BF question...since it isn't an issue for me dunno the answer...

[earthmommy2]

My friend is BFing and having trouble. The baby gags, pulls off screams which I took to mean that her let down is way fast...but then she told me she also thinks that perhaps she can't breath. She says that she tries to make sure that the breast isn't covering the nose but says that baby almost gasps for air. That is where I became concerned, could it be that the let down is fast and that little one isn't mastered the eating/breathing technique?

[The4OfUs]

I had overactive letdown this time around, and my little one did choke, sputter and gasp for air in the beginning. What I read here, and started doing was leaning WAY back during letdown so that I was almost on my back and she was on top of me, so that the letdown had to at least work against gravity and wasn't spurting down her little throat quite so quickly. It helped a LOT. DD is 10 months old and I can still feel letdown and leak (that went away at about 5 months with DS), but I don't have to lean back anymore, she can handle the volume coming out now.

Another thing she can try is to take the baby off during letdown and let the milk go into a cloth or a container, so that she's sure baby is gettign plenty of good, fatty hindmilk and not getting overwhelmed by the "skim" .

Hope that tip helps your friend!

[Amris]

It's almost certainly over-active letdown. In which case, yes, baby can't breathe. No, it's not because of the breast against her nose, it's because too much milk is pouring into her mouth at once. The breath goes into the back of the throat and down into the windpipe, even when breathing through the nose. This is why you can't breathe and eat at the same time... you have to close your throat off in order to swallow into the stomach. The throat's default is to the lungs.

So when you spray into the throat with force, you force open the throat, and milk enters the default passage... the airway.

Then you choke and can't breathe.

I have terrible over-active letdown. Even now, at 6 months old, my DD will let a bunch of it just roll out of her mouth, because she can't catch it. She HAS, though, learned to keep her throat closed and not try to eat when it happens. She just stops, looks at me, and in fact usually grins and lets it all dribble down her little chin. Then goes contentedly back to eating.

What has helped me a ton is block nursing: http://www.kellymom.com/bf/supply/fast-letdown.html

Although I would read that entire page if I were you (and even send it to her/ print it for her, if she'd be open to you doing so), here is the excerpt on block nursing:

If nursing one side per feeding is not working after a week or so, try keeping baby to one side for a certain period of time before switching sides. This is called block nursing.

• Start with 2-3 hours and increase in half-hour increments if needed.
• Do not restrict nursing at all, but any time that baby needs to nurse simply keep putting baby back to the same side during that time period.
• If the second side becomes uncomfortable, express a little milk until you're more comfortable and then use cool compresses - aim for expressing less milk each time until you are comfortable without expressing milk.
• In more extreme cases, mom may need to experiment a bit with time periods over 4 hours to find the amount of time per breast that works best.

[RachelGS]

Yep, I agree. Block nursing made a huge difference for my baby, too.