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Thread: Overproduction/Quick Letdown and Sore Nipples

  1. #1

    Default Overproduction/Quick Letdown and Sore Nipples

    Hi,

    This is my first time posting. My daughter is a little over three weeks old (24 days) and I'm still having a lot of trouble breastfeeding.

    I think that I'm having oversupply issues or quick letdown problems based on what I've read. She gulps a lot and then pulls off (sometimes with nipple still in her mouth), she fusses a lot while nursing and looks uncomfortable, I leak a lot, when she does pull off while nursing I often continue squirting milk, she spits up sometimes, lots of wet and dirty diapers, letdown is pretty painful, she makes occasional clicking noises, etc. I'm feeling a little defeated because my nipples are quite sore and this is all pretty painful and it seems like she wants to nurse every time she's around me which I am beginning to dread. I try to work on her latch (pulling her chin out, making sure her lips are flared) but she comes off a lot and also slips down to the nipple part any chance she gets.

    She's gaining lots of weight (1 1/2 oz a day as of her last checkup) and her doctor suggested that I try block feeding, reclined positions etc. which I've been trying.

    How long will this take to get better? (I need a light at the end of the tunnel) What to do about my super sore nipples in the meantime? (I use lansolin and have some of those comfortgel pads but my nipples stick to whatever I wear and hurt and any kind of brushing against them hurts a bunch). Sometimes when I am doing a block feeding, my daughter doesn't seem satisfied at the end of nursing on the same breast and continues to fuss/root etc so I'm not sure if I should give her the other breast at that time even though after eating, she often seems uncomfortable/gassy and fussy.

  2. #2
    Join Date
    Oct 2012
    Posts
    2,209

    Default Re: Overproduction/Quick Letdown and Sore Nipples

    Hi mama, welcome to the forum! It does sounds like you may have oversupply/overactive letdown, based on what you describe. Laid-back (reclined) nursing is good for that; don't know what information your pediatrician gave you, but here's a link to a picture and a description: http://www.llli.org/docs/00000000000...astfeeding.pdf.

    How are you doing the block feeding? (ie, are you doing it X number of feeds each side, by time, some other method?) Remember that block feeding will decrease supply - sometimes too much! So you do need to be careful. If baby is continuing to fuss/root then I probably would give her the other breast. Also, keep in mind that supply does regulate over time - meaning supply will tend to decrease naturally without any active intervention. It's common for mothers to have oversupply early on, and for the oversupply to get better as time goes on. So if you continue with the block feeding, you may end up with undersupply. I think it's great that you're paying attention to baby's cues - in the end that's really much more important than looking at the clock or following a feeding schedule. Also, make sure to nurse baby frequently, because with oversupply you can be prone to plugged ducts and mastitis.

    In terms of the nipple pain, it sounds like there may be some problems with latch. Hands-on help from a lactation consultant, preferably an IBCLC (certified) consultant, can be really helpful - again it's great that you are actively working on getting LO to latch well! In the meantime, here's a link from kelly mom about dealing with sore nipples: http://kellymom.com/bf/concerns/mother/nipplehealing/

  3. #3
    Join Date
    May 2006
    Posts
    20,847

    Default Re: Overproduction/Quick Letdown and Sore Nipples

    Can you describe the soreness a bit more? For example, is the pain more of a stabbing pain or more of an itching/burning? Does the pain occur only at the beginning of a feeding, persist throughout a feeding, or does it come on after the feeding has concluded? Are there any changes in the skin of your nipples/breasts?
    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!"

  4. #4

    Default Re: Overproduction/Quick Letdown and Sore Nipples

    Thank you both for your replies!

    The dr. recommended doing 3 hour blocks of time so that's what I've been trying to do, though as I said if she seems really hungry and it seems like the one breast has been drained (she's sucking but I don't hear swallowing), then I do offer the other. I've also tried pumping once a day recently so that my partner can take part in feedings sometime soon and to help her get accustomed to the bottle so that when I return to work it won't be too hard a transition (though we haven't offered her the bottle yet). I don't want to decrease my supply too much but I want to make it so that I'm not overly big and leaking all the time and she's not uncomfortable while nursing.

    In terms of the nipple pain, it does hurt when she initially latches but that initial pain goes away but then throughout nursing it hurts - not itching - more of a sharp pain, and then afterwards my nipples are sore and they stick to everything (my bra, my shirt, etc). I haven't had bleeding but the tips of my nipples are significantly lighter than the rest so I can't tell if that's blanching. And when she initially pulls off they are often lipstick shaped. And I had a line/bruise on one for a while, though that's faded now. I have read lots of postings and forums and think it has to do with her latch/clamping down to stem the flow but I just haven't had success in correcting it. Like I said, I can change it for a few seconds by detaching and relatching or trying to pull her chin or her lips but she pulls off and it starts all over again.

    One other question - if she keeps pulling off and looking uncomfortable and stops nursing and then spits up but starts rooting again, should I offer her the other breast or give her stomach a break? I'm not sure what to do after spit ups - if that's a sign that she's had too much and I shouldn't heed her hand-sucking/rooting or if she's hungry because she just emptied her stomach again. Any thoughts?

    Thanks again!

  5. #5
    Join Date
    May 2006
    Posts
    20,847

    Default Re: Overproduction/Quick Letdown and Sore Nipples

    Block feeding is more of an art than a science. You want to block feed more by how full your breasts feel and how your baby is acting than by the clock. This is in part because milk supply fluctuates throughout the course of the day- for many women it is most abundant in the wee hours of the night and least abundant in the late afternoon-evening. So moms often need long blocks during the times when supply is highest, and short blocks or no blocks at all when supply is lower. It sounds like you're paying attention to your body and your baby, so that's great!

    Spit-up is a totally normal part of being a baby. It doesn't happen because you've done something wrong, or overfed the baby, just because the muscular sphincters that keep stomach contents in the stomach are, like all of a baby's other muscles, relatively weak. They'll strengthen in time, and by the time your baby is sitting up unassisted you'll probably see a marked decrease. Anyway, there's no harm in nursing more after a spit-up event. Sometimes a big spit-up means there's more space in baby's tummy. And because breastmilk is very mildly alkaline, it helps neutralize any stomach acid that made it back up into baby's esophagus.

    The pain you describe sounds like it's related to compression- that would match well with the lipstick shape, the blanching (in this case, probably vasospasm due to compression), and the sharp pain that lasts throughout the feeding. It may well be that your baby is compressing the nipple in order to control a fast flow of milk. Have you seen a lactation consultant, preferably an IBCLC, for help with positions and to check baby for tongue and/or lip ties? Keep rocking the reclined positions, and rest assured that time should improve this problem- larger, stronger, more adept babies can control milk flow without clamping your nipple and they can achieve a deeper latch with relative ease because their mouths are bigger.
    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!"

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