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Thread: Coughing/choking & gasping

  1. #1
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    Default Coughing/choking & gasping

    Hi everybody, some of you may have been following my feeding trouble with Sophie from another thread. I made a new one because it is a slightly different topic, I hope this is okay.

    We have been improving but one thing that really concerns me is that she sometimes seems to choke, or partially breathe in some milk instead of swallowing it. When this happens, she pulls away from the breast instantly, she chokes, coughs, and gasps for a few seconds. She does it almost every time we feed. She is currently 8 days old... Is it because she's still learning how to coordinate breathing and swallowing together? What if she gets some in her lungs?

  2. #2
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    Default Re: Coughing/choking & gasping

    Sounds like OALD. http://www.kellymom.com/bf/supply/fast-letdown.html

    There are a few things that you can do if your LO is having a hard time with the initial let-down. You can start block feeding - offer the same breast for 2-3 hrs (to start). Also, you can let the first let-down spray into a towel and then latch your LO. The website above may have some other ideas for you - as well as, other moms here.

    HTH

    Jennifer
    Amazed and Proud mom of Luke (Lucas) - 4/5/2006; 9 lbs 12 oz , 22in
    Wife to best friend Carl - 11/4/2001

  3. #3
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    Default Re: Coughing/choking & gasping

    Yes, it sounds like overactive letdown to me as well (OALD). Are you still spraying when your lo pulls off your breast? That is a good sign that she is having trouble handling your flow, which will get easier as she gets older! Luke's mom gives good advice for handling oald!

    Erin
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    Born by one c-section and 2 amazing VBACs


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  4. #4
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    Default Re: Coughing/choking & gasping

    Sure does sound like possible OALD, also sometimes called strong MER (milk ejection reflex). The PPs suggestions are great. Also, you can try nursing while leaning back on some pillows or in a recliner. This way your milk sort of has to fight against gravity to 'escape' and that takes just a little of the edge off the velocity of the flow!

    FWIW, I had this very same issue/experience with my DS and I worried constantly about choking him. My MIL kept reassuring me that he would be OK, that he would grown and learn to handle it... I never totally accepted that - too busy worrying about him.... but it does seem - in hindsight - that she was right. He did fine.....

    Good luck.......
    -linda
    Last edited by jsmom; September 18th, 2006 at 04:13 PM.

  5. #5
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    Default Re: Coughing/choking & gasping

    Hi Sasha -- a baby coming off the breast choking/gasping does sound like overactive letdown, where the milk rushes out so quickly at first that the baby just can't keep up with the flow.

    I don't believe there is any risk of harm if she breathes in a little milk -- it won't be enough to compromise her breathing provided she is a normally healthy newborn, and the breastmilk is full of antibodies, etc., so the milk isn't going to hang around in her lungs and cause an infection (that's the usual risk with aspirated material, as I understand it).

    Newborns seem so tiny and fragile, but they are also "hardwired" with some really amazing reflexes that are all geared towards their survival and well-being. Little Sophie isn't going to let herself be drowned by her momma's milk, so don't worry about that!

    This link from the LLL website is mostly about oversupply of milk, but about midway down the page, you will find some strategies for dealing with overactive letdown as well. This is because OALD and oversupply often occur together ... and I want to make sure you understand this connection, as unnecessary pumping can pretty easily lead to an oversupply problem.

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

    I suspect that your rapid flow of milk is one reason that Sophie has been okay nursing only a few minutes at a time -- she's getting more than we realized! So I think the pieces of the puzzle may be starting to fit together here. I was so happy to see your latest update on the longer thread, with news that you kept her awake and nursing for 25 minutes at one point! Hang in there -- I'm hoping you have turned a corner on the sleepiness and your other concerns, and that it will soon be smooth sailing.

    --Rebecca

  6. #6
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    Default Re: Coughing/choking & gasping

    Whew! At first I was overwhelmed with the idea that I have yet another problem, but it does seem to make so much more sense that she feeds in such shorter sessions!

    I am new at this, and don't really know many people who could give me experienced advice. I spend so much time worrying if I'm doing the right thing, that I overlook the common sense. For some reason I never thought that she could be eating enough because I have lots of milk. And yes, it does continue to spray out after she lets go sometimes. I usually let it drain in a cloth diaper. I didn't think anything of it.

