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Thread: oversupply & blocked ducts

  1. #1
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    Dec 2013
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    Default oversupply & blocked ducts

    Hi there,

    I'm nursing my 3 week old, and last week, I had a constant oversupply of milk in both breasts. This resulted in blocked ducts on my right breast that i'm just starting to get over (it's softened significantly). My left breast meanwhile has been feeding my LO and it's gotten even more milk. I'm now spraying! I'm terrified that when my right breast is 100 % back in action, going back to a one breast per feeding routine will result in blocked ducts on the left side. my LO feeds every 3 hours.. how can i manage this?

    thank you!

  2. #2
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    May 2006
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    Default Re: oversupply & blocked ducts

    Welcome to the forum!

    The keys to coping with oversupply are time and patience. At 3 weeks, a lot of moms are in the peak of hormonally-driven milk production. But in time milk production switches from being driven primarily by hormonal factors to being driven primarily by the baby's demand. So eventually, your body is going to "read" the amount of milk left in the breast after feedings and will gradually adjusts supply so that it meets demand more precisely.

    The best ways to give your body the message that it is making too much milk are:
    1. Feed on demand
    2. Finish the first breast first
    3. Leave milk in the breast
    4. If you have a pump, avoid it except in case of emergency (like mastitis)- every time you remove milk from the breast, you're encouraging your body to create the same amount you took, maybe even a little extra if you happen to be unusually sensitive to pumping

    If your baby spontaneously goes 3 hours between feedings, that's fine. But if you're feeling uncomfortably full, it doesn't hurt to offer the breast to the baby before she is hungry, allowing her to relieve some of your fullness. When she nurses, don't switch her from breast to breast or rely on predetermined time limits for feeding. Allow baby to finish the first breast at her own pace before offering the second breast, and don't sweat it if she refuses the second side. Letting the second breast really fill up will give your body the message that it's making too much milk, and it will start to throttle back on production.

    Now, if doing the above does not result in a gradual downward trend in production, then come back and let's talk about block feeding and cabbage leaves and other things you can do to really beat back an oversupply. They're just not the things you want to try right off the bat.

    It sounds like you have been nursing exclusively on the left side, correct? If so, then that's not something you want to when you have oversupply. You do want to keep the milk flowing on both sides, particularly when you have plugs. Not removing milk from a plugged breast increases the risk that you will get mastitis on that side- zero milk flow through the plugged area can allow nasty bacteria to set up housekeeping.

    How does the baby handle the flow? Is she gasping/gagging/choking/spluttering? If so, adopting reclined feeding positions may help, as gravity will slow milk flow to the baby. You can also take her off the breast when a letdown is happening, and allow the milk to flow into an absorbent cloth.

  3. #3
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    Dec 2013
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    Default Re: oversupply & blocked ducts

    Thanks for the reply! Today my breasts got better (???)

    To clarify, this is what I experienced/did:
    -both breasts were overproducing, with the left more so than the right breast
    -then right breast got blocked ducts
    -LO got really upset since he cant get as much milk from right breast
    -I started topping him up with the left breast to make sure he gets enough milk for each feed, but i always made sure to start with right breast to try to get the blocked ducts cleared
    -this resulted in my left breast producing even more milk (i started spraying)
    -finally today, the blocked ducts appear to be mostly gone -- i'm not 100% sure because the breast does not feel as soft as the left breast, but it's reasonably soft with no noticeable lumps
    -milk supply in right breast is still very low.. LO is even more upset. when he pulls away, the nipple feels dry-ish. I can express a drop of milk, but only after a little bit of massaging/manual expressing. (compare to before where I just squeeze and it comes out)
    -somehow the milk supply in my left breast regulated itself! Despite the extra feeds each time, I'm not spraying anymore, so it's a good thing.

    So now i'm wondering.. will my right breast milk supply go back to normal? Should I pump to stimulate it?

    Thank you!!
    Last edited by @llli*bluegirl; December 19th, 2013 at 01:24 AM.

  4. #4
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    May 2006
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    Default Re: oversupply & blocked ducts

    Glad to hear that things got better! It's actually quite common for some moms to experience a rather abrupt transition from overproduction to making a more reasonable amount- though plenty of other moms experience a much more gradual switchover. Don't be too surprised if you go through some intermittent oversupply in the next few weeks/months, as oversupply is something that often comes and goes.

    Thanks for clarifying your situation- from your first post I thought that you'd even avoiding the plugged right breast, which obviously you didn't and don't want to do.

    I don't think that I would get out the pump for the slow-producing right at the present time. First, I would want to give the baby a chance to manage the right side and bring production up to a satisfactory level. Keep offering the right side. I would offer it at the conclusion of every feeding, regardless of which side you started on. I would also maybe try to start more feedings on that side. Give that routine a few days and see if anything changes. If you feel like production still really isn't what it should be, and the baby is increasingly frustrated by the slow flow, to the point where he's even refusing the breast, then it might be time to think about pumping. But honestly, 3 weeks is the time to focus on nursing the baby- just 2 variables, you and baby. You don't want to introduce a third variable (the pump) into your nursing relationship unless you absolutely have to.

  5. #5
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    Default Re: oversupply & blocked ducts

    Yikes, the same ducts are plugged again. Perhaps they never got cleared in the first place. I think this will be an ongoing battle -- the same ducts were plugged the very first time I started nursing, but they went away until now.

    I will keep at it, and let LO manage the right. It is getting difficult as after one session, he starts to refuse even the left so I have to force it in his mouth when he cries. Hopefully this will resolve soon as I don't want him to get turned off breastfeeding.

