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Thread: Overactive letdown & engorgement in mornings

  1. #1
    Join Date
    Mar 2014
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    Default Overactive letdown & engorgement in mornings

    Hi,

    I have a 9 week old son who eats about 5-6 times in 24 hours. I have an issue of overactive letdown, especially on the right side. This is making baby very gassy & he only naps while being held. He started sleeping long stretches at night about 2 weeks ago & I get painfully full in the morning. I started pumping in the morning while hubby have bottle to the baby. Now this solved the problem short term. Since LO keeps changing his schedule & I realized pumping is not helping me, I stopped pumping 6 days ago. My questions:
    1. I am still very full in the morning, to the point where it hurt bad. LO has started eating only one side, so sometimes one side is not being emptied for about 10-11 hours. Will my body start making less milk? If yes when?
    2. LO gulps a lot of air & past 2 days he eats only 5-6 mins on one side only. He is not getting hungry more often so I am guessing he is having enough. But can he go from eating for 30+ mins to 8 mins in a day?
    3. I am not sure if he is getting enough hind milk. While my breasts do feel empty within 5-6 mins he seems to stop mid letdown needing for a burp & doesn't latch at all after that. I burp him every 2 mins since he is gulping all that air.
    Please help! Due to these 2 issues, he is so gassy that he doesn't nap in crib & I end up holding him most of his naps which is killing my back.
    Thanks!

  2. #2
    Join Date
    May 2006
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    21,178

    Default Re: Overactive letdown & engorgement in mornings

    Welcome to the forum and congratulations on the new baby and on making it through the first 9 weeks of nursing!

    My first question is a to your baby's feeding routine. Did he spontaneously go to 5-6 feedings per day, or is that something you are encouraging happen? And would he nurse more if you offered more? There are two reasons why I am curious about this. The first is that most exclusively breastfed babies need to nurse a bare minimum of 8 times per day in order to get their calorie needs met. The second is that when mom has oversupply, frequent feedings are often better for both mom and baby because the breast doesn't get so full in between nursing sessions.

    My second question is about sleep. Is there anything you're doing to encourage longer sleep stretches, like swaddling the baby or offering a pacifier at night? If so, you might want to take those things away. If baby would wake and eat a bit more often at night, you wouldn't be waking up in pain from engorgement.

    Third question is about pumping. When you were pumping instead of nursing, about how much milk did you get?

    To answer your questions:
    1. Your body will eventually detect that it is making more milk than your baby is taking, and will reduce supply. But it is impossible to say how long that process will take. Some moms find that their supplies adjust literally overnight. Other moms find that it takes weeks or even months. It's a process that is as individual as we are!
    2. When a baby is coping with oversupply, it is quite normal for him to get all his nursing needs met in just a few minutes at the breast. And most babies become more efficient feeders as they get older, and when they get more efficient feeding times shorten up- and yes, this too can happen overnight!
    3. Do not worry about hindmilk. A baby can grow well- often exceedingly well- on the so-called "foremilk" alone, provided he gets enough of it. All milk, both foremilk and hindmilk, contains everything a baby needs to grow and develop. A baby who gets a lot of foremilk gets the same fat and protein that other babies get. He also gets a lot of lactose (milk sugar) and that can make him a little gassier than usual. But this is not a health problem.

    Finally, the question you didn't ask: not napping in crib is textbook for a baby. Babies' brains are stuck in caveman time. They don't know that they live in a nice safe house. As far as a baby knows, getting put down means an increased risk of ending up as sabretooth tiger food. Therefore, babies instinctively feel safest in mom's arms. The best way to deal with this is to accept it. Get a sling so baby can nap on you without you having to carry him. A swing or stroller are also good places to nap, as motion is sometimes an acceptable substitute for being held. Your lovely crib will make a great laundry bin for now. Maybe later in your baby's first year you'll get more use out of it.
    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
    Join Date
    Mar 2014
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    16

