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Because of the discomfort for baby and I, please give knowledge!

Posted by on Sep. 20, 2012 at 4:30 AM
  • 12 Replies
My son was in the NICU after birth and was on the bottle when he came home. It took several weeks to get him on the breast once returning home. I pumped ALOT when he was in the hospital and when he came home to make sure that I had enough milk plus some. I know have a ridiculous over supply. I should have known better to pump so much but I was anxious in making sure he got breastmilk and having back up in the freezer.

My son currently eats every 2 to 3 hours. He is currently gaining weight well but of course an oversupply creates other issues as stated below.

Having such an oversupply has caused him to spit up (overflow like a water flow) after each feeding, is super gassy, and he all of a sudden wants to nurse often. If I pump before I feed him he does not have such problems so I know it's not reflux. However, pumping before hand just creates more milk! I only pumped before hand to get him at the breast in the beginning but I'm paying for it now.

My question is, how do I get my milk to adjust for the comfort of my baby and I?

How long does it normally take for a milk supply to adjust?

How do I deal with really really full breasts until it adjusts?

(When I say oversupply, I can easily pump over 4 ounces from each breast every few hours. Which also means it does not take long til I feel super or painfully full).
by on Sep. 20, 2012 at 4:30 AM
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Replies (1-10):
mama02040608
by on Sep. 20, 2012 at 7:00 AM
One breast for a number of hours (3, 6,......some women even have a day boob and a night boob) and after that time is up, switch. Keep alternating until both of you stop being miserable or until it is manageable for both of you. Pump or hand express the unused side for comfort. OT takes a few weeks but will work.
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K8wizzo
by Kate on Sep. 20, 2012 at 8:45 AM
1 mom liked this

http://kellymom.com/bf/got-milk/supply-worries/fast-letdown/

Forceful Let-down (Milk Ejection Reflex) & Oversupply

AUGUST 20, 2011. Posted in: SUPPLY WORRIES

By Kelly Bonyata, BS, IBCLC

 Is forceful let-down the problem?

Does your baby do any of these things?

  • Gag, choke, strangle, gulp, gasp, cough while nursing as though the milk is coming too fast
  • Pull off the breast often while nursing
  • Clamp down on the nipple at let-down to slow the flow of milk
  • Make a clicking sound when nursing
  • Spit up very often and/or tend to be very gassy
  • Periodically refuse to nurse
  • Dislike comfort nursing in general

If some of this sounds familiar to you, you probably have a forceful let-down. This is often associated with too much milk (oversupply). Some mothers notice that the problems with fast letdown or oversupply don’t start until 3-6 weeks of age. Forceful let-down runs the gamut from a minor inconvenience to a major problem, depending upon how severe it is and how it affects the nursing relationship.

What can I do about it?

There are essentially two ways you can go about remedying a forceful let-down: (1) help baby deal with the fast flow and (2) take measures to adjust your milk supply down to baby’s needs. Since forceful let-down is generally a byproduct of oversupply, most moms will be working on both of these things. It may take a couple of weeks to see results from interventions for oversupply, so try to be patient and keep working on it.

Help baby deal with the fast milk flow

  • Position baby so that she is nursing “uphill” in relation to mom’s breast, where gravity is working against the flow of milk. The most effective positions are those where baby’s head and throat are above the level of your nipple. Some nursing positions to try:
    • Cradle hold, but with mom leaning back (a recliner or lots of pillows helps)
    • Football hold, but with mom leaning back
    • Elevated football hold – like the football hold, but baby is sitting up and facing mom to nurse instead of lying down (good for nursing in public).
    • Side lying position – this allows baby to dribble the extra milk out of her mouth when it’s coming too fast
    • Australian position (mom is “down under”, aka posture feeding) – in this position, mom is lying on her back and baby is on top (facing down), tummy to tummy with mom. Avoid using this positioning frequently, as it may lead to plugged ducts.
  • Burp baby frequently if she is swallowing a lot of air.
  • Nurse more frequently. This will reduce the amount of milk that accumulates between feedings, so feedings are more manageable for baby.
  • Nurse when baby is sleepy and relaxed. Baby will suck more gently at this time, and the milk flow will be slower.
  • Wait until let-down occurs, then take baby off the breast while at the same time catching the milk in a towel or cloth diaper. Once the flow slows, you can put your baby back to the breast.
  • Pump or hand express until the flow of milk slows down, and then put baby to the breast. Use this only if nothing else is working, as it stimulates additional milk production. If you do this, try to express a little less milk each time until you are no longer expressing before nursing.

