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tips for oversupply/foremilk-hindmilk imbalance?

post #1 of 11
Thread Starter 

So, after a struggle mid-week when my milk wasn't coming in fast enough to please little Kate (LOL), it is now coming in with a vengeance! I haven't done ANYTHING to stimulate extra production - no supplements/teas, no pumping, and no marathon BFing sessions. However, now that my milk is in it is really IN! (My mom always said that she produced enough milk with her babies to feed a small 3rd world country, and I guess I'm following in her footsteps!) I seem to have more milk than Kate can keep up with... today at each feeding we have basically been feeding off of one breast and maybe a tiny bit of the second. 

 

She's had a bunch of dirty diapers in the last 24 hours, many of which are still meconium (not sure why). We haven't really seen a "regular" BFing diaper yet because it's all been mixed with meconium. Well, tonight she had a poop that was very watery and quite green! (On the wipe, it looked almost electric green.) I thought I remembered reading that green newborn poop wasn't a good sign so I googled it tonight and found that it might be a sign of her getting too much foremilk and not enough hindmilk, which would make sense considering how "full" I am feeling. She's also been pretty gassy for the last 2 days, which I read can also be a sign of too much foremilk.

 

So, I have two questions... 1. Has anyone else had this issue, and what worked for you? and 2. I keep reading things (and the LC at the hospital at the beginning of the week mentioned this as well) that say it's important to make sure you have drained the first breast before going on to the second. Um, I realize this is a dumb FTM question, but how on earth do I know if I've drained it??? I can feel when I'm engorged and feel when I have LESS milk in there but I honestly have no idea how to tell if I've actually drained it and gotten to the hindmilk. Any ideas??? I usually feed Kate on one side until she stops eating and I can't get her to latch on again, and then I usually burp her (to wake her back up, LOL) and do a few minutes on the other side until she reaches that point again. Pretty much every time I take her off there is milk dribbling down her cheek so I don't think I've ever reached a point where nothing more came out... and I'm not sure how I COULD reach that point if I can't get her to latch back onto the first breast.

 

I'm reluctant to do anything like pumping that could increase my supply anymore, both because I don't want to intensify the problem and because as of tonight I had to start taking my antibiotic, which means we have to introduce a formula bottle to give enough time between me taking my dose and her feeding. So, I already probably have a bit more supply than I will need in the coming weeks.

 

Also, I'm a little worried about my hindmilk anyway. I have cystic fibrosis, and one of the components of that is that my exocrine (digestive) pancreas no longer really functions. I take synthetic digestive enzymes to eat but still don't absorb fat very well. Most of my CF friends have been able to BF their children with no problems, but there does seem to be a small subset of the population who don't produce hindmilk because they don't process fat well enough. So since I'm seeing these potential signs of foremilk/hindmilk balance, it makes me very concerned & motivated to figure out if the problem is just oversupply and she's not getting to my hindmilk because I'm making too much foremilk, or if I legitimately am not producing hindmilk.

 

Any thoughts?

post #2 of 11

Hmmm, well I could totally be wrong about this and I am too tired to look it up in my LLL book: The Womanly Art of Breastfeeding, but I am pretty sure one doesn't need to think much about it all as long as you are making enough milk...there are steps to take to get your supply under control so that you begin to only make what your baby needs, but the whole foremilk/hindmilk theory, I believe I read, is not so black and white. Meaning, you don;t have to worry about it. The different qualities of milk get to your baby whether or not they get both qualities at each feeding...your breasts and body know how to reserve the "hindmilk" for next time baby is on breast if they don't get to it at this feeding. Does that make sense? I may be explaining it poorly since I've only slept a few hours. 

 

I had oversupply issues last baby, but I don't this time. The best thing I did to help it was to nurse only on one side until that breast felt very flaccid/soft/empty. If you can still feel bits of hardness, fullness, lumps...then it probably still has a bit of milk and should be massaged down to baby while suckling. If baby is still sucking vigorously and not swallowing much, AND your breast feels soft, you know you are probably out of milk on that side. 

 

As for poops, I don't worry about those either...Unless your baby has gone from normal yellow/seedy poop to a new and strange color/texture then I think it is normal to transition from meconium to green to other colors then yellow. My baby definitely had a dark green poop and variations on that color until he finally had yellow ones consistently. It just takes another day or two. If your baby doesn't have yellow poops by 6-7 days pp, then I might look into it. 

