Forceful let down breastfeeding problem, anyone?

[astrid83]

Hi,

I have a one month old baby boy and we have been very lucky with no problems with breast feeding, until now.

It might seem like not a problem at all, but we are struggling with very forceful letdown of the milk. It's great that I have more than enough milk to feed my baby, but the milk comes so fast so it sprays all over his face and he gags on it and gets very upset.

I have tried all various things to make it easier, different feeding positions, expressing a little milk before offering the breast, hand expressing in to a muslin, nipple shield and nothing seems to help.

He also gets terrible wind as he swallows a lot of air when breast fed. We've now starting to feed him with expressed milk from bottles when we are at home to make feeding times less painful.

The problem we now have is that he has started to refuse the breast. I don't know if he does that because of the fast let down or that he has just started to prefer the bottle. Which would be understandable as he gets milk all over his face when I BF him and can't keep up with the flow.

However, I feel so guilty about it. I'm starting to think that I might have to keep expressing and give him breast milk in bottles when we are at home, and feed him formula when we are out.

Before he was born I kept saying that I would not feel guilty about feeding him with formula if BF did not work. And now I feel guilty about feeding him from a bottle with breast milk. How ridiculous isn't that?

I don't know if I am writing this with hope for a solution or just pure reassurance that I'm not a bad mother!

[simonethebeaver]

Breastfeeding brings out very complicated emotions in us, astrid. You're not being silly.

I think you'd benefit from a good chat with a lactation consultant or peer supporter. We are lucky round here to have many breastfeeding cafes where they can be found. They provide excellent moral support and personalised practical advice. There has been at least one thread on here where local cafes have been listed but am on my phone so can't be that helpful. Both Southwark and Lambeth have their own cafes, and I'm sure at least one will be running tomorrow.

[midivydale]

Reassurance that you are an excellent mother I can give you endlessly! I understand the feelings of guilt all too well. Have you tried speaking to clare kedeves at kings? There is also a lactation consultant called kate fisher that we used last year. They were both excellent!

I have also heard great things of the bf cafe at peckham library. I am sure that some of the more recent mOthers can give you more information as mine is out of date.

There are many ladies on here (Fuschia and Pickle are two names from the top of my head) that have had great success with breast feeding so fingers crossed they see this post and can point you in the right direction.

[gillandjoe]

Maybe have a look on the La Leche League website - they have lots of tips for over-supply. Good luck! xx

[bluesuperted]

Sure Fuschia will be on here soon. I have a fast let down (two children) and it calmed down both times around 8/10 weeks. It didn't bother either of mine that they vomited up the excess either... What I'm saying is you might just be able to wait it out. My daughter does still regularly get squirted though, I think she's used to it though!

Think re seeming to prefer bottles, babies do find bottles easier so I'd recommend stopping bottles, doing lots of skin to skin and getting him to BF as much as poss so he gets used to it again to avoid what sounds like a kind of nipple confusion.

Hope this helps and sure F will be on here soon with some pearls!

[GinaG3]

Hi astrid, I'm a trained breastfeeding peer supporter and have worked in both Peckham and Dulwich cafes. Please rest assured you are not a bad mother, when you go through problems in breastfeeding they can be extremely emotional especially with such a small baby. I had very difficult problems with my baby for the first 2 months and went on to breastfeed for 2 long and very happy years, its just a matter of finding good support and a solution that works for your baby.

Have you tried feeding laying on your back, baby and you tummy to tummy? As if he had just been put on you after birth and he was rooting for your breast. I've found this to help in some women with forceful let down, it may help you if you haven't already tried. You may also want to try having a bath together and feeding in the bath whilst surrounded by the water, this can create a calm atmosphere in which to try to restore feeding directly at the breast.

I throughly recommend Peckham breastfeeding cafe for support during the early days/weeks/months of breastfeeding I wouldn't of got by without their service. You can drop in any time on Thursdays 10-11.30am, Peckham Library 5th floor. Dulwich cafe runs in Townley road clinic on Mondays 10am-12 noon.

http://kellymom.com/bf/got-milk/supply-worries/fast-letdown/

[bluesuperted]

Yes good point Gina I used to do the on my back feeding to curb vomits and it definitely helped.