Adjust your supply to better match baby’s needs

  • If baby is gaining weight well, then having baby nurse from only one breast per feeding can be helpful.
  • If baby finishes nursing on the first side and wants to continue nursing, just put baby back onto the first side.
  • If the second side becomes uncomfortable, express a little milk until you’re more comfortable and then use cool compresses – aim for expressing less milk each time until you are comfortable without expressing milk.
  • Avoid extra breast stimulation, for example, unnecessary pumping, running the shower on your breasts for a long time or wearing breast shells.
  • Between feedings, try applying cool compresses to the breast (on for 30 minutes, off for at least an hour). This can discourage blood flow and milk production.
  • If nursing one side per feeding is not working after a week or so, try keeping baby to one side for a certain period of time before switching sides. This is called block nursing.
    • Start with 2-3 hours and increase in half-hour increments if needed.
    • Do not restrict nursing at all, but any time that baby needs to nurse simply keep putting baby back to the same side during that time period.
    • If the second side becomes uncomfortable, express a little milk until you’re more comfortable and then use cool compresses – aim for expressing less milk each time until you are comfortable without expressing milk.
    • In more extreme cases, mom may need to experiment a bit with time periods over 4 hours to find the amount of time per breast that works best.
  • Additional measures that should only be used for extreme cases of oversupply include cabbage leaf compresses and herbs.
  • Even if these measures do not completely solve the problem, many moms find that their abundant supply and fast let-down will subside, at least to some extent, by about 12 weeks (give or take a bit). At this point, hormonal changes occur that make milk supply more stable and more in line with the amount of milk that baby needs.

    Sometimes babies of moms with oversupply or fast let-down get very used to the fast flow and object when it normally slows somewhere between 3 weeks to 3 months. Even though your let-down may not be truly slow, it can still seem that way to baby. See Let-down Reflex: Too Slow? for tips.

     

     Additional Information

    Too Much Milk? by Becky Flora, IBCLC

    Oversupply by Kathy Kuhn, IBCLC

    Tips for taming a monster milk supply by Kathy Kuhn, IBCLC

    Gaining, Gulping, and Grimacing? by Diane Wiessinger, MS, IBCLC

    Oversupply: Too Much Milk by Anne Smith, IBCLC

    Colic in the Breastfed Baby by Jack Newman MD, FRCPC

    Finish the First Breast First by Melissa Vickers (LEAVEN, September-October 1995, p. 69-71)

    Overactive Let-Down: Consequences and Treatments by Mary Jozwiak (from LEAVEN, September-October 1995, pp. 71-72)

    Common Side Effects of an Overactive Let-Down by Mary Jozwiak (from LEAVEN, September-October 1995, p. 69)

    Too Much of a Good Thing by Kate Drzycimski, from New Beginnings Vol. 19 No. 9, July-August 2002, p. 129.

    PDF Resolution of Lactose Intolerance and “Colic” in Breastfed Babies by Robyn Noble & Anne Bovey, presented at the ALCA Vic (Melbourne) Conference on the 1st November, 1997

    gdiamante
    by Group Mod - Gina on Sep. 20, 2012 at 10:30 AM


    Quoting Angel_Red7:

    My question is, how do I get my milk to adjust for the comfort of my baby and I?
    As long as it takes. If you're not already using the oversupply techniques on kellymom, START NOW. Reclined nursing can provide relief for baby instantly.
    How long does it normally take for a milk supply to adjust?
    Six weeks from birth. In your case, we can probably get you adjusted in far les time but key to it is reducing and then stopping the pumping.

    How do I deal with really really full breasts until it adjusts?
    Cabbage leaves in your bra... no more than five minutes. Ice packs. Pump ONLY enough to take the barest edge off.. when you're not gritting your teeth, STOP even if you're still full. That's how you tell the factory to slow down production.

