Overactive Letdown and Lactose Overload

[@llli*qd]

Hi all. This is my first post and my first baby. He is now four weeks old and has been constantly fussy; day or night (usually about 45min after eating), hungry, gassy and has occasional green poop for the past three weeks. I haven't weighed him recently but his second week of life he gained 12oz. After much research I have come to the conclusion that I have over active letdown which could also be causing lactose overload for him. When I nurse him he fights to latch, chokes and sometimes comes off the boob when my initial letdown occurs. I try my best to make this easier on him by reclining and if he's not too hungry crazy I pull him off and catch the milk in a cloth. I also try to let him nurse as long as he needs as long as he's sucking and swallowing. He very, very rarely will come off on his own (He loves the boob!).

I do need to go back to work in eight weeks so block feeding to regulate this doesn't seem possible since I need to start pumping and saving soon. If I simply allow him to feed on one side until he appears to have emptied it and only offer the other side if he still is hungry will this rectify the problem? Will he eventually be able to handle the letdown? I reluctantly gave up dairy over the last week thinking it was an allergy with no true results (it may not be long enough tho) but it seems that might be an unlikely contributor. I just really want a happier baby and I'm becoming desperate for a solution. Any other suggestions would be much appreciated!

[@llli*zaynethepain]

First it usually takes at least two weeks to notice a change when eliminating foods. Ice packs helped my oversupply. Ds was able to latch without choking if I iced my breasts down for a good 10 min before a feeding. could you do short blocks? Just two nursing sessions per side for even two or four weeks? I always caught my expressed milk in a bottle, didn't see the point in wasting it.

[@llli*lllkaren]

Overactive letdown is more likely than dairy allergy (unless you have a strong family history of food allergies), and the symptoms you describe do sound like OALD.

Nursing reclined and taking him off the breast at letdown until the milk flow is a little slower are good strategies. Nursing very frequently (say, every 1.5-2 hours or so) can also help.

As far as block feeding goes, OALD doesn't necessarily mean you have oversupply. You may not need to reduce your supply, just find ways to help your baby cope with the fast flow of milk. Nursing on one side per feeding is fine; if he doesn't get quite enough that way he'll want to nurse more often, so it's not going to decrease your supply too much, but it could help the OALD.

And yes, he will eventually be able to handle the letdown without any trouble at all. My personal experience was that it seemed to be worst during the second month and then started to get better. So hang in there! It'll get easier!

[@llli*joe.s.mom]

Totally agree with Karen. I would not jump to the conclusion that your baby has a dairy allergy without more symptoms. OALD is way more likely and would explain your issues. And I would first focus on OALD specific remedies, like reclined nursing, or letting down into a towel and then latching back on, before I did any block feeding. IMO, block feeding is only necessary if your oversupply is causing you a lot of discomfort and your baby's poops are ALWAYS green and explosive. Occasional green poops can be normal. You don't want to overdo it and end up with a low supply from block feeding, you know? Of course, it's always good to let your baby really "finish" the breast. Don't switch sides unless your baby seems to be done with the first side. This may mean offering only one side at a time, which is a mild form of block feeding.

Do be careful with pumping for your work stash, though. If you don't have terrible oversupply now, pumping could easily cause it! I am currently pumping for my work stash (I go back in 4 weeks - WAAAAAAH ) by pumping just once a day in midmorning. I'm doing it then because (a) my supply tends to be higher in the morning and (b) increasing my supply during the work day makes sense so that I'll start back with a supply "cushion". Also, the kids are in a better mood in the mornings so it's easier to pump. Doing this every day until I go back to work will give me a more than adequate stash. You don't need a giant stash, just your first day's supply plus a little extra in case you spill a bottle or something.

[@llli*qd]

Thanks for all the responses! I didn't necessarily try block feeding but at most times he won't take more than one breast. He (at 6.5 weeks now) is still a very lazy eater and I struggle to get him to eat most of the time but maybe its due to the frequency (1.5 hours from start to start). His weight would disagree with me tho seeing as he's gained nearly a pound a week since week three! With the way I've been going he seems better, less fussy. I actually get to spend time with him and see him smile!

Once I get this potential thrush infecting taken care of I will go to pumping once a day early in the morning. I'll try taking him off when my let down happens every time to see if that helps even more. He seems to be choking more often at the end of my let down but most likely since he just took in a whole lot of milk?