Fat and Frequent Spit-ups

[Lineymom]

I have bfed all three of my children. They were all very big babies. My DD is 5.5 months and HUGE. She started out at 9lb10oz, which was smaller than her brothers, but has now pasted them. They were both 23lbs at 6 months, she is already about 25lbs and not as long as they were, thus fatter.
I know you are not supposed to be able to make a bfed baby too fat, but I am doubting that now. I KNOW she overeats. It is a combination of the super milk supply I have and her frequent nursing. She wants to just comfort nurse... but there is a huge supply. She spits-up a lot, way more than my others did. They took pacies, she won't, so I think that contributes. By this age with them I don't think they really spit-up at all, and I did not leak. I have to wear nursing pads still! She spits up many many times a day, in spurts. Like one week, all the time and the next week, not so much. Most of her poop is yellow, but sometimes she has green, so too much foremilk, right?
I don't really know what I am looking for by posting this, but please go ahead with any advice. Oh, and no we haven't started solids.

[Llyra]

Have you tried block feeding? If you have, I apologize for being redundant, but if you haven't, you might consider it.

I'm going to explain what it is, for you if you haven't done it, and for anyone else who wonders. Forgive me if I'm rattling on and on about something you already have tried...

That means you keep baby on one side for a specified period of time, no matter how many times baby nurses during that time. Start with say four hours, and if baby nurses more than once during that time, she goes back on that same side. You only make the other side available after the time block is over, and then you stay on THAT side for that period of time. If four hours doesn't help enough, go to five or six hours on each side, until you get to a point where the supply and demand are more in sync with each other.

Each time you go for a longer block, give it four or five days to even out, and then see how she's doing then. It'll take a few days for the supply to get the message to reduce.

If baby starts to complain about overly reduced supply, or you notice too little urine output, or weight gain slows too much, you go back to shorter blocks for awhile.

You may find that you are VERY uncomfortably full on the "off side" by the end of the time block. Don't pump. It's okay to express just a bit to take the pressure off, but pumping is going to continue telling your breasts to make more, more, more. The discomfort should become less within a few days.

This is a classic method of reducing oversupply. It also helps with the comfort nursing, because the breast that baby is on will be less overwhelmingly full. If it works well, by the end of the time block baby will be getting trickles of hindmilk instead of gushing bellyfuls.

As for baby's weight and the spitting-- the spitting is her way of getting rid of what she doesn't need. Reducing the oversupply should help a lot. Keep in mind though that some kids just spit a LOT and it's okay. My DD1 for example spit up in fountains and rivers until she learned to walk. She's fine now; she's five now and slim and healthy.

What I wouldn't do is to restrict how often baby nurses, or how long she spends on a breast. I don't think that's wise, because I think it's important that we don't make "eating" into a struggle issue. Baby should be allowed to nurse on cue as always.

FWIW, did your older kids slim down once they got mobile and ate more solids?

[goodygumdrops]

I agree completely with Lyra

Green frothy poop is a sign of oversupply not hindmilk/foremilk issues.

[isabchi]

Ditto!

[Parker'smommy]

I've heard of babies with reflux eating more because nursing soothes their irritated throats. Just an idea...

[Lineymom]

Thanks to the replies!
I don't block feed by that strict of standards, but I do try to only do one breast per feeding. I am very prone to clogged ducts/mastitis, so I really can't let myself get too engorged. 4-5 hours in the day would kill me! At night, we probably do that. we cosleep and I think I only switch sides once during the night (I sleep really good, so not sure)

I guess I will time it and see how many hrs I can keep from switching sides in the day.

Her poop is only sometimes green, and never a full dipe of it when it is. maybe ever couple of days she will have a small green one followed by or after another that is yellow.

Oh... she is also fussy... but I think thats teething.

Yeah my boys are skinny now. Still off the charts in height while down to about average for weight.

goodygumdrops: Does oversupply cause fore/hindmilk imbalance? Does it make you have more foremilk? I have kinda assumed that, but i don't know.

You hear so much about babies these days, even bfed ones being on meds for reflux I just was starting to get paranoid about that.

[Llyra]

If you can stick out the four or five hours blocks for just a couple days, your supply should reduce to a point where you're not uncomfortable anymore. It's usually just a matter of enduring it for a few days. It's the multiple feeds on one breast that really make it work.

[Lineymom]

Ok, maybe this sounds lazy, but do I do any harm to her by not doing the block feedings to reduce supply. Is it possible I am letting her get too big or is all I'd be accomplishing by reducing supply is reducing spit-up?

I am nursing her on the left breast now. It has been about 3.5hrs since I last did. She nursed on the right side less than 2hrs ago. If I'd have put her to it again now then it would probably be 6 hrs w/o nursing for the left and I know I'd get a clog... I just can't risk it unless the benefits outweigh the risks, yk.

[goodygumdrops]

We are being taught that there are no differences between hind milk and fore milk nutritionally. We are now told that fat content in bm varies through out the feed.

[Megan73]

Originally Posted by Lineymom

Ok, maybe this sounds lazy, but do I do any harm to her by not doing the block feedings to reduce supply. Is it possible I am letting her get too big or is all I'd be accomplishing by reducing supply is reducing spit-up?

I am nursing her on the left breast now. It has been about 3.5hrs since I last did. She nursed on the right side less than 2hrs ago. If I'd have put her to it again now then it would probably be 6 hrs w/o nursing for the left and I know I'd get a clog... I just can't risk it unless the benefits outweigh the risks, yk.

Honestly, I haven't BTDT but after watching a friend go through mastitis and having an abscess drained I don't think it's the least bit lazy.
It sounds like her weight-gain pattern is normal and healthy for your kids and the spitting up is, as Dr. Sears says, more of a laundry problem than a health problem.
I'd just enjoy my big healthy girl. I bet she's adorable!

[rparker]

Your post could have described my daughter perfectly at that age and now she's 2.5 and on the small side (after being at the top of the charts her first year). I agree with previous posters... it's more of a laundry problem than a medical problem and you can't overfeed an exclusively breastfed baby. My daughter's pediatrician said there was no need for her to be on reflux meds when she was clearly getting enough to eat and didn't appear to be in pain.

For what it's worth I had oversupply and an overactive letdown and DID block feed and it had no impact on her weight gain and only marginally reduced the amount of spit up, although it did make her poop less green. I block fed more for my own comfort (cutting down my supply), so if I knew I was prone to mastitis I'd probably avoid doing it too.

[boobs4milk]

millie is my largest at 19lbs at 7 1/2 mos. she spits a bunch and i know she overeats when she spits because it just comes right back out. like a glass thats too full. it hardly ever smells and it's usually right after she power nurses.

good luck! i'd be wary of block nursing. i had oversupply in the beginning and block nursed to curtail it, then went through low supply and i still struggle at af time!