Too much glandular tissue?

[AdalynsMama]

I'm pregnant with my third baby and feel a lot of anxiety about nursing again. With my past two babes I've experienced major over-supply issues that didn't resolve until introducing solids and a sippy cup. In addition to extremely painful engorgment and let-down for the first six months both babes had to deal with forceful letdown and foremilk/hindmilk imbalance. The only thing I found that helped before introducing solids was pumping twice in a 24 hour period and only nursing after pumping for a few minutes. I was expressing 9 oz per side each pumping session (36 oz total per 24 hrs) not counting hand expressing an oz or so a few times a day to relieve severve engorement pain. So now that I'm pregnant again I'm wondering if there is an opposite to hydroplastic breasts/ too little glandular tissue? Has anyone heard of this? I have a lot of glandular tissue in my arm pit area that is lumpy and super sore already and will also become engorged when my milk comes in. I hate even thinking about the hell my babe and I will go through Besides birth control pills I've tried everything: sage, B6, cutting calories, block feeding 24 hours per breast. Anyone have advice or experiences to share? Any feedback is greatly appreciated! TIA!

[CheriK]

Wow! You're definitely blessed with too much of a good thing. Have you thought about donating to a milk bank?

You've probably already read this info, as it sounds like you've tried the tips listed, but just in case: http://www.llli.org/FAQ/oversupply.html

The challenge with pumping, as you probably already know, is that when you remove milk you're signalling your body to make more. Besides pumping once or twice a day to "empty", ideally you'll want to avoid it. Definitely only pump if you absolutely have to, and only to relieve the worst engorgement (yes, I know, easier said than done when you are so full you know baby will just drown if you try to nurse). When you express immediately before nursing, are you expressing both sides? Double pumping increases stimulation and hormone levels; it's actually recommended as a method to increase supply. You'll want to pump only the breast you're about to feed on, and leave the other breast full.

Nursing Mother's Herbal by Sheila Humphrey also lists peppermint as an anti-galactogogue. She recommends making peppermint tea and adding up to a quarter teaspoon of essential oil to a quart of tea, drinking several cups a day. She does caution against it's use in women w/ liver or gallbladder disease. She also lists doses for sage and parsley; you might want to research to be sure you were using enough.

How long did you continue block feeding in the past, and when did you start? I wonder if starting as soon as your milk starts to come in with this baby would help. Also, you may need to block feed for a LONG time for it to be effective. . .perhaps as long as you continue nursing, or at least until your LO starts solids. Have you used cabbage leaves for the engorgement? Some women find that cabbage leaves also lower supply. Potato or carrot (raw, grated) poltices can help with engorgement, too (rinse off before nursing ).

Are you opposed to trying estrogen/birth control pills? I'd definitely work with an IBCLC if you try. My understanding is you only take them for a short time - a week or so, or until your supply starts to drop. Working with an IBCLC who's used this technique would be important to avoid decreasing supply too drastically. Pseudophedrine can lower supply, too.

[AdalynsMama]

Thanks so much for your reply!!

Originally Posted by CheriK

Wow! You're definitely blessed with too much of a good thing. Have you thought about donating to a milk bank?

I donated to quite a few mamas in the area, but not to a bank.

You've probably already read this info, as it sounds like you've tried the tips listed, but just in case: http://www.llli.org/FAQ/oversupply.html

The challenge with pumping, as you probably already know, is that when you remove milk you're signalling your body to make more. Besides pumping once or twice a day to "empty", ideally you'll want to avoid it. Definitely only pump if you absolutely have to, and only to relieve the worst engorgement (yes, I know, easier said than done when you are so full you know baby will just drown if you try to nurse). When you express immediately before nursing, are you expressing both sides? Double pumping increases stimulation and hormone levels; it's actually recommended as a method to increase supply. You'll want to pump only the breast you're about to feed on, and leave the other breast full.

I was actually pumping exclusively hoping that only twice in a 24 hr period would be enough to drop my supply. I never pumped to relieve engorgement; only to empty. Normally at 7am and 9pm. I was pumping both sides at the same time, only because I wasn't nursing. Pumping each side at a different time would only add to the amount of time I spent at the pump

Nursing Mother's Herbal by Sheila Humphrey also lists peppermint as an anti-galactogogue. She recommends making peppermint tea and adding up to a quarter teaspoon of essential oil to a quart of tea, drinking several cups a day. She does caution against it's use in women w/ liver or gallbladder disease. She also lists doses for sage and parsley; you might want to research to be sure you were using enough.

I've tried the peppermint and sage, but not the parsley. I'll def look into those more.

How long did you continue block feeding in the past, and when did you start? I wonder if starting as soon as your milk starts to come in with this baby would help. Also, you may need to block feed for a LONG time for it to be effective. . .perhaps as long as you continue nursing, or at least until your LO starts solids. Have you used cabbage leaves for the engorgement? Some women find that cabbage leaves also lower supply. Potato or carrot (raw, grated) poltices can help with engorgement, too (rinse off before nursing ).

