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Thread: Fast let-down . . . how to manage this?

  1. #1

    Default Fast let-down . . . how to manage this?

    Hi folks,

    I'm a new 1st time mom, bf'ing my 1-month old. My baby is gaining weight well and I have plenty of milk, however I have 2 problems which are making nursing kind of difficult. Any suggestions/thoughts/comments are welcome.

    1) Despite lots of lactation consultant help and an ointment, on my left side I have a really sore nipple that's always painful, even when the baby has a really good latch. Even when the lactation consultant did it and said it was right, it was still painful. Not unbearable, just not comfortable either.

    2) On the right side, the nipple isn't sore at all but I have really fast let-down. The second I let-down (and I know it when it happens, 'cause it hurts) my baby starts gasping and choking and usually lets go of the nipple. Literally, she can't eat for more than 10-20 seconds at a time on that breast. I've tried manually expressing milk, pumping out some milk, positioning her head higher than the breast (football hold, cradle hold, leaning back, etc.) Nothing helps, she still chokes and cries. It's really distressing, especially when I know she's hungry and the there's no more milk available from the other breast. After awhile, she sometimes seems to give up and just lies there quietly not taking the breast, even thought I know she's still hungry, and that really worries me.

    So what this means is, I effectively can't feed her from the right breast and it hurts to feed her on the left breast. So I've been nursing her from the left and just dealt with the pain, and pumping from the right breast and giving her the milk via bottle.

    Anyone else had similar challenges? Thanks!
    Last edited by @llli*janine; September 21st, 2008 at 07:39 PM. Reason: typos

  2. #2
    Join Date
    Apr 2008

    Default Re: Fast let-down . . . how to manage this?

    for the fast letdown, I use to unlatch my ds when I would feel the letdown start, spray the fast flowing milk into a burp cloth, and then re-latch him when the flow was slower.

    It is called Overactive Letdown (OALD).

    Here is some information on OALD

    mother of 2 boys!

    Birth: 7lbs 12oz, 1 year: 22lbs 11oz
    until he self-weaned 4 days before his third birthday ... still on occasion ... and happily

    ************************************************** ************************************************** *****************
    People need to understand that when they're deciding between breastmilk and formula, they're not deciding between Coke and Pepsi.... They're choosing between a live, pure substance and a dead substance made with the cheapest oils available. ~Chele Marmet

  3. #3

    Default Re: Fast let-down . . . how to manage this?

    Thank you for the suggestion. Not to be a pain, but I've tried this and it sometimes works a little bit, and other times not at all.

    Once I unlatch the baby, the milk only flows on it's own for a short time. I've tired breast massage and pressure to try and keep it going, with not so much success. When it stops and I latch her back on, she can usually eat for only a minute or so (sometimes less) before she starts choking and coughing again. So I rinse and repeat . . . needless to say, it takes up a *lot* of time since she's constantly hungry and feedings can take an hour or even two, easy. I'm not getting much else done with my days . . . . like, for example, showering.

    I'm concerned if she keeps inhaling milk she's going to get pneumonia. That's the main reason I want to try and solve this problem, if I possibly can.

  4. #4
    Join Date
    Sep 2008

    Default Re: Fast let-down . . . how to manage this?

    Hi! My son used to choke whenever I had a let-down, too. What I did was nurse in the Australian position (me lying down with him on top). I guess the gravity reduced the spray, because he hardly choked anymore when I did that. Hope this helps!

  5. #5
    Join Date
    Aug 2006

    Default Re: Fast let-down . . . how to manage this?

    I guess the good news at this point is that they usually get to where they just gulp and deal with a fast letdown as they get older. That being said, you have to figure out something that works for you now. Have you tried laying all the way on your back with her on top of you like is shown in the link the pp posted? Have you tried a sidelying position? Some moms find that babies are able to let some of the excess milk dribble out of the side of their mouth this way. Have you looked into possible oversupply? Sometimes getting supply under control through block feeding can be helpful.

    As for the sore side, I have one side that was not comfortable to nurse on for quite a few months. It is still the side that is more impacted by the hormonal changes of menstrating and pregnancy and hurts much more than the other side during those times. I wish I could offer a fix for that. For me, it just took time.

    I've never heard about a baby getting pneunomia from asperating breastmilk. Your concern might be worth mentioning to your dr b/c he or she might be able to put your mind at ease at that. There are so many antibacterial properties to breastmilk I wouldn't think it likely.

    BTW, the all consuming nature of feeding at this point won't last forever! You will both get things figured out over the next month or two and it will become SO much easier!
    DS 1/2006 9 lb. 2 oz. 22 in.
    DD 10/2008 8 lb, 2 oz. 20 in.

  6. #6

    Default Re: Fast let-down . . . how to manage this?

    Thanks to everyone for the ideas! I'll try the "australian" position and look into block feeding.

    I'll also try the side-lying position again . . . I tried it once and we both got totally covered in milk, and I couldn't quite get her lined up with the breast, but I'm motivated to give it another go.

    As for the sore nipple, I'm sort of resigned to it at this point. I think that anatomically that breast is a little lopsided, and maybe that's what's causing it. The pain is less than it used to be, and is somewhat manageable.


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