Lazy nurser + abundant supply = ouch

[Harmony96]

DS is 1 week old today, and ever since my milk came in, I can't seem to get him to empty me when he's eating. He's a lazy nurser and will swallow only about three times on his own before his eyes start to close and/or he lets the nipple just fall out of his mouth. It doesn't help matters any that I'm massively engorged, so latching him on seems like a 3-handed effort. But b/c he isn't emptying me (I feel softer, but definitely still swollen, and not nearly as soft as I should feel after a feeding), the engorgement is not going away.

I mostly want to address the lazy nursing, b/c I feel like once that is resolved, then the 24/7 engorgement will also be helped. I am already undressing him and stretching him during feedings and taking a washcloth to stimulate him. I don't know how many times/day he is nursing b/c I only just started keeping track of that last night. And also, rather than letting him eat as long as he wants on just one breast (b/c if I do this, then I can't get him to take the second one at all), I've tried to give him 5 minutes on the first breast, then as long as he wants on the second one. Then the next time he eats, I start the 5 minutes w/ the "long" breast from the prior feeding, to try to get the engorgement down a little bit.

But is there anything else I can be doing? He did have a little bit of jaundice, but it's well on its way out the door now. When DD was this old, I don't remember still having this problem. She latched on and stayed on and ate and that was that. I don't want to pump, either, b/c I don't want to make the engorgement any worse (although I guess if I want to build up any freezer stash at all, now would be the time to do it, right? lol).

[cdmommie]

I had the same problem with DD2. I eventually realized that I was just nursing her too often so she was never actually getting a full feeding and therefore never hungry enough to empty me. My first nursed like every 45min to 90 min so I just assumed every hour and a half or 2 hrs I would put DD2 to the breast and all would be well. It turned out that DD2 only needed to nurse every 3 hours and sometimes it was even 3.5 durring those first 3 months.
However, I also started pumping because of the major oversupply and I donate everything I pump. I felt compelled to help other mamas out so this works for us. I didn't start pumping until she was almost 4 months old though. If I had known about MilkShare I would have started sooner.

Eventually I think your body should regulate, but personally I dealt with an oversupply with both girls so I can't tell you when "regulation" would happen.
Good Luck!

[pastrygirl]

I would have him checked for tongue tie, and a posterior one in particular. My older son couldn't latch on well, and my 7-week-old could latch but couldn't empty the breast until we had his tongue tie clipped at 4 weeks. Both had posterior tongue ties. The laziness was a telltale sign -- if he could get the milk to flow faster, he wouldn't fall asleep so much.

[ashleedio]

I had had a similar problem with my ds, and on the advice of the lactation consultant, I'd self-express a little milk into a bottle or burp cloth before trying to latch him. It helped him to latch because I wasn't QUITE as engorged. I had ds's bili levels rechecked and he wasn't high, but I think that it has a lot to do with how sleepy he is at the breast. I just do a lot of skin to skin, and stimulate him the best I can, and keep telling myself that this, too, will pass, once my body knows how much milk he needs. Good luck - I know how painful and frustrating it can be.

[sunnygir1]

My dd was preterm and a lazy nurser and jaundiced. It took a good 2 weeks or more for her to start nursing enough that I wasn't worried about her not getting enough.

I pumped, sometimes before she nursed to ease the engorgement and make it easier for her to latch on. I used hot compresses before pumping or nursing. I froze the milk and didn't have a problem using it up later. I tried to pump only as much as I needed to to relieve the engorgement so that dd could regulate my supply to her needs. It worked out fine within a few weeks.

You might actually want to switch to block feeding and pumping on the other breast to take the pressure off. If your lo is nursing for 5 minutes on one breast and then switching to the other, he may not be getting enough hind milk, especially if he is never emptying your breasts

Hang in there, mama.