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Thread: about to give up and heartbroken: low-supply + fast letdown

  1. #1
    Join Date
    Jun 2016
    Location
    France
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    Default about to give up and heartbroken: low-supply + fast letdown

    Hello,

    I'm miserably trying to hang to bf. My DD is 9wo and we've been struggling with getting my supply up. My production got off to a bad start after a c-section and then rapid weight loss (she was still passing meconium on day 6) which led to supplementing, followed by me getting a kidney infection and being to weak to pump properly. Even today, I can only pump out about 80-100ml per day.

    About 10 days ago, I started having a forceful letdown and she's not adapting to it nor am I able to make it easier for her. It's only when I express or she nurses; I don't have the milk pouring out otherwise. I've tried all of the positions, which she hates for the most part. Sometimes she'll accept starting off in the biological nurturing position or nurse for a while in the side-lying position. I've also tried "scissor-pinching" around the nipple, pumping prior to nursing to get past the first letdown, taking her off and hand expressing when the forceful letdown starts. Sometimes these things help, sometimes we both end up crying. I've already had one LC give up on me.

    I'm supposed to be trying the weaning from supplements protocol which means nursing her more often, which means anticipating the letdown problems more often. I spend my day setting up for the next nursing session, doing some sort of nursing-pumping-supplementing combo, cleaning the materials then setting up for the next session. Only our night feedings are nurturing and cozy.

    I'm exhausted. I so want to breastfeed. Before the letdown problem, I loved that time with her, even though I have to supplement. She loves it too. It breaks my heart to think about giving up but I can't go on like this. I don't see how this is good for our relationship.

    Is there hope? Does a forceful letdown ever lighten up? She doesn't seem to be able to adapt to the letdown.

  2. #2
    Join Date
    May 2006
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    24,911

    Default Re: about to give up and heartbroken: low-supply + fast letd

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

    Can you describe exactly what you are seeing that has led you to conclude that you have fast letdowns? The reason I ask is that in general, fast letdowns are associated with oversupply, not low supply. The more milk, the faster it comes out, the less milk, the slower it comes out. So it would be unusual for fast letdowns to crop up suddenly in a mom who is having issues with making enough milk.

    It would also be useful to know the following:
    - How often baby nurses in a 24 hour period
    - How often you are pumping
    - How much you get per pumping session- I'm not clear if you are getting 80-100 ml per pump session, or if that is your daily total output?
    - How often you are supplementing and how much is in each supplemental bottle
    - What you are supplementing with- is it expressed milk or formula?

  3. #3
    Join Date
    Jun 2016
    Location
    France
    Posts
    3

    Default Re: about to give up and heartbroken: low-supply + fast letd

    Thanks for the reply!

    As for the fast letdown, I know it's much more common to have it with oversupply. For the past ten days, my LO starts nursing, swallowing with every pull and then about 45s into it she starts gulping really fast and loud and gasping for air and takes herself off, crying. She's also started burping after breastfeeding, which she only did after formula before. If I hand compress, I have 2 or 3 fine streams that shoot out across the room, but it's not running everywhere and soaking us. It calms down but unless she's sleepy, she gets really upset. She'll try it once or twice more and just gives up from frustration. When it gets to this point, I don't ever force the nipple into her mouth, I give her a small bottle of formula (or expressed milk if I have it) to calm her down and try to pump off some of the letdown and then try to put her back to my breast.

    She nurses 10-12 times in a 24hr period, both breasts each time. I've been pumping 5-6 times a day--prior to that, I was only able to get in 3-4 pumps but as I'm trying to pump before nursing now to manage the letdown, I get a few more in. My max output for a 24hr period is 80-100ml, on a good day. Yesterday, I got about 30ml per pump, today, it's more like 15-20. I've been supplementing 60ml, 5-7 times a day(when she's still hungry after emptying both breasts). I do one 80-90ml at the end of the day. I'm supplementing with as much expressed milk as possible and the rest is an organic goat's milk formula that she does well with. Fortunately, she's never been colicky once or spit up much at all.

    She has been a great nurser from the start--never had a latch problem. She loves it. I think we were poorly advised when I had problems after her birth. My supply was starting to improve when this letdown problem popped up all of the sudden.

    Thank you again for taking the time to reply.

  4. #4
    Join Date
    Jun 2009
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    10,740

    Default Re: about to give up and heartbroken: low-supply + fast letd

    I hope mommal will not mind me jumping in- I have a couple thoughts.

    My supply was starting to improve when this letdown problem popped up all of the sudden.
    Don't you think perhaps the two are related? You are making more milk, so the let down is faster?

    I also wonder if baby is possibly becoming acclimated to bottles, and this is starting to cause breast refusal. Not saying that is the whole issue, just wondering if it is contributing.

    I am not sure how you are measuring your milk production or how low milk production was diagnosed in the first place? Baby was gaining poorly early on, then you were ill. I get that. But at this point it sounds like you are measuring your production by how much you pump, which is rarely very accurate. What you pump only gives you the minimum possible number.