 

Let me know if any of that didn't make sense and I can try again to explain what I mean.thumb.gif

post #3 of 11

oh and check out kellymom.com on breastfeeding....fantastic resource.

post #4 of 11
I wonder if there is a way ti get your milk tested for fat and sugar content??
post #5 of 11

I second kellymom.com. Very great resource.

 

You can have your milk tested, at least according to the LC at the NICU, but they only do that if there really is a problem. I didn't even know that until recently.

 

I would wait a few days to give baby a chance for the BF poo. If you're still worried on Monday or Tuesday, then by all means call your MW or pediatrician. 

post #6 of 11
There's a simpler way to determine how much hind milk you're making: fore milk and hind milk are distinctly different in appearance. This is what i mean: http://imageshack.us/photo/photo/248/imagefny.jpg/

I learned this when i would pump for DD. it was especially easy to tell after it had been in the fridge for a few hours--the milk would separate: hind milk is heavier so its on the bottom and the lighter fore milk is at the surface. I recommend trying that and then noticing what color it is, comparing it to the picture i linked to, and also noticing any separation to see the ratio of the two. I hope this helps!

Also, dont worry about oversupply for now--a lot of women experience oversupply at first and then it adjusts itself to fit your baby's needs.

I forgot to mention that DD would feed off one breast at each feeding when she was a newborn, too, and just a little from the second. I've heard this is very common. A general rule of thumb is to keep her on one breast for at least 20 minutes before switching to the other side--that way you're ensuring she has drained your breast.

Also, i've heard its normal for there to be a transition period between meconium and normal baby poop, so that could be the reason for the green poop. Although the electric color is a little odd. Keep an eye on the color, if it doesnt change to yellow in about a week then i'd be concerned.
Edited by sunshinelove - 3/31/13 at 11:50pm
post #7 of 11
Thread Starter 

Yeah, sunshinelove, I'd actually begun suspecting that this weekend. Sometimes the milk on Kate's face when she comes off is pretty blue-ish and watery, and sometimes it's quite thick and creamy... I figured that meant she was getting some hind milk (and that I'm making it, hooray!!!!). After doing some more reading and trying some different stuff I'm not too worried about it anymore. I've definitely only been feeding her from one breast at a time, and depending on how "drained" it feels after she feeds, sometimes I go two feedings in a row on one side only - kind of like block feeding. It is not very comfortable on the other side, LOL (not to mention holy cow, I am SOAKING through breast pads!) but it seems to be working for now. Also, her diapers have not stayed solidly green, they have just been completely crazy and all over the place... all different colors and textures, some fairly freaky! But from what I've read this is completely normal for the transition from meconium to BF poops... so I'm just keeping an eye on it for now. Also possibly most reassuring, my hubby and I both have noticed that in the last few days she's regained some serious chub in her cheeks. She's always had fat little cheeks (even in utero on the 3D ultrasounds - it was awesome!), but when we left the hospital Friday and she was down 1lb2oz from her birth weight, her cheeks were a lot leaner. So the fact that they're nice and round again is definitely comforting. We go to the pediatrician tomorrow for her followup weight check, so hopefully everything will be looking good. :)

 

Just from a personal comfort level though... holy cow, I'm SO ready to be done with the engorgement phase! Ha!

post #8 of 11

I have had oversupply issues with each of my kids.  This last time, I was able to take care of it quickly since I new the first signs.  With DD1, it took MONTHS of gassiness, green poops and other symptoms for me to figure it out.  

 

Electric green poop certainly sounds like a symptom of oversupply.... How old is your little one?? A week, right?  I am thinking it is probably a bit of oversupply.  What worked for me was block feeding.  Basically, it consists of feeding on one side only for a block of time, no matter how many times babe wants to eat during that block of time. So, for three or four hours, I would nurse on the left side only. Then, when the time was up, I would nurse on the other side for three or four hours. (I started with 3 hour blocks and moved to 4 hours blocks when 3 wasn't enough.) So, when you nurse her on the right and then burp her, feed her more off the right side instead of switching. If she's hungry again in an hour or two, stay on that side.  Don't switch until it has been 3 (or 4) hours on one side.  Pumping is the last thing u want to do with oversupply!  more stimulation means more supply. So, if the opposite side gets so very full that you are in pain, pump/hand express only a very little for comfort.

