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Thread: Long, but I'm desperate - oversupply???

  1. #1

    Default Long, but I'm desperate - oversupply???

    Hello,

    I had a little girl nearly four weeks ago (July 11th) and she is my first baby. I have been breastfeeding her from day one, and would like to continue breastfeeding her, but I'm finding it really hard.

    I seem to have a problematic oversupply in one breast only (the right) - this breast typically feels large, hard and lumpy when full (which happens pretty quickly), and tends to spray and drip milk frequently. My other breast is by no means producing at a perfect rate either - it also gets large and uncomfortable - but it doesn't throw up any particular problems for my daughter and she generally feeds fine on it.

    My right, however, chokes and upsets her. This usually happens during the initial let down, which is very forceful, but can also happen several minutes into a feed. The flow seems to be consistently aggressive. She rarely feeds from it for more than ten minutes - usually five or less - before she unlatches and falls into a restless sleep. Thus, my right breast is rarely drained, but it still doesn't seem to get the message. I offer one breast per feeding - she has never seemed to need the second breast.

    She is a good feeder, and my breasts do both feel softer when she has fed, the left of course more so than the right. Her weight gain has been really good so far too, so that doesn't worry me. However, I am 99% sure she is receiving too much foremilk, possibly from BOTH breasts, as her poop is consistently either voluminous and a runny greenish-brown or yellow-brown, or it is just a scanty, bitty green stain in her nappy. Today (witnessing a poop in action, ha), I noticed that it was bubbly when it came out.

    She suffers with uncomfortable wind too, most of the day - I burp her during and after feeds, which usually brings up the air she swallows during her gulping/choking sessions, but once the milk hits her intestines, she starts to squirm, strain and cry in pain. She passes gas a lot when she is in this state. It can go on all day and night, as long as she isn't sleeping or nursing, and she now finds it hard to sleep because of it (so do I). She seems to find some relief in a sitting position, but as soon as she is laid on her back, the problem begins again. She also has a few small raw, sore patches on her bottom (around the anal area) that are proving difficult to heal because she releases small amounts of poop when she farts. She has had these since she was just two weeks old, which I find devastating, because she's still so little.

    I am so upset by this. Everything seemed fine in the beginning - her nappies moved swiftly from meconium, to green, to bitty yellow and stayed there for a while. She was happy, quiet and satisfied almost all of the time, and fell deeply asleep after feeding. I don't understand why things had to change? Our latch is ok - probably not perfect yet - but the only pain I ever feel is in the breast during let down. She occasionally makes clicking noises during feeding, usually on the right breast, but I am inclined to attribute this to her struggling to cope with the flow of milk.

    I have managed to produce a couple of yellower nappies by pumping around 20 ml from my right breast in the morning - this takes about 20-30 seconds and allows her to feed from it easier, but I've read I should probably stay away from the pump altogether. I have probably pumped in this way a total of five times. I've also done my research into the foremilk/hindmilk imbalance debate and understand this, but despite her weight gain being great, the gas, nappy rash and her discomfort are very much getting me down. She is such a lovely, content little baby in every other way and I feel so guilty for doing this to her, but it's either that or she doesn't eat at all, unless I put her on formula. :'(

    I know it is early days. I sincerely hope that in time my supply will regulate, but is there anything I can do now to help her? Feeding her reclined on the evil right breast has helped a little with the choking, but she is still receiving so much foremilk. I read today that one woman with the same issue had been told by a LC to try a type of block feeding, feeding twice in a row on the good side, and then once on the bad side. Would this help does anyone know? Would I be at risk of increasing my supply in my good breast? That one is bordering on being too productive as it is, and has increased production significantly during a recent growth spurt so that I'm now experiencing several uncomfortable let downs from both breasts at random points during the day.

    Sorry this is so long, but someone please help! I'm 26 but I have absolutely no idea what I'm doing or how to make things better for my baby. I am so depressed about it. :'(

  2. #2
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    Default Re: Long, but I'm desperate - oversupply???

    Welcome to the forum and congratulations on the new baby!

    First, take a deep breath and congratulate yourself on getting this far and on providing your baby with the absolute best start. Then take another and remind yourself that gas, fussiness, discomfort, and nappy rash are all normal parts of infancy. I know it's distressing to see your child in discomfort from gas or to open up her diaper and see a raw-looking bottom- but these issues are a small price to pay for the right to be a breastfed baby, and they also could be the same or worse with formula!