[GinaG3]

Incase you are wanting to attend a cafe tomorrow you can drop in at - Kintore Way Childrens Centre, SE1 10-12noon. I believe that is still the right time, I will check with a peer supporter I know that works there and post back tonight if it needs revised.

[yeknomyeknom]

Hi,

I had the same thing. Took supplements, funny teas, used cabbage leaves etc. Tried all the tricks. Ended up with an under supply! Nothing worse than not having enough food for your baby. In the end, everything regulated around 6 mths and I am glad I stuck it out. Breastfeeding was my biggest trauma for the same reasons you said. But now it's a real pleasure. Stick it out if you can.

[Pickle]

I'm by no means an expert :)

My letdown was quite forceful in the early months with my 2nd and 3rd babies, but it didn't seem to bother them too much generally. It was worse in the morning, but I tended to do my first feed of the day while still lying in bed which helped.

It regulated by about 3 months from memory.

P x

[astrid83]

I've tried feeding him on my back and it's still a struggle. He gags and almost chokes on the milk and gets so upset by it all, which I can understand. It's also very difficult when we are out and about as the milk goes everywhere and we both get soaked.

I will try one of the BF cafes and see if they can help.

If I do choose to express breastmilk and bottle feed him, does anyone of you know of anyone who does this exclusively? How do people manage when they are out and about? I've seen that there are special cooling bags you can buy...

[bluesuperted]

Hi Astrid,

I take my hat off to exclusive pumpers, it sounds hard work to maintain the same supply through pumping as you would with a nursing baby but people definitely achieve it. Here is a list of resources on Kellymom:

http://kellymom.com/bf/pumpingmoms/pumping/bf-links-excpumping/

I have heard the Ameda Lactaline double pump is the best around. I have two friends who pumped exclusively for premature babies (so a different situation with other stresses that could affect things) and they both managed until 4 months when their supply couldn't keep up.

There is also a group on baby centre I believe.

If you can persevere for a bit longer (thinking in terms of day targets, then weeks might help?) I think you'll find that things (everything not just feeding) get SO much easier at week 6 onwards. Babies know what they are doing a bit, mums feel less overwhelmed etc.

[Pickle]

You certainly can do it exclusively, it's hard work but doable. I expressed full time for 8 weeks with my 1st who was tongue tied, then successfully switched back to breast feeding directly once he had his operation. At the time I used to take bottles out with me in just a standard Avent coolbag, but never expressed when I was out (was never far from home at that stage).

With benefit of hindsight I wouldn't have struggled so much to try and provide 100% of his milk myself - I gave him the occasional formula top up and really felt guilty, which is just silly when I look back on it. It was the middle of winter, after feeding him expressed milk at 3am I used to put him back to bed then sit expressing for an hour. While it probably did help me keep my supply up, I really doubt I would do the same if I had my time again!

Sorry for waffling - but even though I have breasted 3 kids, I just want to say that the most important thing is that both you and baby are happy. If that means breast feeding, great. If it means partially feeding with breast milk and supplementing with formula, great. If you decide life's too short to spend expressing and give him formula, great. Don't beat yourself up about it. Make sure you enjoy the lovely cuddles you can have with a baby so young - before you know it he will be at school!

P x

[Fuschia]

Hi!