    Default Re: Overactive letdown & engorgement in mornings

    Thank you!
    I am & have been nursing on demand. He has gradually come down to 5-6 feedings. Normally he takes 6 feedings. I have tried offering him more often but he won't nurse if he is not hungry or will just nurse for 1-2 mins. I can certainly try that again. From past 2-3 days, he will just not latch after first 6-8 mins of nursing. I would try burp him & try offering for about 20 mins & with different positions. He will look away.
    My hubby offers him paci if he wakes up in the night & if he is not hungry. And I am swaddling him for naps/bedtime. I have been thinking about dream feeding to reduce my pain & I might have to try that. I am worried that he will start waking up to eat when he can go longer. It seems like a double ended sword now.
    I initially started pumping after a feed & would get about 1 & 1/2 oz total. I also started pumping in the evening while hubby gave him a bottle & I could get 3-4 oz. In the morning when I pumped I could get 6-7oz total. This was after going for 7-9 hours of stretch.
    My other question is how do I correct fast letdowns. I am not sure if I had oversupply as he was nursing both sides up until 3 days ago. I have tried different positions & the only one we both are comfortable is side laying, but that has not helped in amount of air he is taking in.
    Thank you so much for your advice! I
    do want to continue to nurse & not switch to pumping full time & giving him bottles.

  4. #4
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    Jun 2009
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    Default Re: Overactive letdown & engorgement in mornings

    My other question is how do I correct fast letdowns.
    more frequent nursing, even if sessions are short, should definitely help. As mommal points out, Short sessions are fine and normal especially if mom has abundant production and baby is gaining well. Frequent nursing, one side at a time (unless baby clearly prefers both) is usually the best and fastest fix for forceful letdown. When baby nurses so infrequently, even if baby is getting enough milk, the infrequency of the nursing potentially leads to a host of problems including fast letdown. I think it was very smart to stop the pumping and bottles and I would also suggest consider eliminating or cutting back on pacifier and the swaddling for now. Both encourage longer sleep stretches which believe it or not, you do not want. If baby can be brought to a more normal frequency of nursing, especially not going so long overnight, that and time may well solve everything. Personally I had to set an alarm and wake my baby every 3 hours overnight in the early weeks so we could nurse frequently enough to fix that super abundant morning milk issue.

    also if you are worried about so called hindmilk/foremilk imbalance, and it possibly causing baby discomfort, the long stretch between feedings worsens that situation too, because you get a build up of foremilk in the breasts. (the discomfort is caused by the high amount of lactose baby gets with lots of foremilk) As mommal points out, this is not really a medical concern. But it can cause baby discomfort and frequent nursing usually helps it. nursing in a 'laid back' or semi-reclined position with baby more on top of you also helps quite a bit in many cases.
    Last edited by @llli*lllmeg; March 29th, 2014 at 08:03 PM.

  5. #5
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    Default Re: Overactive letdown & engorgement in mornings

    with LLLMeg. Take the paci and swaddle away for now. It would be to your benefit if your baby ate more often, and if the paci and swaddle are standing in the way of that, they are harming, not helping. Please don't worry about his sleep. It's very unlikely that the long sleep stretches you are getting right now are going to last, no matter what you do. Most babies who sleep through early on return to night-waking and night nursing at a certain point, and there's nothing a mom can do to prevent that. (Much as we all wish there was!)

    One reason I really encourage you to aim to nurse more often is that the amounts you re getting with the pump were not so far in excess of baby's needs. Based on pump output alone, I kind of wonder about how much oversupply you really have. I mean, clearly there's some because you're feeling overfull pretty often. But is it so much that your baby can get all his needs met from just 5-6 feeds per day? Maybe! But also maybe not. Feeding more often would be a good way to hedge your bets.

    And of course, nursing more often will help with fast letdowns. The more full the breast gets, the faster the milk comes out. Keep the breast a little emptier and the flow will be slower. Have you tried nursing in reclined positions? That is also helpful, because gravity slows the milk flow to the baby.

    How has baby 's weight gain been so far?and how does nursing feel?
    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!"