    (When I say oversupply, I can easily pump over 4 ounces from each breast every few hours. Which also means it does not take long til I feel super or painfully full).
    That says to me you're pumping too much which is merely adding to your troubles. Pump a LITTLE. When you have an ounce per bottle, put the pump away.


    Angel_Red7
    by on Sep. 20, 2012 at 10:57 AM
    Thanks! Yes, I was pumping a lot while my baby was in the hospital and then I started pumping every 3 hours once he returned home but was still on the bottle. Once I got him to take the breast after a few days I found myself pumping twice a day (before his feeding) because I felt extremely uncomfortable. I pumped yesterday morning only to realize that I am getting too much.

    Since last night I started recline feeding. He is still a little fussy but much less spitting up. I am hoping it doesn't take too long for my milk to adjust. I have been so full that I spray when I take off my bra or drip and it is super watery.

    I have started block feeding and pumped literally less than an ounce from each breast today so I could breathe. I am still so full tho that my baby chokes, gulps, cries, and so on.

    Would it help any if for 24 hours I give him a few bottles and pump at least an ounce from each breast every few hours? I just feel bad that every feeding is like a gushing hose for him no matter how long he feeds for....

    Quoting gdiamante:


    tabi_cat1023
    by Group Mod - Tabitha on Sep. 20, 2012 at 11:08 AM

    I would not go back to the bottle...toss the pump, hand express only.  Start with 4 hour blocks if after 2 days that doesnt work move to 6 hour blocks.  

    Since supply is SO high, you can do rounds of sudafed for a few days, you can try chilld crushed cabbage leaves in your bra

    mama02040608
    by on Sep. 20, 2012 at 11:14 AM
    If you're that full, you could try pumping fully in the am and then starting your blocks. It is suggested to do this in LLLI's 'The Womanly Art of Breastfeeding' for those who have severe oversupply.

    As your supply regulates, you can back off on the am pumping or keep it to maintain pump response.


    Quoting Angel_Red7:

    Thanks! Yes, I was pumping a lot while my baby was in the hospital and then I started pumping every 3 hours once he returned home but was still on the bottle. Once I got him to take the breast after a few days I found myself pumping twice a day (before his feeding) because I felt extremely uncomfortable. I pumped yesterday morning only to realize that I am getting too much.



    Since last night I started recline feeding. He is still a little fussy but much less spitting up. I am hoping it doesn't take too long for my milk to adjust. I have been so full that I spray when I take off my bra or drip and it is super watery.



    I have started block feeding and pumped literally less than an ounce from each breast today so I could breathe. I am still so full tho that my baby chokes, gulps, cries, and so on.



    Would it help any if for 24 hours I give him a few bottles and pump at least an ounce from each breast every few hours? I just feel bad that every feeding is like a gushing hose for him no matter how long he feeds for....



    Quoting gdiamante:


    Posted on CafeMom Mobile
    gdiamante
    by Group Mod - Gina on Sep. 20, 2012 at 11:52 AM


    Quoting Angel_Red7:

    I have started block feeding and pumped literally less than an ounce from each breast today so I could breathe. I am still so full tho that my baby chokes, gulps, cries, and so on.
    Hand express a little into a towel before latching to get the worst of the letdown.
    Would it help any if for 24 hours I give him a few bottles and pump at least an ounce from each breast every few hours? I just feel bad that every feeding is like a gushing hose for him no matter how long he feeds for....
    No, that would make things just as bad. I'd actually put the pump away, hand express when things feel bad ONLY enough to take the edge off and to get rid of the first letdown when you feed. Every pump encourages the firehose effect.
    Gruntlings
    by on Sep. 20, 2012 at 12:20 PM

    You want to decrease your milk supply until he can manage it. This is usually done with block feeding, but in your case your supply is so high that you might easily pay for that with mastitis.

    What everyone has recommended so far is good, but your supply is a bit high for switching to block feeding just yet, and I get the feeling that "taking the edge off" is still going to result in more milk pumped than would be necessary to feed two of your babies.

