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Thread: Engorgement at 8 weeks

  1. #1

    Default Engorgement at 8 weeks

    Hello, I am a first time mother of 8 weeks who is exclusively breastfeeding, and I have been having some issues with engorgement/possible over supply for the past week.

    I'm not exactly sure why it is happening, but I seem to be engorged or very near engorgement almost all the time nowadays. I'm not pumping anymore (I only pumped regularly for the first three or four days after birth after receiving false information about having to pump to build up a good supply) and if I do ever pump it is solely to relieve my breasts/help prepare my nipple for latch, not to drain them or to stock up. I actually felt like my breast pump was collecting dust until a couple weeks ago.

    On top of the engorgement issue, my baby is showing signs of having issues during feeding due to over supply... She chokes and coughs or visibly struggles and she pulls back on my nipple during letdown and sometimes repeatedly slurps me in or clamps down, which really hurts! She has also spit up large portions of milk three times in the past couple of weeks, which makes me think she's getting too much milk on accident because she's not used to this new flow. She has also started to suffer from gas and gas pains more than usual and I know it is because she's getting too much foremilk. We never used to have this problem until a week or two ago.

    My question is, why is this happening now and how can I stop it? I thought that by 6 weeks, my milk supply would be pretty set? I have been feeding from one breast a feeding from the very beginning as it felt most comfortable to me, and lately I've taken to using the same breast two feedings in a row because I read somewhere that it might help with oversupply/help my baby get more of the hindmilk. My breasts will become hard and engorged even if she is just ten minutes past two hours between feedings.

    Some extra information about us: I feed on demand, and she's only ever had two bottles of expressed milk (and only finished one). She definitely went through a growth spurt two weeks ago, which I'm pretty sure boosted my supply quite a bit... was she just over-zealous? Her diapers are always wet, and her poops are still a good color, although somewhat irregular (two one day, none for four days) but that's nothing new for her. Her last poop was pretty watery, though.

    What can I do?

  2. #2
    Join Date
    Jun 2009

    Default Re: Engorgement at 8 weeks

    I cannot explain why this is happening now rather than before, but the '6 week' number is really shorthand, and milk production is never actually 'set." While milk production does tend to be at its natural, hormone driven height somewhere around 4-8 weeks, every mom is different so it is possible it happened later for you.

    Also, fast letdown can be worse if baby is going longer between nursing sessions. Longer time for milk to build up in the breast leads to a faster, more overwhelming flow.
    First, some things I suggest there is no need to worry about.
    Baby cannot get too much milk at the breast, on purpose or on accident. If there is literally too much coming at once for the tummy, babies handle this quite nicely by spitting up. Spitting up is normal, not harmful, and some even theorize is actually beneficial for a baby to spit up breastmilk because so many babies do it.
    Foremilk/hindmilk is much less of an issue than some might have you believe. It may cause a little more gassiness, but babies are also simply just gassy. In any case, a little or even a lot of discomfort now is not hurting baby in the long term. All your milk is good for baby.

    What to worry about: Engorgement. This can lead to serious issues for mom. There is feeling a little full, and there is rock hard painful engorgement, and there is everything in between. Every breast is different in how long it can go before engorgement or bad overfullness sets in. So it is important to listen to your body. When block nursing to decrease milk production, you should feel some fullness, but probably not to the point breast is hard or hurting. So even while blocking one side, it is important to express a little milk as needed to relieve pressure. This can be done with hand expression or a pump, but the idea is to express just enough to feel more comfortable and avoid getting engorged.

    Baby choking at the breast, etc. This is caused by fast letdown, and at its worst can cause breast refusal.

    Going 2 (or more) nursing sessions with baby nursing only one side is called block nursing. Block nursing has one purpose, and that is to reduce milk production. And it usually does this quite well. As far as if this also means baby gets less foremilk and more hindmilk, I would question that. Yes of course, once the block nursing as done its job and milk production is reduced, that helps with all the fast letdown issues. But prior to that, while mom is blocking, every time baby switches sides, baby is going to a breast that is likely to be very full and thus have a fast letdown. So the fast letdown may even get a bit worse while mom is blocking- at least, every time breasts are switched- until your production reduces.

    You getting engorged so often does sound like overproduction to me, but reducing your milk production is a serious thing to do, so you want to be very very sure that you are overproducing before doing it. Other things like baby not being able to nurse efficiently can cause these issues, and there are latch issues that may be hidden when a mom overproduces, so I suggest please read this article about block nursing very carefully, especially the point about infant weight gain and how long to continue trying block nursing. http://www.nancymohrbacher.com/blog/tag/block-feeding

    Meanwhile, tips for helping baby handle the flow:
    Nurse frequently. If you are getting engorged after two hours, try not to go two hours. See if baby will nurse more often.
    Nurse in a laid back position. This helps baby handle the flow. Play around with this position it is very adaptable.
    Make sure baby is latching well and you both are comfortable when nursing.
    If engorgement is causing latch issues, try reverse pressure softening.
    Pumping pulls fluid into the areola, making engorgement worse. It is really best to avoid pumping. However, if you cannot hand express and baby will not nurse, you may have to pump to avoid bad engorgement. Just keep it as short and on as low a setting as possible.

    If your production does not reduce enough just with block nursing, there is another technique called Full Drainage and Block Feeding where mom pumps to "empty" one time before starting block nursing. Sometimes the pumping has to be repeated in really severe cases.

    Suggestions: Aside from not pumping, make sure you are not doing anything else to increase milk production. Switch nursing (making sure baby nurses each side each session) or taking galactogogues. Yes I have talked to moms who knew they had oversupply and were drinking mothers milk tea or some such.

    Nursing laid back to help baby with the flow: http://www.nancymohrbacher.com/blog/...-breastfeeding

    hand expression: http://www.llli.org/docs/00000000000...expression.pdf

    Engorgement FAQs and RPS: http://www.llli.org/faq/engorgement.html

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