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Thread: Overactive supply - foremilk/hindmilk balance?

  1. #1

    Default Overactive supply - foremilk/hindmilk balance?

    Hiya! I'm looking for some recommendations regarding overactive supply.

    My one month old baby girl has acid reflux and severe gas problems. Her pediatrician prescribed maalox for the reflux and gas drops as needed (which seems to be every 2-3 hours). The gas drops seem to work for the most part, but she does still have at least a couple episodes a day where her belly is bloated and hard, she's screaming and it takes her 10-15 minutes to pass gas and/or poop. We try the bicycle movements and massage, but she generally has to just work it out on her own.

    She also has problems with gas when she's sleeping. She sleeps in her car seat (only thing she'll sleep in right now, plus it keeps her upright to help with the reflux) and often cries during the night while trying to pass gas. We often have to take her out, let her stretch out and fart, then she'll calm back down.

    In doing some research to see if I could find a cause for the gas, I think I figured out I have an oversupply and an overactive letdown. I've just started trying to pump off an ounce before feeding her to try and reduce the amount of foremilk and to help with the overactive letdown. But I'm wondering if that's enough to pump off? I can easily pump 5-9 ounces per breast after 4+ hours of no feeding. (I pumped 14 ounces the other day after about 6 hours of no feeding.) I watched the pumping tonight and the first 2 ounces looked almost just like water. By ounce 3, it started to get a little more color to it.

    My question is, do you think I should pump off more than an ounce? Sometimes it's hard to get just that ounce out while she's screaming to eat, but if it'll help her gas in the end, I figure I should do it. And I don't want to pump more than I have to since I already have more than enough supply. (And I'm okay with the oversupply as long as it doesn't hurt her - it's giving me a wonderful back-up supply for when I'm back to work full-time, plus I'm able to donate some.)

    By the way, her weight gain is great (born at 8 lbs, 8 oz and was 10 lbs, 13 oz at 3 weeks). And we're using a nipple shield due to flat nipples.
    She's bottle fed (with pumped milk) by my husband as needed. And she's a hungry girl - will usually take 4-6 ounces per feeding by bottle, but she does eat slowly (possibly due to the reflux?) and feedings often last 1-2 hours. To give you an idea of her appetite, when my parents watched her a week ago, she ate 11 ounces in 4 hours.

    So, do you think I should pump more than 1 oz off before a feeding? Any other suggestions you have?

    Thanks in advance!

  2. #2
    Join Date
    Nov 2008

    Default Re: Overactive supply - foremilk/hindmilk balance?

    Do you notice a difference in the gassiness when you pump first? What do her stools look like?

    My first thought is that if it is oversupply, then pumping before nursing will help for an individual feeding, but overall it's going to increase your supply. Have you tried nursing on only one side per feeding? Or even on the same side for two or three feedings in a row? Block feeding can cut down the amount of foremilk your baby is getting and get your supply under control if you have too much. But since it's actually reducing your supply, you should only try it if your baby is gaining well.

    How often are you nursing? Is your baby sleeping through the night? It's just that 4-6 hours without nursing seems like a long time for a one month old, unless it's a long stretch of nighttime sleep. Foremilk is the milk that's been stored in your breasts between feedings -- it started out high in fat and as it collects behind the nipple the fat is reabsorbed. The more frequently you nurse, the less that happens and the higher the fat content will be. It can seem counterintuitive to nurse more often when you have an oversupply, but, especially combined with block feeding, it can really help.

  3. #3
    Join Date
    May 2006

    Default Re: Overactive supply - foremilk/hindmilk balance?

    Excellent advice from the PP. I think I'd leave the pump alone for now, and focus on taming the oversupply via block feeding. When you have a supply that's more in line with your baby's needs, that's a good time to try the pump again.

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