    I would suggest sage tea. Sage tea dries milk up. You'll want to start with a single cup of VERY dilute sage tea and wait two days and see if you have any effect on your milk supply. Then you gradually make it stronger until you start seeing a decrease in what you are pumping. Once you start seeing a decrease you can wean off of the pump and start block feeding. Be careful because sage can decrease your supply pretty quickly if your body reacts to it. Make sure you don't misinterpret growth spurt behavior for having "dried up" all the way. If your milk dips too fast you can bring it back. But don't go nuts with the sage tea until you know how you respond to it.

    Definitely do the cabbage leaves, and don't "pump until you're empty". When you leave milk in the breast it signals to the body to decrease milk production.

    -Sarah
    ---------------------------------------------------------
    Sarah is a mom to three and a moderator in the "Breastfeeding Moms" group. She runs Nurshable.com where she blogs about finding joy in gentle parenting.


    Angel_Red7
    by on Sep. 20, 2012 at 1:00 PM
    I am really sensitive and would rather not risk anything with the sage tea. When I weaned my toddler I was able to go cold turkey by using sage tea only a few times.

    I am not too sure what you are telling me tho. Are you recommending to wait on block feeding and pump to prevent an infection or are you bluntly telling me that there is no way around an infection at this point?

    Quoting Gruntlings:

    You want to decrease your milk supply until he can manage it. This is usually done with block feeding, but in your case your supply is so high that you might easily pay for that with mastitis.

    What everyone has recommended so far is good, but your supply is a bit high for switching to block feeding just yet, and I get the feeling that "taking the edge off" is still going to result in more milk pumped than would be necessary to feed two of your babies.

    I would suggest sage tea. Sage tea dries milk up. You'll want to start with a single cup of VERY dilute sage tea and wait two days and see if you have any effect on your milk supply. Then you gradually make it stronger until you start seeing a decrease in what you are pumping. Once you start seeing a decrease you can wean off of the pump and start block feeding. Be careful because sage can decrease your supply pretty quickly if your body reacts to it. Make sure you don't misinterpret growth spurt behavior for having "dried up" all the way. If your milk dips too fast you can bring it back. But don't go nuts with the sage tea until you know how you respond to it.

    Definitely do the cabbage leaves, and don't "pump until you're empty". When you leave milk in the breast it signals to the body to decrease milk production.


    Gruntlings
    by on Sep. 20, 2012 at 1:05 PM

    Ok, if you're sensitive that's probably a good thing and you can probably bring your supply under control easier. Drying up/weaning a toddler with sage tea is a bit different from weaning down from massive over supply, but if you're concerned and responded that well to it before, I agree that avoiding it is a good idea.

    I'm not saying "there is no way around an infection". Just "be careful".

    Try to decrease the pumped amount by a half ounce per session each day. Then once you no longer need to pump to prevent engorgement you can do block feeding if you need to bring your supply down further.

    Quoting Angel_Red7:

    I am really sensitive and would rather not risk anything with the sage tea. When I weaned my toddler I was able to go cold turkey by using sage tea only a few times.

    I am not too sure what you are telling me tho. Are you recommending to wait on block feeding and pump to prevent an infection or are you bluntly telling me that there is no way around an infection at this point?

    Quoting Gruntlings:

    You want to decrease your milk supply until he can manage it. This is usually done with block feeding, but in your case your supply is so high that you might easily pay for that with mastitis.

    What everyone has recommended so far is good, but your supply is a bit high for switching to block feeding just yet, and I get the feeling that "taking the edge off" is still going to result in more milk pumped than would be necessary to feed two of your babies.

    I would suggest sage tea. Sage tea dries milk up. You'll want to start with a single cup of VERY dilute sage tea and wait two days and see if you have any effect on your milk supply. Then you gradually make it stronger until you start seeing a decrease in what you are pumping. Once you start seeing a decrease you can wean off of the pump and start block feeding. Be careful because sage can decrease your supply pretty quickly if your body reacts to it. Make sure you don't misinterpret growth spurt behavior for having "dried up" all the way. If your milk dips too fast you can bring it back. But don't go nuts with the sage tea until you know how you respond to it.

    Definitely do the cabbage leaves, and don't "pump until you're empty". When you leave milk in the breast it signals to the body to decrease milk production.



    -Sarah
    ---------------------------------------------------------
    Sarah is a mom to three and a moderator in the "Breastfeeding Moms" group. She runs Nurshable.com where she blogs about finding joy in gentle parenting.


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