    It sounds like you do have some pretty significant oversupply going on. So if it were me, I would continue to feed in reclined positions and I would also start block feeding. It's important to remember that block feeding is an art, not a science. It's something you do by feel, not by the clock. And it's something you stay flexible about. If it's working, continue. If baby is suddenly seeming hungry after finishing one breast, don't be afraid to offer the second side.

    I think the LC's suggestion-feed twice on the lower producing breast, then once on the higher-producing breast- is a good one. I would try it for a couple of days and see what happens!

  3. #3
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    Default Re: Long, but I'm desperate - oversupply???

    Hi nylesmom. Welcome to the forum.

    I am SO SO SORRY that you are feeling so upset over the issues you are seeing. PLEASE, let me rest your mind-

    It sounds like you have some possible oversupply. And certainly forceful letdown. IF these things are causing any problems, for you or baby, THAT is the problem, and I am going to offer several ideas for handling those things. But the main problem is NOT some issue with so-called foremilk/hindmilk. Sure, baby may be getting a little more lactose during a feed than baby can easily 'handle." When your fast letdown calms down- and it will-your baby will probably be less fussy overall.

    BUT- Baby having digestion discomfort, Gas (wind) and green poops, bubbly or otherwise, are nothing to feel devastated about! This is nothing to worry yourself so much about! Your breasts are not evil! They produce only something not only good but vital- the lifegiving miracle food designed by nature ONLY for YOUR baby, food your baby is clearly thriving on! "too much foremilk" is simply NOT a health concern!


    So.

    For forceful letdown
    Keep nursing one side at a time as baby prefers
    Nurse very frequently, day and night. Try to nurse at least ever 2 hours when you are awake and at least every 4 when you are in bed. More often is FINE and will help, but you have to sleep sometime too.
    Nurse in a reclined/laid back position
    Express a little milk into a cloth before latching baby
    and/or, take baby off when the letdown comes and then relatch baby.

    For the rashes- if you are using baby wipes of any kind, stop. As much as possible, Soak bottom clean with warm water and a soft cloth. and put a good barrier cream on every change once bottom is clean.

    Try these things for a few days and see what happens. If baby has extremely fast weight gain, block nursing may be in order. But block nursing can cause supply to go down too much. So you want to only approach that very carefully.

  4. #4
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    Default Re: Long, but I'm desperate - oversupply???

    Sorry I did not mean to disagree with mommal, I posted before seeing her post.

    Block nursing-ok, but please read this first. I am more worried about that in this case than I otherwise would be, and you know block nursing always worries me, as it sounds like latch is not 100 percent. http://www.nancymohrbacher.com/blog/tag/block-feeding

    YOu can block one breast and not the other if you wish. It is the breast that is being blocked (not nursed on for longer periods) that will reduce in milk production.

  5. #5
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    Default Re: Long, but I'm desperate - oversupply???

    Please proceed with caution. While I think block nursing is worth a try in this situation, it's certainly something to be cautious about and to back off of if things seem to be getting worse rather than better.

    Especially that "too much foremilk" is not a health concern. An irritation, to be sure, but not a health problem.

  6. #6

    Default Re: Long, but I'm desperate - oversupply???

    Me again. Bumping this nearly 3 years later - I need help again.

    So the bad news is that at 10 weeks, my then-newborn girl, who I talked about in the above post, started to completely refuse the right breast. And then both breasts. And then the nursing strikes were on. She had about 3 or 4 I think, lasting up to a week at a time. I did a lot of dream-feeding, and a lot of crying. We still don't know what caused them for sure - she would display many signs and symptoms of teething pain/movement in her gums during an 'episode', but maybe it was the flow from my ridiculously engorged breasts, or maybe it was gastric discomfort or something I ate. I'll never be sure. After being repeatedly fobbed off by healthcare professionals and the NHS, I finally found an IBCLC who took a proper look in her mouth. Her posterior tongue tie was cut at a whopping 4.5 months. Things got better after that - but her first tooth popped through at 5 months, so maybe that was part of the problem. No idea.

    The good news is that she is still nursing, aged very nearly 3. Success.

    However ...

    I've recently had another little girl who is exactly the same age as my first daughter was when I wrote that first post funnily enough (3 weeks 4 days) and her behaviour at the breast recently has been EXACTLY the same. The only thing that isn't going on with her is the green poop/nappy rash. Her poop is the usual yellow. Weight gain good for now, loads of pee, plenty of poop. I know she's been getting enough.