    This makes me feel much better about her short feedings. I thin the main reason that I have been so reluctant to stray from "safety supplementing" is because I feel liek I should be following my pediatrician's orders. She is in favor of nursing, but told me clearly that she should be nursing 10-15 minutes per breast and sleeping an dhour and a half to two hours after eating. She then said that if she doesn't do these things then I need to give her an ounce of formula per feeding.

    I really want to remove formula, but I would also like to remove bottles and pumping until she's old enough to be baby-sat occasionally. I am going to talk to my pediatrician this week and see what she says about my situation. Personally, I'd be much happier to nurse her for shorter sessions more frequently than to supplement.

    Thanks again for all the responses. I've gained some valuable insight.

  7. #7
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    May 2006
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    Default Re: Coughing/choking & gasping

    Just a warning. Peds. are often not very knowledgable in BF and how to remedy problems with it. They are usually supportive as long as it is going well and if not many tend to say "time for formula". If you want one-on-one advice about BF I would strongly recc. finding your local LLL leader or LC. What concerns me is what your ped. said:

    "...but told me clearly that she should be nursing 10-15 minutes per breast and sleeping an dhour and a half to two hours after eating. She then said that if she doesn't do these things then I need to give her an ounce of formula per feeding."

    That is just not what all babies do. Some nurse longer, some shorter and there is a HUGE range in "normal" sleep patterns of newborns. There are many degrees of normal and none need supplemented with formula. You KNOW you are producing enough. Trust yourself! You're doing your baby good!

    Jennifer
    Amazed and Proud mom of Luke (Lucas) - 4/5/2006; 9 lbs 12 oz , 22in
    Wife to best friend Carl - 11/4/2001

  8. #8
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    Default Re: Coughing/choking & gasping

    I too thought it was strange that she laid down such exact guidelines for a newborn, since we all know they make their own rules, besides the fact that they are individuals and there are a wide range of factors that could vary her expectations. I plan on telling her that I have been feeding a certain way and will continue to do so, so long as she looks healthy, hydrated and weighs what she should.

    As of 11 am, I have done nothing but nurse for 24 hours. So far her diaper output is 3 soiled and 3 wet, unless the soiled ones were wet as well. She seems to be a bit more fussy though, sleeps for much shorter intervals, and as mentioned before, I now wish I never pumped at all because my milk flow is just outraegeous for her. Once let down begins sheoften lets go or chokes because the milk is streaming out, even when she lets go. Now here's a good question- is there any way to decrease my lmilk supply, tailor it to her needs? Or will I just have to wait until she grows enough to catch up with it's flow?

  9. #9
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    Default Re: Coughing/choking & gasping

    Did you see this kellymom.com link on forceful letdown and oversupply yet?

    http://www.kellymom.com/bf/supply/fast-letdown.html

    I am a little hesitant to recommend one-breast-per-feeding to you at just 9 days postpartum. I think it might be wise to wait until you know that she is back to birth weight and gaining well on exclusive breastfeeding ... Let's flag a Leader to look at this thread and share her thoughts on that question. In the meantime, you can certainly do the cold compresses between feedings, the "uphill" nursing, and the "spray into a towel" thing.

    About the diapers -- three soiled is a good number for this age. As for the number of wets, I'm wondering if you are checking her diaper every time she nurses? Disposables in particular are very absorbent and can feel quite dry to the touch even with some urine in them. Have you tried pouring a couple tablespoons of water into a clean diaper and then lifting it to feel the weight difference? That will give you an idea of what one wet diaper is like.

    I suspect it is safe to assume that the dirty diapers are also wet, and I don't think a dehydrated baby would be pooping three times a day.

    --Rebecca

  10. #10
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    Default Re: Coughing/choking & gasping

    I feel horrible! Now that I know I have enough milk, it turns out I have too much! So much sprays out all on it's own after she gets it going and lets go... I feel so badly every time she coughs and chokes... She has refused to nurse a few times already and sometimes gets a rattle when she breathes,I assume form milk she half-breathed.

    I wish I'd never pumped now, but I was just trying to do the right thing. I was so worried she wasn't getting enough to eat... Now I'm afraid she won't WANT to eat. I read the article, it says it could take up to three months to solve the problem!

    I wonder what else I can do...

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