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Thread: reduced flow in one breast only

  1. #1
    Join Date
    Feb 2006
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    Default reduced flow in one breast only

    I noticed the other day that my 24-day old son was tugging hard and pulling back on my right breast after only 10 minutes of feeding. He repeated the behavior at the next few feedings and so I pumped today to see if he was just draining expediently or if my production had decreased. Since he was about a week old, I had been getting about 1.5 oz from that breast, but am now getting only 1 oz or less. As a result, he's not full or satisfied after being put to both breasts and becomes frustrated and upset when put back on an empty breast.

    Does this sound like a latch problem? I nearly always use a cross-cradle hold but at night I try to get him to latch laying down. His latch seems no different although both positions are often uncomfortable and/or downright painful on my areola (it feels like sandpaper sometimes!). He's got an asymetrical latch, and gets most of the areola on the side of his lower lip and half of the other side. The nipple has a normal shape after he delatches, although it sometimes gets dry and sore after feeding from the dryness.

    I'm taking the "More Milk Plus" tinture 3 times a day and am feeding every 2-3 hours.

  2. #2
    Join Date
    Jan 2006
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    Default Re: reduced flow in one breast only

    Hi there and congratulations on the birth of your ds! These early weeks of brastfeeding are such a learning experience for both of you and it sounds like you are doing pretty well with your new baby!

    First of all, don't be fooled by what a pump takes from your breast as opposed to your baby. Your baby is much more efficient and your body is trained to react to him instead of the pump, so what you are getting from pumping afterward is not a definite indication of production.

    Also, take heart, your breast are never truly "empty"! They are actually always making milk, but if they are not stimulated (maybe by a poor suck or infrequent feedings) they will remain more fill and production will slow. The more milk a baby takes out, the more that will be made! If you want to ensure that you are producing enough milk on the right breast, make sure you are offering that side just as much as the left. If you do not offer it for feedings, it won't produce the milk! If you feel you can't offer that side due to pain, then pump or express the milk manually. You mentioned pumping. What type of pump are you using?

    The best way to tell that your baby is transferring milk well is by growth-is he gaining steadily?; and by wet/dirty diapers. Is he having about 6-8 wet cloth diapers a day?(5-6 disposable?) Is he having about 3-4 BMs a day?

    How often does he nurse in 24 hours? Does he always nurse from both sides? When he tugs and pulls back does he show any other signs of discomfort, such as gagging, choking or sputtering? Does he show any other signs of fussiness or discomfort throughout the day? Does he take any supplements? Does he take a pacifier? If he is doing a lot of sucking on things other than your breast, then he is not stimulating the breasts to produce milk.

    When you nurse in the cross-cradle do you feel any pain or discomfort, or is it just in the other positions? Pain in both nipples or just one? Sounds like he has a good latch. I would suggest that you look over this link. It is about thrush, which may be causing your nipple pain. Let me know if you think this is possible. I can give you some links for treatment options that you could share with your doctor.


    http://www.lalecheleague.org/FAQ/thrush.html

    Keep me posted!

  3. #3
    Join Date
    Feb 2006
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    22

    Default Re: reduced flow in one breast only

    Thanks for your response.

    > What type of pump are you using?

    I rented a Symphony pump from the hospital.

    > is he gaining steadily? Is he having about 6-8 wet cloth diapers a day?(5-6 disposable?) Is he having about 3-4 BMs a day?

    Yes to all those. He was gaining an ounce a day at the last doctor's visit. He does get a small formula supplement (usually about 1.5oz) in the evening sometimes when he's be at the breast for an extended period and not getting enough to be satisfied (I usually cave after we've gone about an hour and a half and he's pulling off but still rooting and sucking his hands...)

    > How often does he nurse in 24 hours?

    Generally in the day he nurses every 2-2.5 hours and every 2.5-3 at night. He's not gone longer than 3 hours day or night.

    > Does he always nurse from both sides?

    About half the time he'll take both, a quarter of the time he'll take both and then start over and take one more, and occasionally (usually in the morning) he'll only take one.

    > When he tugs and pulls back does he show any other signs of discomfort, such as gagging, choking or sputtering? Does he show any other signs of fussiness or discomfort throughout the day?