    Nursing frequently usually helps with fast letdown. The less time for milk to build up in the breasts, the less fast the letdown. Also what if you tried letting baby stay on one side for a whole session at least some of the time? I know this runs counter to the general advice for increasing milk production, but basically I am wondering if maybe you do make enough milk, now.

    An IBCLC 'gave up on you?" How odd. Are you able to see someone else for a complete consult? I would be curious what might be seen now if baby is examined and a nursing session assessed to rule out any issues with latch, suck pattern, or baby's ability to transfer milk. Even if latch feels good, that does not always mean it IS good. If a baby cannot latch all that well or not having a normal suck/swallow pattern, I imagine that might make fast letdown harder to handle and of course causes weight gain issues even if mom makes enough milk. I also think it makes sense to have your pump checked out. Something is just not adding up with that pump output and such problematic letdown.

    I've been supplementing 60ml, 5-7 times a day(when she's still hungry after emptying both breasts). I do one 80-90ml at the end of the day.
    So you are supplementing about 13-15 ounces per day- and how is baby's weight gain now?

    As far as is this "good for your relationship" Ok. Lots of moms who are struggling with breastfeeding issues have this concern. I distinctly remember having it myself with my oldest, when every nursing session was a struggle and I was in pain and exhausted with all the pumping. This is a personal parenting area and every mom is going to have to make her own decision based on her own beliefs. But here is my opinion.
    When we say " it is hurting our relationship" what we are really saying is "can this possibly be worth it? Well yes, it can, imo. I do not see how anyone can argue otherwise. We are talking about an upset mom and baby who are trying to figure something out together. Not neglect, not abuse, not long separations - not anything that is actually likely to hurt your relationship with your child. We are moms and it hurts us to see our babies cry and when we are exhausted we cry, get upset. We do not want our babies seeing us like that. But is it causing some permanent harm? I do not think that is even possible.

    And what is the possible- in fact, likely benefit to this frustration? Is that something that is worth it?

    Every few months at least, another benefit of breastfeeding- both the milk, and the act of nursing at the breast- is discovered, rediscovered, or further confirmed. What the facts tell us is that being breastfed is something that has real and permanent benefits to a person's lifetime health. Breastfeeding is something that has real and permanent benefits for a woman's health.

    Even with your struggles with production and needing to supplement pump, you were enjoying nursing your baby. Well, of course you were. To derive pleasure from nursing is the norm. Nature in it's infinite wisdom made nursing one's young be something that feels good. It feels good for mom and it feels very good for baby. Maybe not now, at this moment, with the issues you are having. I get it. But do you really think it will always be this way? It won't. There is a problem. Most breastfeeding issues are fixable problems. Breastfeeding is something that can continue for years. Not months, years. Even if you nurse for one year, that is still another 10 months of nursing. Even if you nurse for 6 months, that is 4 more months of nursing- twice what you have already done. 4 months or 4 years, That means there is plenty of time to fix whatever is going on and for you and your baby to enjoy nursing again. If that were the only possible benefit, wouldn't it be worth it?

  5. #5
    Join Date
    Jun 2016
    Location
    France
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    Default Re: about to give up and heartbroken: low-supply + fast letd

    Thanks for your input too--I need all the help I can get!! Thank you also for your encouragement. I do think it's worth it to hang on and see if we can't figure this out together, my DD and I.

    I have wondered if my increased production was related to the faster letdown. The letdown isn't "a gusher" and is over in about 30s. Maybe it was so radically different from before that she's taken by surprise? The past 2 days, I've been trying to talk her through the letdown or sit her up when she pulls herself off and hand pump. I'm also nursing her much more frequently to reduce the force behind the letdown. It's going a little more smoothly, but some sessions are rough.

    As for my supply and her weight gain: she's gaining well. Sometimes she nurses on both breasts until nothing more is coming out and she's still hungry--I know that breasts are never "empty" but she's frustrated and wants more than comfort nursing. Her impatience could very well come from being acclimated to bottles. I just ordered an SNS and should have it tomorrow. And I started this weaning from supplements program on Friday. http://kellymom.com/bf/got-milk/basi...rease-formula/

    I'm still hanging in there!

  6. #6
    Join Date
    Jun 2009
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    10,740

    Default Re: about to give up and heartbroken: low-supply + fast letd

    Yes I think it is entirely possible baby was taken by surprise and will learn to handle the flow. I have nursed three when having fast flow and it is obvious to me that when it comes to flow, babies are like Goldilocks- what is "fast" for one baby is "slow" for another and "just right" for another, and also, any baby can learn to nurse with pretty much any flow unless it is very severely forceful.

    I think your plan sounds great. I am sure that you have researched it and know that using an sns will have a learning curve, (possibly more frustration) but in the long run it can be very helpful to mom as a time saver as well as of course reducing the problem of nipple confusion. Here is a short article about this:http://www.cwgenna.com/smartnothard.html

    If you end up seeing another IBCLC, this article might be helpful: http://www.cwgenna.com/lconsult.html

    Please make sure pump is working correctly and fits you correctly. You are making lots of progress and do not want an equipment failure holding you back.

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