    Strangely, I haven't suffered with oversupply this time really. I did for the first week and a bit, like loads of people, but my breasts no longer get engorged, just a bit full overnight. My flow is still mega forceful and fast and my poor baby can't cope with it at all, but I just unlatch and spray and can usually complete a fairly good feeding this way. When she actually wants to feed. And I never know when that is.

    I have awful trouble reading her hunger cues (have had this problem with both my girls) and I'm not sure if this is because I just constantly offer the breast for everything so she never really gets a chance to become hungry and root or whether it's because she's just not an especially hungry baby. Sometimes she will latch and have a good feed - always one breast only, not for long because of my fast flow, but an obviously full, decent feed. Other times she will squirm and grunt and strain and pull and have what seems like a snack - and I'm not sure if this is because of some sort of pain, and she's cutting her feed short, or whether it's because she's not really that hungry, so my flow is annoying her or what. WHAT IS IT.

    Today so far went something like this: big feed at 6:30 am, straining/squirmy snack around 2 hours later, big feed at 11:30 am, squirmy snack at around 1:30 pm, big feed at 4:30 pm. Now I'm just sitting here waiting and unsure whether to offer or what to do as it upsets me when she seems so uncomfortable and I'm not sure she's even really feeding at those times as it seems like she hardly has anything, but 5-ish hours between decent feeds is a long time for a newborn to go right?

    If she really doesn't want to nurse then she will just not latch on. She is a ****e sleeper and also gets very overtired/overstimulated very easily and then absolutely will not latch for love nor money and just screams (she hates comfort nursing as she gets blasted with milk), so the evenings are a battle and a nightmare.

    Can ANYONE please shed any light on this behaviour for me? Has anyone had a similar experience? Am I offering too much? Does she not really want to feed when she's wriggling about all over the place acting like she's in pain or would she just not latch if she didn't want to? How can I be more confident and wait for her to show me she's hungry if that means waiting up to 5 hours and panicking she won't get enough?

    I realise that past trauma from my first daughter's nursing strikes is likely a factor in how panicky and lacking in confidence I am feeling about this, as I am absolutely terrified of the same thing happening again. I'm also 90% sure she has a posterior tongue tie too but need to wait for my specialist lady to come back from holiday.

    I should add that she feeds quite well at night and usually only goes 2 -3.5 hours at that time, so maybe she is getting lots of calories that way? Is that ok?

    Sorry in advance for the essay.

  7. #7
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    Default Re: Long, but I'm desperate - oversupply???

    Hi and welcome back!

    To me this all sounds pretty normal. Maybe I am not understanding the problem. I am not a believer that one can offer to nurse too often...but of course the whole point is you offer, and baby takes what they want, and that is going to vary nursing session to nursing session. So short sessions and "squirmy snacks" are entirely normal. Basically, as long as baby is gaining normally, nursing at least 8-12 times in 24 hours, and you (mom) are comfortable, there is usually no problem.
    but 5-ish hours between decent feeds is a long time for a newborn to go right?
    It depends how you define decent. 5 hours is a long time to go without nursing at all, yes. But some babies this age might sleep that long at least once a day. It depends on the baby and how much they nurse other times.

    Frequent nursing is very helpful in cases of fast letdown. So encouraging baby to nurse often, plus the other ideas I gave you last time for helping baby handle the flow, should help with that. Over time your milk production will calm down a bit and the fast letdown will resolve then too.

  8. #8

    Default Re: Long, but I'm desperate - oversupply???

    Thanks. I think maybe she is desperately looking for comfort between nutritive feeds and getting none as she just gets more and more milk, leading to the squirming, groaning, wincing, gagging etc. I am seeing. It just makes me sad. I think I need to start watching properly for hunger cues and trying to comfort with other methods than the breast in the meantime as I'm sure all the extra milk is giving her stomach aches and compounding the problem, as well as leading to sleep issues and just totally not doing what it is supposed to I guess. I don't know - this is my gut instinct on the matter, but she's a mystery really and I can't be sure what this behaviour is or how to stop it, which is bothering me loads. Especially as I was so hopeful that this time it would be different, but it isn't really and I'm so disappointed.

  9. #9
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    Default Re: Long, but I'm desperate - oversupply???

    I think moms should follow their gut and you know your baby best. So by all means do what feels best for you. My suggestions are based on you reporting that you have a fast milk flow. Milk production is often a bit greater with each child, so if a mom is prone to overproduce she is likely to experience that again with each baby, so that is not surprising. The longer your baby goes without nursing the faster the flow is likely to be, this is just a physiological fact. I have had three kids with fast letdown issues and frequent nursing and laid back nursing helped the most. So I guess I do not see the mystery here, your baby seems to be acting like a newborn acts when mom has fast letdown...and in fact how most newborns act regardless of milk flow.

