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Strong letdown

Posted by on Jul. 31, 2014 at 10:50 PM
  • 7 Replies

This may seem silly but my newborn is spitting up.. a lot. From what I can find it seems like it has to do with the fact I have a strong letdown. I know I do. He gets scared of it and lets go most of the time or was. Anymore he seems to try and eat threw it more and then it all comes back. I've tried pumping before hand to make sure it's not over full, which happens a lot. But even after taking 6-8 oz I still have a shooting strong let down and he chokes on it. I don't know what to do about it. Any suggestions? 

by on Jul. 31, 2014 at 10:50 PM
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Replies (1-7):
masesmom
by Member on Jul. 31, 2014 at 11:03 PM
Best advice I got was to unlatch baby and letdown into a towel. Hand express a little to help.
mostlymaydays
by Group Mod-Stacy on Jul. 31, 2014 at 11:33 PM
Pumping 6-8 oz is over stimulating. That's 2 extra feeds right there. Your body is wondering if you have twins and is constantly readying the milk for that extra demand. Only pump to take the edge off. Yes, you will get uncomfortably full, and that's the point. Your body needs to get the signal that it's in hyperdrive. You may also want to slow down how often you switch breasts. Try only only breast per feeding; or for two consecutive feedings. (I end up nursing on only one breast during 6 hour blocks, for a week or two until this is managed and then can nurse back and forth on both breasts again.) Go to kellymom.com and search oversupply/overactive letdown for more tips here. Smart of you to recognize what the problem is here! I have yet to even have a pediatrician acknowledge the mess of overactive letdown.
gdiamante
by Group Mod - Gina on Jul. 31, 2014 at 11:57 PM
1 mom liked this

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 againstthe 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

Am I making too much milk? from La Leche League International

Fighting the Battle Against Oversupply  by Vanessa Manz

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

hillmom
by New Member on Aug. 1, 2014 at 9:42 AM
As a mom who has had forceful let down with all my kids, and I'm sure I will with #4 too, I understand. Taking baby off when letdown hit worked best for us. I also produce enough in the beginning to feed triplets, and can still shoot milk across the room when baby is 18 months. A more laid back nursing position is also helpful for us. Letting gravity help hold the tsunami back.
Mylilmonkey1120
by New Member on Aug. 1, 2014 at 12:17 PM

I know it is. But just to do it threw a let-down is over 4oz. I get 6-8 in less then 10minutes. I  need to pump to some since I'll be going back to work soon but it's insane. If I don't pump at all they just letdown on their own and that's a whole other mess. Speaking of which any tips for getting it out of .. well everything, the bed, the couch it came out fine from my tops but going threw 5-6 a day is nuts too. I tried a wet rag but I can see spots still.

I only figured it out since I end up with puddles on the floor behind him if he lets go. =/

Quoting mostlymaydays: Pumping 6-8 oz is over stimulating. That's 2 extra feeds right there. Your body is wondering if you have twins and is constantly readying the milk for that extra demand. Only pump to take the edge off. Yes, you will get uncomfortably full, and that's the point. Your body needs to get the signal that it's in hyperdrive. You may also want to slow down how often you switch breasts. Try only only breast per feeding; or for two consecutive feedings. (I end up nursing on only one breast during 6 hour blocks, for a week or two until this is managed and then can nurse back and forth on both breasts again.) Go to kellymom.com and search oversupply/overactive letdown for more tips here. Smart of you to recognize what the problem is here! I have yet to even have a pediatrician acknowledge the mess of overactive letdown.


mostlymaydays
by Group Mod-Stacy on Aug. 1, 2014 at 1:08 PM
The 8 oz you pump is enough already for an 8 hour workday. As long as you keep pumping that much you'll keep making that much. Read the kellymom.com info about oversupply and overactive letdown. You may have to suffer through some engorgement to get the engorgement to go away. There is also another method of managing oversupply that involves pumping to empty in the morning and then block feeding through the day. I'll get the link so you can read the technique.

(And to go back to work you only need to have enough pumped for the first day: 8-10 oz for an 8 hour day- and from there you pump on one day what you'll leave the next. You don't need a *stash*, especially when your body is trying to regulate and you and/or baby are suffering from oversupply/OAL problems)


Quoting Mylilmonkey1120:

I know it is. But just to do it threw a let-down is over 4oz. I get 6-8 in less then 10minutes. I  need to pump to some since I'll be going back to work soon but it's insane. If I don't pump at all they just letdown on their own and that's a whole other mess. Speaking of which any tips for getting it out of .. well everything, the bed, the couch it came out fine from my tops but going threw 5-6 a day is nuts too. I tried a wet rag but I can see spots still.

I only figured it out since I end up with puddles on the floor behind him if he lets go. =/

Quoting mostlymaydays: Pumping 6-8 oz is over stimulating. That's 2 extra feeds right there. Your body is wondering if you have twins and is constantly readying the milk for that extra demand. Only pump to take the edge off. Yes, you will get uncomfortably full, and that's the point. Your body needs to get the signal that it's in hyperdrive. You may also want to slow down how often you switch breasts. Try only only breast per feeding; or for two consecutive feedings. (I end up nursing on only one breast during 6 hour blocks, for a week or two until this is managed and then can nurse back and forth on both breasts again.) Go to kellymom.com and search oversupply/overactive letdown for more tips here. Smart of you to recognize what the problem is here! I have yet to even have a pediatrician acknowledge the mess of overactive letdown.

mostlymaydays
by Group Mod-Stacy on Aug. 1, 2014 at 1:09 PM
Here's that link for managing oversupply:


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2075483/
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