  6. #6
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    Default Re: oversupply & blocked ducts

    The other thing on my mind is that perhaps LO isn't doing a good enough job draining the right. He's only on there for about 15 mins and he nurses every 3 hours roughly. When he is on there, it's mostly the gentle sucking with lots of pauses.

    Should I try manual expression? I can soften the lumps just by massaging now but you can still feel the "core" if you press hard enough.

  7. #7
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    Default Re: oversupply & blocked ducts

    Some babies don't like being held in a particular position. One thing you could try is to maintain the baby in the exact same position you're using on the left for the right breast, as well. This might mean getting creative with pillows or something, but it might "trick" the baby into nursing on the right as if it were the left.

    I would definitely try manual expression, massage, and warm soaks to help manage the plugs.

  8. #8
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    Dec 2013
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    Default Re: oversupply & blocked ducts

    Quote Originally Posted by @llli*mommal View Post
    Some babies don't like being held in a particular position. One thing you could try is to maintain the baby in the exact same position you're using on the left for the right breast, as well. This might mean getting creative with pillows or something, but it might "trick" the baby into nursing on the right as if it were the left.

    I would definitely try manual expression, massage, and warm soaks to help manage the plugs.
    Tried all of that, but it's not going away... I started taking lecithin, it has allowed the right to soften fully, but lumps still there. It feels like they'll never go away, and since it's been a week and hasn't turned into mastitis, I'm wondering if they'll be ok left alone.

    There has been more changes to left again. Argh, the flow to the left has slowed so much, now he's fussing on there in addition to the right. By fussing I mean tugging and twisting at the nipple and making lots of noise. I try to relatch, burp and calm him and he starts crying. I don't understand how it can go from him choking at times to this.

    Last night, it was so bad. I pumped after to get him some milk to drink sine he appeared starving ( fists going to mouth etc) but there was hardly anything coming out of both sides.

    On top of this I think he started getting really gassy, as I can hear his stomach going when he starts nursing. After we are done, it is like he doubles over in pain on his sides ( we started co- sleeping).

    I am throwing in the towel when it comes to breastfeeding. I'll nurse and pump as much as I can in the next bit and start transitioning him to formula.

  9. #9
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    Default Re: oversupply & blocked ducts

    I am throwing in the towel when it comes to breastfeeding. I'll nurse and pump as much as I can in the next bit and start transitioning him to formula.
    I hear you are frustrated but I just want to ask if you are sure? Because once a mom goes down the eping/bottles/formula road, over time, what often happens is baby gets used to bottles and refuses the breast, and milk production dwindles, until mom & baby reach a point of no return-or at least a point where it is really really hard to return. I have talked to too many moms who felt overwhelmed with difficult issues in the early weeks, stoped nursing, and then regret it later when life calms down and they adjust to life with thier baby (this happens even if it is the 2nd, 3rd, 4th etc, baby, because every baby is a new beginning, and often, a new challenge.) So I have to ask this, please take it in the spirit it is asked, from someone who never wants to face another mom who three or four months down the line changes her mind and has to face the fact her milk production is gone and baby is refusing to nurse. That is a really hard and uncertain road back. If you are done, that is your choice and I respect it. But if you wish to keep trying, here are my thoughts.

    When you say you have plugs, is it only plugs, or were you also engorged? The two can go together and the remedies are often similar, but it is not the same thing.

    A plug, even several plugs, is unlikely to create a situation where no milk comes out. Because a mom has lots of milk ducts. But engorgement can cause overall inflammation and swelling, so the milk is harder for baby (or even a pump) to get out.

    Baby may be fussing for any number of reasons. You think you were overproducing-I find it very odd that you would then start underproducing that quickly that there is suddenly not enough milk for your baby. Your breasts feeling softer is normal esp. if you were engorged before. What you pump is not good information to go on as there are simply to many variables the most important being, pumps do not extract milk as well as babies. Babies behavior is not always good evidence to go on either. Is baby pooping? Peeing? Gaining? that is how you tell if baby is getting enough. Unless you have taken something to dry your milk up, or something has occurred where your breasts have ben severely injured internally, your body is still going to be producing milk. If baby is having difficulty extracting the milk, that may be a latch issue.

    Have you seen an ibclc for a one on one consult? called local lll? worked on latch/positioning with anyone, or on your own?
    You said in an earlier post that baby is nursing every three hours. Over 24 hours, that adds up to 8 times a 24 hour day. A newborn will more typically nurse a minimum of 10-15 times a day. Baby not nursing with normal frequency causes many issues. Have you tried nursing more often, or pumping or hand expressing if baby will not nurse more often? Yes pumping can lead to more overproduction but the immediate issue is getting the milk flowing out of the breasts frequently. This would help alleviate and prevent further plugs.

    Heat and massage can help but in some cases may actually exacerbate the swelling of engorgement or plugs. Have you tried cold compresses? taking an anti-inflammatory? Vibration on the plugs? (like an electric toothbrush.)

    As far as your baby’s gas pains-intestinal gas is a by product of the digestive process. So gas pain immediately after eating would probably not be related to what baby just ate, as that milk is still in your babies tummy. ‘hearing’ the milk hit your baby’s tummy indicates a fast, not a slow flow. It also indicates baby’s tummy is entirely empty so nursing more often may help. Breastmilk-your breastmilk- is the infant food made specifically for your baby. Gas or no, breastmilk has long been shown to be the normal and thus healthiest food for babies.

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