Preventing engorgement when block feeding

[minkajane]

My DD is 10 days old. She was cluster nursing and snacking a lot and has had a couple of nights where she's up all night fussing and gassy. She has also had very watery poops. So I looked things up and it seems like I either have a foremilk/hindmilk imbalance or oversupply. I started block feeding last night and her poops are already starting to firm up, so it seems to be helping. Problem is, the breast I'm not using gets HUGE and uncomfortable. I don't want to end up with mastitis, but I also don't want to encourage even more milk production with pumping.

Is there any way I can get her to stop snacking? She'll eat just a bit every half hour for several hours, then take a nap. I'm trying to use breast compression to keep her nursing and it seems to work so far, but she pops on and off all the time and sometimes I just can't convince her to keep nursing.

[Llyra]

It is normal for newborn babies to have watery poops. The poops typically vary from totally liquid, to about peanut butter consistency, until babies start taking a large percentage of their calories from solids. It may be that there is no problem. Fussing and gassiness is very normal and typical for babies in the first few months-- most of the time, there is no problem other than an immature digestive system, and it resolves itself with age.

What color are the poops? They should vary from yellow, to yellowish brown, yellowish orange, or even green-tinted yellow. These are all normal variations. The only time I would suspect oversupply is if the poops were really, really green, all or most of the time. (An occasional green poop wouldn't worry me.)

So I would wonder if it's even really necessary for you to be block feeding-- what else are you seeing, besides just loose poop?

"Snacking" is also normal. Small, frequent feeds are the biological norm for human babies. The patterns many of us have been led to expect--- big feeds spaced out with a few hours between-- are patterns more typically seen by bottlefed babies. Some breastfed babies do space out their feeds, but it is less common than you might think. Small feeds every half hour to two hours seem more usual-- my kids always nursed about 24 to 16 times in 24 hours, and often more, at this age.

If she's popping off, it may mean that the flow has slowed on that side. I always took that as a cue to switch sides. Or it may mean that she's full-- if your milk is coming down quickly, she may be filling up quickly. There's no need to pressure her to eat more than she's hungry for-- a newborn's stomach is very, very small, and breastmilk is digested very quickly. I would rely on her cues, and you should be fine, as long as she begins to gain weight.

In other words, I think that you may be misinterpreting normal patterns, for a problem. Unless you're seeing other symptoms that are indicative of oversupply, I wouldn't hesitate to stop the block feeding if you're uncomfortable. And I wouldn't let "snacking" bother you.

One thing that can really help is to get the hang of nursing side-lying, so that you can rest while baby does her thing.

[EchoSoul]

Agreed. I switch sides whenever I burp(or attempt to) our son, or when he keeps popping off of one. It seems to work for the most part, but sometimes he follows along the same lines as your daughter, and he'll only feed for half as long as the typical nursing session, take a break while his stomach settles, then cry out for more. And sometimes he doesn't! Sometimes he has watery poops, too, but usually it's the seedy-type. I wouldn't worry! You can't force an infant to feed, so you kinda have to just flow with it. :/ Have you tried burping her when she refuses? That's what I do. Sometimes a burp clears up enough space in their stomach for them to want to eat a bit more. I do that, and if I get nowhere with that, I lay him down in his cradle or rocker or wait it out. He'll either cry out for more a few minutes later, or just go to sleep. But like it's already been said, if she's gaining weight I wouldn't worry!

Oh, I've also read you shouldn't exclusively use one breast to nurse; because the baby can get used to it. Are you switching breasts every feeding, or something? Sometimes it can be difficult - sometimes our baby nurses every 1 1/2 hours, sometimes every hour. It's always changing. Are you sure when she cries, it's always from hunger? 20-30 minutes after a feeding, our baby will cry. But it's not from hunger, it's because he's wet. So I change him, and hold him for a while(he does NOT tolerate being put down after a diaper change, because apparently it's THAT traumatic, lol), and then I put him down, and the next time he cries out, he IS hungry. And the thing is..if I were to hold him, or attempt to nurse him instead of changing him, he'd calm immediately. Him being wet is apparently only a minor concern that's easily comforted by nursing or being held, but if his crying is inconsolable, then I know for a fact he's hungry again.

[jksmith]

I had the same issues with my LO. Poor kid, I was constantly hosing him down with milk (probably good for his eczema though : ). He also had slimy bright-green poos and was pretty gassy. My midwives recommended sage tea, but only one cup every other day for a week at most because it's very strong (made with 1 teaspoon dried sage leaves per cup), and block-feeding, and cabbage leaves to ease engorgement (raw, cold cabbage leaves, slightly bruised for 20 min).

I actually only used the cabbage once, and never used the tea. Instead I expressed my extra milk and stored it (you prob don't need a pump if you're that full) but I only expressed 1-2 ounces off the full breast to take the pressure off. I also block-fed, in 2 hr blocks, I am not sure if it did anything or not, but it certainly didn't hurt either. I have heard of women doing longer blocks too, up to 2 days on one side, and using cabbage or expressing just for comfort.

Around 6 weeks his poops just magically turned yellow again, despite that I still seemed to have loads of extra milk and he was eating just as frequently. I wouldn't try to push her to eat more unless she isn't gaining enough weight, instead, feed on demand and hand-express milk or use cabbage leaves for your comfort. (I am also a midwife student btw)

I also think (but this is personal reflection not based on evidence) that maybe hand expressing doesn't stimulate as much milk production because of the lack of nipple stimulation? Anyone have thought on this?