    No. He will sometimes grunt, but usually he vocalizes the same way he does when he's rooting and not being put to the breast fast enough (an "eh-eh-eh" sound).

    > Does he take any supplements? Does he take a pacifier?

    He gets his supplements with a syringe and does not take a pacifier.

    > When you nurse in the cross-cradle do you feel any pain or discomfort, or is it just in the other positions? Pain in both nipples or just one?

    It's uncomfortable in all the positions, but most uncomfortable in the football hold and when lying down. It's generally most painful on the areola -- I figured out this morning when he was sucking my pinky that he thrusts and grinds with his lower gum and it's got a sharp little ridge to it. I think that's the source of the pain. Is there a way to get him to be more gentle?

    > It is about thrush

    I've thought about thrush though the baby has no symptoms of it. I wasn't given antibiotics but my nipples did dry, crack and bleed in the first few days. I bought some acidopholus (sp?) yesterday and will see if taking it changes anything.

  4. #4
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    Jan 2006
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    Default Re: reduced flow in one breast only

    You are certainly welcome!

    Renting a hopsital-grade pump is a great idea!

    Sounds like growth, wet and dirty diapers are in a normal range as well.
    What color are his BMs? Do you notice a difference after the formula?

    He is nursing within the 8-12 range, but more like 10x per 24 hours. Good.

    He is not receiving any pacifier or bottle nipples to confuse his suck. Good.

    Pain in one position more than another is sometimes indicative of a baby pulling off from a good latch. I would suggest nursing in the most comfortable position right now until this is rectified.

    The fact that you have had cracked and bleeding nipples suggests that yeast may have gotten into your nipples that way. Yeast can be a problem in two different ways: 1. Normal levels of yeast can over grow in the body due to antibiotics, increased sugar in the diets, and other causes. 2. Yeast can enter in through cracks in the nipples.

    If he has an incorrect latch and is causing abrasions to your nipple, than you could also be at risk for yeast. I can give you some information on this, but I suggest you contact your doctor or an IBCLC for more help. Oh-and babies can show no signs, but still have thrush! Do you still have open cracks or abrasions on your nipples? Are you using anything on your nipples for the pain? Some moms find it helpful to use deep-breathing exercises to help them through the pain of nursing with sore nipples.

    http://www.lalecheleague.org/FAQ/thrush.html

    As far as his sucking/latch. If you feel he is not latched properly and grinding on your nipple, you can take him off and reattach him. You sound like you understand the importance of him taking a "mouthful of breast". Make sure his mouth is open wide like when yawning and be sure to keep his body close to yours the whole time. Try not to let him fall away. This can disengage the latch. Also, try to keep his head in a straight line with the rest of his body, so he is not turning his head to nurse. If you are using a pillow for support, put it under your arm, not him.

    One last question: Was ds checked in the hospital by an LC? Would you be able to get in contact with an IBCLC or LLL Leader? Here is a link:

    http://www.lalecheleague.org/leaderinfo.html

    It might be helpful to see someone in person.

    Let me know how things are going!

  5. #5
    Join Date
    Jan 2006
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    Default Re: reduced flow in one breast only

    BTW, I think I got caught up with your sore nipples and didn't really address your initial question about supply in one breast.

    If ds has normal growth, and wet/dirty diapers, then I would suspect a supply issue.

  6. #6
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    Jan 2006
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    Default Re: reduced flow in one breast only

    Oh, I should really preview my posts...I meant to say that I WOULDN'T suspect a supply issue! Sorry!

  7. #7
    Join Date
    Feb 2006
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    22

    Default Re: reduced flow in one breast only

    I think you were right that it was a growth spurt -- his second in as many weeks. I assumed since we'd already had one that I was in the clear until the 6th week. Now that he's nursing less often, I'm getting 3 oz from that breast.

    In the hospital my son was checked by the nurse, but not an LC specifically (or she might have been, but it was 3am after a long labor and I barely remember it). We have a very local LLL chapter, so I'll look into having his latch checked again. He's definitly started retracting his tongue and today seems to be sucking his lower lip in as well. Hopefully it's not too late to change that.

    Thanks again for your help!

  8. #8
    Join Date
    Jan 2006
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    Default Re: reduced flow in one breast only

    So is the pain any better?

    Glad to offer the support and information you needed! You will do well with attending a local LLL meeting.

    Good luck!

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