I started block feeding as soon as my milk came in. I was doing 12 hour blocks when I was nursing and stopped nursing at about 10 weeks and switched to pumping exclusively which was also on 12 hour blocks. I would occasionaly offer to nurse DS immediately after pumping to make sure he would still nurse. He stopped taking the nipple at about 6 months so I boxed up my pump and threw the bottles away. I continued to do 12 hour blocks until he weaned at 18 months. The cabbage leaves didn't work at all.
Are you opposed to trying estrogen/birth control pills? I'd definitely work with an IBCLC if you try. My understanding is you only take them for a short time - a week or so, or until your supply starts to drop. Working with an IBCLC who's used this technique would be important to avoid decreasing supply too drastically. Pseudophedrine can lower supply, too.

I am not opposed to trying BC pills if it would lower my supply. I was working with an IBCLC the first six months last time and tried B6 and pseudophedrine. I guess BC pills will be the next step.

Thanks so much for your thoughts! Let me know if you have any other ideas!

[steedalyn]

I feel your pain momma! I had major oversupply issues with my DD as well and they really didn't go away until I completely QUIT pumping. I had to pump when I went back to work at 4mo. I had oversupply right from the get go and I was trying to pump to relieve engorgement which only made things worse. After I stopped pumping (before I went back to work) things started to get better. I would occasionally hand express just a little if I got engorged and that didn't seem to make it any worse. Then it got worse again when I started back to work and had to pump. What worked for me was to only nurse on one side for a period of 6 to 8 hours, then nurse on only the other side for a period of 6 to 8 hours. I never restricted her feedings or frequency of nursing, just which side I gave her. I only just started feeding her on both sides during a feeding within the last month or so (she is 18months old) and only because I am trying to wean her down to 4 times a day or so, so we are not nursing on demand anymore. I don't know if this will help you but I will say a prayer for you and your new little one.

Edited to add I quit my job altogether when she was about 9 months and things got much better.

[CheriK]

If you're pumping instead of nursing, I would think you'd want to pump in blocks as well. So if you pump every 12 hours, then pump only one breast. That would mean 24 hours without any breast stimulation on one side. But I would think that pumping at the same frequency as baby would nurse, and sticking to block pumping, would be better for decreasing supply than pumping only twice a day & double pumping. Otherwise, you're telling your body that you have two babies who each need milk. And you're increasing hormone release with double stimulation. Most women would not be able to maintain lactation with the schedule you were using, by the way!

Have you heard of storage capacity? We know from research and experience that most women are capable of making enough milk for one, usually two, and sometimes even more babies, regardless of breast size. But, the amount of milk that can be stored between feedings does vary. This is why some mamas and babies can happily nurse every 3-4 hours, with baby content and gaining well, while some nursing couples will need to nurse every hour. If you could go 12 hours without expressing any milk and without feeling like you were going to explode from engorgement, I would guess that you have a VERY large storage capacity. Being able to pump 9 ounces from one breast is another clue (for comparison, when I was breastfeeding twins & even when trying to manage oversupply with a single baby, I could never pump more than 3 ounces from BOTH breasts - small storage capacity, and at that point I'd feel pain from engorgement). For block nursing to be effective, the milk actually has to build up in your breast. There are substances in the milk that inhibit further milk production. The physical pressure of a "full" breast also inhibits production. For you, it sounds like it will take quite a while to get to that "full" point (maybe 24 hours ).

The pump adds a unnatural variable to the nursing relationship. If at all possible, I'd put it away and try to simply nurse your baby. If you're nursing 12 hour blocks, then each time your baby nurses, your breast won't be "emptied", unlike when you pump to empty. Leaving milk in the breast, as your baby will do, also signals your body to slow production. If you do choose or have to pump for whatever reason, I'd try to keep it as much like nursing as possible (pump at the same frequency your baby would nurse, pump only one side & stick to your block schedule, instead of pumping to "empty" only pump the amount of milk you'd expect your baby to drink). If you need to express milk so as not to drown your baby, then try hand expression IMMEDIATELY before feeding & as little as possible - an ounce or less, ideally.

Have you explored ways to make nursing easier for your baby, such as nursing while laying down, "uphill" nursing, nursing MORE frequently instead of less (still using block feedings, though), encouraging baby to come off the breast at the first heavy flow of milk & catching it in a cloth/bottle, nursing while baby is sleepy. . . Some moms even find using a nipple shield can help if baby is struggling with milk flow (be careful, though, because nipple shields can reduce supply ). And some babies handle a fast flow with more ease than others, so perhaps this baby will not struggle like your older children.

If you do decide to try BCP, I'd search now for an IBCLC with experience in this area. Your local LLL could probably help you with this search, or you could simply start making phone calls to local IBCLCs. Not every breastfeeding professional has the same type of experience; ideally, you'd want to work with someone who has had some in this area (not just whoever is closest but who's only worked with moms struggling with low milk supply).