Over active let-down

[AppleCrisp]

Does anyone have experience with this? I posted on the BF forum as well.

We are really struggling...nursing is just getting miserable. He latches for a few sucks, comes off screaming and arching his back, then re-latches, and we start all over again with the screaming. He is SO fussy, just constant shrieking and wants to nurse all the time, but struggles on and off the breast the whole time. He also coughs like a little old man every time he nurses, sometimes so forcefully he sprays the milk back at me! Its either this, or maybe reflux?

My LC said that once you have let-down the hindmilk is there, but I'm wondering if this isn't correct and he's getting too much foremilk. I can easily hand express at least an ounce to two ounces at the start of a feeding and it flows very quickly. I usually have 2 let downs per feeding.

I am going to try to express off what I can before latching him, but how the heck am I supposed to do that in public? At home it makes a huge mess and soaks the cloth and gets both of our outfits soaked and sticky. I have to be able to nurse this kid and still get out of the house once in a blue moon.

[willow659]

That must be so difficult. I wish I had some advice.

[honeybee]

Do you have a recliner? I know some moms in my LLL group have recommended reclining backwards to nurse, so you're fighting gravity a bit.

How long has the fussy nursing been going on? That's pretty common newborn behavior, especially during a growth spurt. I've had one of those days myself. I've discovered that when Kian gets fussy, I need to take him off the breast, hold him upright, and burp him for a while before he's ready to nurse again. Actually, it's better if I hand him off to dh for burping. He smells me and thinks what he really wants is bm, when he really needs to let out some gas. Dh gets him calmed down, and then he's better able to nurse.

It does get better, though! I keep reminding myself of that.

You might want to try the LLL forum for more detailed advice...in fact, I think they have a whole board for OALD.
http://www.lalecheleague.org/vbulletin/index.php

[berlina]

I can relate to this post as my new ds and I have been experiencing the same thing. I have a quick question though...how do you know that you have two let downs per feeding? Sorry if it's a silly question, but I only ever felt the letdown in the early weeks of breastfeeding and no longer ever feel it. Since my ds and I have been having the same issue, I thought this could be our problem, too, but I have been curious about the multiple letdowns.

Thanks

[AppleCrisp]

Honeybee - thanks for the link. After a few days of investigation I'm beginning to think we have both reflux and OALD. We're soaking the bed every night, going through three to four towels between the milk and the spit-up, soaked the boppy, several baby and mama outfit changes all day long.

Berlina - I think I read somewhere, maybe kellymom that OALD can be uncomfortable - and I do have an unpleasant stinging sensation with each let-down. Also I can see a sudden burst of milk out the sides of his mouth after he's been nursing awhile and a quick struggle to keep up by increased sucking.

I am trying expressing out a little and it seems to be helping...less choking and struggling, but its so messy.

[Tine]

Originally Posted by ahwuko

I do have an unpleasant stinging sensation with each let-down.

I get that sensation, too. (However, I don't think I have OALD.) Another sign of impending letdown (for me) is that about half a minute before the stinging, I can feel the oxytocin surge.

[Ell-Bell]

I do have OALD, but it doesn't sound nearly as strong as yours. The main problems we have as a result is that he clamps down to control the flow, and that hurts. Also, it has caused vanoplasty (sp?) of the nipple, it turns white/purple because of a lack of circulation, and gets painful after I nurse. He's also really gassy.

Our lactation consultant recommended positioning the baby so that he has to suck- meaning position him above the nipple, so that gravity is working against him. If he's laying down and the breast above, then gravity is just forcing the milk to flow faster, KWIM? This does seem to help, today I nursed football style, but with him almost sitting up. Also I will recline back when in cradle hold so that his head is above the breast. So far today it seems to be helping.

Another thing she recommended is nursing sidelying, so that DS can let the milk dribble out of the side of his mouth if it gets to be too much.

Also, we were feeding on one side, then the other. Then next time we'd start with the last boob. She suggested feeding only from one boob for 3-4 hours, then switching. We haven't had any problems with DS gaining weight, so she didn't think this would effect his weight/eating.

HTH, I'm interested in what others post...

[melamama]

I also have oald. Babe had been (and still is a bit) pretty gassy. I'm not a vigilant burper and I know that had something to do with it also.
I eliminated dairy--since ds was having some projectile spitups immediately after nursing--but I think it was a combination of dairy/getting too much milk at once/ and nursing on top of an air bubble.
The http://www.kellymom.com/bf/supply/fast-letdown.html is helpful.

At home I'll nurse him sitting up--so he's basically sitting on my lap, and I'll lean back a bit so he is level with/slightly over my breast. When I feel a let down, I'll take him off for a minute, then put him back on. I also try to keep him upright after a feeding so gravity can do it's work. Even if we've been side lying and nursing, ds needs to be upright after or everything comes up. I also stick to one side for a few feedings.

As he's gotten older (he'll be 7wks on monday) it's gotten better. He's also 15 pounds so we don't have any weight gain issues--so that eases my mind a bit.

I don't have any good tips for nursing when out at this age. I carry extra cloth prefolds and try to have a spare shirt for me as well as him--because inevitably he will splort right down my shirt and into my bra--like when we nurse in the stands during dd's ice skating practice. I also still really need to hold my breast while he feeds or he just unlatches, so nursing while out is hard. I also keep a flannel receiving blanket in my purse--it's a good size to have over my shoulder and it can actually nearly contain a full belly spit up.

I know from kids #1 & 2 that I was always happy when they learned to burp on their own and they grew into their intestines a bit and gravity didn't make such a difference after a feeding. It does get better.
At this age it seems like it's always something, then once you master the problem it goes away and something else pops up.
Deep breathing and lots of spare shirts (and pants).

[liseux]

"She suggested feeding only from one boob for 3-4 hours, then switching. We haven't had any problems with DS gaining weight, so she didn't think this would effect his weight/eating." Ell-Bell

Lurking from Sept...I am a volunteer LC & had this problem with my 3rd. I think nursing from one breast for 3-4 hours is a huge help. The good news is your baby will outgrow this soon, both your supply & his ability to take it will even out, you will be able to get out & about & nurse. I remember how akward it was, and then when he was about 2 months old it all got easier. Good luck!

[AppleCrisp]

Thanks everyone. I do believe its working.

Seems like he's been here forever - hard to remember that its only been 6 weeks and still a lot of adjusting and learning to do.

[nubianamy]

Glad it's working. I second the advice above, especially nursing on one breast for three hours, and pausing after about 10 min. and making sure to get two or three burps before continuing nursing. Ivy spits up a LOT less now.