  6. #6
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    Mar 2014
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    Default Re: Overactive letdown & engorgement in mornings

    Hi mommal & lllmeg,
    I took upon your advice & fed LO when he stirred a bit at night & nursed him while he was sleeping, he ate on both sides. This was about 5 hours since his last feed. His next feed was after 4 hours in the early morning hours again when he started to stir & seemed hungry.
    Both me & hubby decided to give up paci for good. He only took in the night though & didn't give him last night.
    I have not been engorged today since LO took an additional feed in the night. I started to get engorged only when LO started sleeping longer & doing 7+ hours. But I had fast letdown right from 2nd week I think. (It's funny how fast we forget stuff!)
    LO's weight gain: his weight gain has been as expected & he is maintaining his growth & percentile group. I asked his Ped about him doing only 6 feeds & she said that is pretty normal for many babies.
    Nursing positions:
    I had tried laid back position 2 weeks ago but both of us were not comfortable. LO ended up spitting a whole lot so I stopped. Yesterday, I tried putting LO on my boppy as I would normally do & then I slid back down as much as I could. It seems comfortable so far & will keep trying it. He is certainly pulling off less often so I am assuming it is helping.
    How does nursing feel: pretty good, I don't have any pains or other issues.
    His feeds today:
    Today he has been eating every 2 to 2 & 1/2 hours & hoping that he will continue to do that.
    Oversupply: I am not sure either if I have oversupply, could it be just fast letdowns alone? When hubby gave LO a bottle, he would take between 4-5 oz & occasionally took 5 & 1/2 oz.
    thank you ladies again for your advice!!! I will keep you posted on how things are going!

  7. #7
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    Default Re: Overactive letdown & engorgement in mornings

    It sounds like the more frequent nursing helped right away! That is great. I think you found the perfect solution for nursing 'laid back.' This is more of a nursing 'style' than any one position. All it really means is that mom is semi-reclined for the bulk of the nursing session rather than sitting straight upright. So the amount of recline that is comfortable will vary. Baby can be in any position and it's fine to use a nursing pillow as well if it is helping, or to latch baby and then recline, if that works better. Basically, you make whatever adjustments work for you. Also, sidelying nursing (mom and baby lying on there sides, facing eachother) seems to help with forceful letdown issues with some babies as well.

  8. #8
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    Default Re: Overactive letdown & engorgement in mornings

    You can definitely have fast letdowns without oversupply. Fast letdowns are more about the baby's ability to handle your flow speed than the absolute speed of your letdowns. So it's quite common to have normal supply and normal letdowns, and still have your baby struggle with them because he's still so young and tiny.
    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!"

  9. #9
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    Mar 2014
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    Default Re: Overactive letdown & engorgement in mornings

    Hello ladies,

    I just wanted to update you that things are much better now in terms of the fast flow. It is still there, but only when he doesn't empty the breast this usually happens on the right side. Thank you again for your help! He used to be extremely gassy & needed about 10-12 burps.

    I do have one more question: from past 2-3 days LO seems 'impatient' on the right side if he is awake. After about 5-6 mins, I see him sucking few times & swallowing. I guess he is waiting for another let down. At this point, he pulls off & latches & pulls off again & re-latches. I can see that he is still hungry. I try to burp him & put him back on the breast & same story. Once or twice I kept an eye on the clock & it took about 5-6 minutes for the let down, this is with him pulling on & off. Am I stressed out? Yes, sometimes. When he starts getting impatient I take deep breaths & try to relax by visualizing water fall or milk pouring etc. it helps a bit but since he keeps latching unlatching it takes longer. What can I do about it? Shall I switch sides at this point? How do I make sure he empties first side if he keeps pulling off but wanting to latch again? I don't know if this was happening before. I must say he is distracted too & I try using a blanket without much use.

    Thank you!

  10. #10
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    Default Re: Overactive letdown & engorgement in mornings

    That's terrific news, mama! So happy for you and baby.

    Sometimes when a mom has oversupply, the baby comes to expect fast and easy letdowns. Then, when mom's supply adjusts to be a bit more in tune with baby's needs, and letdowns are slower and take more effort, the baby does just what you're describing: acts fussy, pulls on and off, seems to be waiting for the letdown to happen... The best thing to do is to allow him to learn how to generate the flow speed he wants by nursing more assertively, and to be really patient and allow him unlimited time in order to get his needs met. There's no harm in switching breasts if he comes off fussing- just be prepared to switch back if he comes off the second side still acting fussy.
    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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