively in a reclined position for weeks because my letdown was so bad. I did massage my breasts in the shower to help work out plugs, but that was enough to prevent anything problematic.