    Newborns infants are often not terribly contented creatures. They have spent 9 months in the womb living and growing and thriving while neither breathing or digesting anything, constantly floating, constantly "held" and seeing and hearing little. Due to human anatomy (narrow hips, large brains) human infants are born "early" so that they can be safely born at all... and are thus far less developed than most other mammals at birth. So it takes a long time for the various systems to adjust to life outside the womb, and babies expect to be held and comforted most of the time.

    If you are holding baby close to the breast most of the time, that is all that is really meant by "offering" in most cases. We talk about "offering" because of the modern practices of baby being "put" somewhere rather then held by mom- a crib or bassinet, often swaddled or given a pacifier etc. These babies may need to have the breast "offered." or they will not nurse enough. But if your baby is held lots and given clear or easy access to the breast most of the time, normally rooting signals are clear. Are you not finding that to be the case?

    Here are a couple other ideas:

    - If your baby also has some kind of latch or suck swallow issue caused by a physical problem, that increases the likelihood a baby is going to have trouble handling milk flow.

    - Your older child is nursing as well? When I was tandem nursing an infant and my then nearly 3 year old, my baby would sometimes gag when he came to the breast directly after my older child nursed. I have no idea why this was and I never figured it out, I assumed it was some kind of saliva thing but do not really know, and it did not happen all the time. But it happened enough that I tried to adjust the nursing so toddler followed baby on each side, rather than the other way around.

    - If you are tandem nursing that may be why your breasts feel softer and you are not having as much obvious issues with OP. Because your older child is taking some of the milk and alleviating that problem.

    Also, Do you have good support there? Someone you can talk to? The extreme negative feelings your have mentioned having in the early weeks post partum with both babies makes me wonder if it might make sense to explore the possibility you are having some post partum mood issues. If you think this might be the case I urge you to seek help. I had some pretty bad post partum issues after my second baby, but mine were late onset (arose several months after baby was born) and I did not even realize that was what was going on until years later. After a similar situation arose after my third I talked to my doctor right away when the symptoms started and got help.

  10. #10
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    Default Re: Long, but I'm desperate - oversupply???

    Sorry, I was thinking about your post again this morning and realized I had missed something. You think baby is perhaps getting too much to eat and that is the problem? OK, When I suggest gently encouraging baby to nurse more often, I am not suggesting baby needs or should get more to eat...nursing more often would slow the fast letdown, resulting in smaller individual meals...smaller individual meals would be easier to digest, and overall, mean baby gets the same or in fact less to eat (if baby is indeed getting too much to begin with.) This is because when the flow is slower, baby can control far better how much they get at once, and a baby will not generally intentionally over eat to the point it is bothersome (although yes, occasionally a baby might eat to the point baby is so full baby spits up, because spitting up is actually a great way to handle too much milk in the tummy and causes no harm.)

    It might take several days to get there but smaller, more easily digestible meals is the result of more frequent nursing, usually. Again laid back nursing also taking baby off at letdown helps too of course. Also, if the nursing sessions are very close together some of the time, you could offer the same breast at the next session, which would also act to help baby get a slower letdown and less of the so called "foremilk" that may cause some babies to have minor gastrointestinal discomfort. If baby is gaining well and happy taking one breast at a time, rather than both, that is another strategy to help with fast letdown issues.

    As far as some nursing sessions being"nutritive" and others for "comfort." These are terms that are pretty useless when it comes to a normal breastfeeding situation, where it is normal for a baby to taking in more milk at some nursing sessions than others. When a baby nurses they transfer milk and they (hopefully) get comforted- at the same time. It is all one and the same. Sometimes it is a little milk and sometimes it is more, but as long as baby is transferring milk the nursing session is "nutritive." Yes, sometimes the flow is so great that the session is not comforting, but that is problem that can be addressed with the ideas you are using and that I have suggested, and usually reduces entirely on its own given a few weeks. Also, it is entirely normal for a baby to not 'always" be comforted at the breast all the time. There is no one thing that always comforts all babies. If there were, whoever invented it would be a billionaire. Babies tend to be very fussy and figuring out how best to comfort them can be quite tricky, this is all entirely normal. Also, a baby who is nursing for comfort is not desperate, they are acting like a normal baby.
    Last edited by @llli*maddieb; July 1st, 2017 at 10:39 AM.

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