 

If any of that didn't make sense, you can google "block feeding oversupply" and you will get more explanations.

 

<3  Hope that helps!

post #9 of 11
Quote:
Originally Posted by jodieanneanton View Post

I have had oversupply issues with each of my kids.  This last time, I was able to take care of it quickly since I new the first signs.  With DD1, it took MONTHS of gassiness, green poops and other symptoms for me to figure it out.  

 

Electric green poop certainly sounds like a symptom of oversupply.... How old is your little one?? A week, right?  I am thinking it is probably a bit of oversupply.  What worked for me was block feeding.  Basically, it consists of feeding on one side only for a block of time, no matter how many times babe wants to eat during that block of time. So, for three or four hours, I would nurse on the left side only. Then, when the time was up, I would nurse on the other side for three or four hours. (I started with 3 hour blocks and moved to 4 hours blocks when 3 wasn't enough.) So, when you nurse her on the right and then burp her, feed her more off the right side instead of switching. If she's hungry again in an hour or two, stay on that side.  Don't switch until it has been 3 (or 4) hours on one side.  Pumping is the last thing u want to do with oversupply!  more stimulation means more supply. So, if the opposite side gets so very full that you are in pain, pump/hand express only a very little for comfort.

 

If any of that didn't make sense, you can google "block feeding oversupply" and you will get more explanations.

 

<3  Hope that helps!


That is a perfect way to explain how to block feed. I had to do that for the nurslings that I didn't tandem feed... It is slightly uncomfortable for a few days (and the hand express just enough for comfort only does help)but your breasts seem to figure out what's going on after a few days.. Feeding this way really helped with the oversupply issues!!

post #10 of 11
Quote:
Originally Posted by jodieanneanton View Post

I have had oversupply issues with each of my kids.  This last time, I was able to take care of it quickly since I new the first signs.  With DD1, it took MONTHS of gassiness, green poops and other symptoms for me to figure it out.  

 

Electric green poop certainly sounds like a symptom of oversupply.... How old is your little one?? A week, right?  I am thinking it is probably a bit of oversupply.  What worked for me was block feeding.  Basically, it consists of feeding on one side only for a block of time, no matter how many times babe wants to eat during that block of time. So, for three or four hours, I would nurse on the left side only. Then, when the time was up, I would nurse on the other side for three or four hours. (I started with 3 hour blocks and moved to 4 hours blocks when 3 wasn't enough.) So, when you nurse her on the right and then burp her, feed her more off the right side instead of switching. If she's hungry again in an hour or two, stay on that side.  Don't switch until it has been 3 (or 4) hours on one side.  Pumping is the last thing u want to do with oversupply!  more stimulation means more supply. So, if the opposite side gets so very full that you are in pain, pump/hand express only a very little for comfort.

 

If any of that didn't make sense, you can google "block feeding oversupply" and you will get more explanations.

 

<3  Hope that helps!

I'm also having some oversupply issues and this is exactly what my LC suggested that I do. 

post #11 of 11
Thread Starter 

I keep meaning to check back in and report on this and keep forgetting! The oversupply seemed to correct itself when the engorgement phase ended (2-3 days ago), and we are now producing lovely (HA) mustard yellow diapers. I did block feed while it was happening and it seemed to help a LOT! Now things have calmed down enough that most feedings she drinks from both sides, but if one feels a little "extra" full I'll make sure she goes back on that side until it's drained. We've started doing one formula bottle a night (so that my sick self can get a little extra sleep and we can wait long enough after my antibiotic dose to BF her again), and I usually end up block feeding for the first 2-3 feedings after that because I'm much more engorged, but most daytime feedings she takes from both sides. And she'd gained back half the weight she lost at her pediatrician weight check Tuesday, so it looks like I'm making hind milk ok! Yay. :)

 

Sadly, it seems the gas wasn't from oversupply... sigh. I think it's just an immature digestive tract, since it started in the hospital the day after she first got "real" milk and not just colostrum. It does seem to be calming down a little bit, too, though. It always seemed worst around the time she was getting ready to poop, and so I suspect that it might have partly had something to do with the transition between meconium and BF poops, because her worst gas episodes lined up with her strangest, most bizarre meconium/BF poop diapers! Gas drops and gripe water have both seemed to help. I also have been giving her a probiotic the last few days to protect her system because I'm on an antibiotic for a lung infection right now, and I'm hoping that getting some good flora into her system will help things as well.

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