I expressed for bsby no 4 for 6w as he couldn't latch (tongue tie) and it is incredibly hard, and gets harder as time goes by I think, it makes it hard to ever leave the house

I had quite an active letdown with my first

He would cough and splutter and pull away

Experimenting with positions did help, I found lying on my side with him on a pillow worked quite well for a while, or we had a funny position where I sat up in a high backed chair and he sort of sat on my lap facing me

Clare kedves, i am sure will have some tips

Try not to despair, take it a day at a time

It's very overwhelming when you feel that something is slipping through your fingers somehow and it will never be fixable but in my experience, motherhood is just the opposite and whenever a problem seems insurmountable, it has a habit of sorting itself out somehow, meaning all the worry was pointless

[Fuschia]

http://www.lalecheleague.org/llleaderweb/lv/lvsepoct95p71.html

[Fuschia]

http://kellymom.com/bf/got-milk/supply-worries/fast-letdown/

[crystal7]

I don't have anything useful to add but I had over active letdown with my 2nd child. He would splutter and get really windy. I'd be up all night feeding and winding. Like others I found feeding lying down helpful and the problem seemed to disappear when he was around 2/3 months. I never got around to expressing so don't have any experience but I admire anyone who exclusively does it. It must be incredibly hard work. Do try one of the breastfeeding cafes, I found the advice at the Peckham Library one excellent, good luck!

[bluesuperted]

It may sound silly but used to start feeding, then if baby fell off her latch due to too much milk if take the opportunity to just let the 'tap' flow into a nearby muslin, a cloth nappy inner or blanket or whatever was nearest. Then I'd latch her back on - so I wouldn't rush to put her straight back on if you see what I mean.

[CJ_Scott]

I had fast flow and oversupply both times. Baby one had terrible time, unhappy feedings, colic, explosive poos etc. The breastfeeding clinic I went to said i should try expressing which made things worse for me. I produced more and ended up with mastitis four times before giving up. Did some online research before number two arrived. Once i'd established it was happening again i did two feeds from one side so baby got more than fore milk and boob emptied properly. As soon as i felt letdown i would take baby off and soak up with muslin and pop her back on. She got used to it pretty quickly.

[CJ_Scott]

Wanted to say above posts are great. Pickle has it right, dont feel bad. A happy mum really helps x

[Fuschia]

CJ_Scott Wrote:

-------------------------------------------------------

> I had fast flow and oversupply both times. Baby

> one had terrible time, unhappy feedings, colic,

> explosive poos etc. The breastfeeding clinic I

> went to said i should try expressing which made

> things worse for me. I produced more and ended up

> with mastitis four times before giving up. Did

> some online research before number two arrived.

> Once i'd established it was happening again i did

> two feeds from one side so baby got more than fore

> milk and boob emptied properly. As soon as i felt

> letdown i would take baby off and soak up with

> muslin and pop her back on. She got used to it

> pretty quickly.

Yes 'block feeding' appears as a solution and will reduce the Windiness caused by an excess of foremilk

Feeding in the bath followed by topless snuggles on the bed are good to try to reconnect when bf isn't going well

[astrid83]

I have successfully managed to blockfeed my son today, and I persisted even though he first refused the breast, cried, gagged and coughed. Felt like a bad mum to not offer him a bottle instead, but finally we managed to get a calm and quite long breastfeeding time together. We both got covered with milk again and the spraying did not stop until approximate 20 min in.

I think he gets very windy and slightly colicky because of all the foremilk, we've tried infacol but not sure if it makes that much difference. Gave him gripe water yesterday but he hated it.

Will keep trying the breastfeeding as I'm worried I won't be able to keep up with expressing. Although, have to say, U use a manual Medela pump and its really quick and easy, might not stay that way though.

Thanks for your suggestions and help everyone, and specially Pickle, thank you for your very kind words.

[Saffron]

I wouldn't waste money on Infacol (simeticone/simethicone). Although no data that I know of has shown adverse effects of its use in infants, a systematic review by Garrison & Chritakis (J Am Acad Peds, 2000) demonstrated no conclusive evidence that it helped with colic. This is in line with other research that I have previously read on simeticone.

(We tried Infacol too. Didn't see any difference. I binned it after I read the research, annoyed at myself for getting sucked in by baby marketing!)

Little Saff had to have a few bottles of formula at the start because we had problems with painful latch, and I had very bad postpartum exhaustion. We didn't have a problem with preferring breast v bottle. She was like a suckerfish, and anything that got too close got sucked in: nipples, teats, fingers (hers/ours), earlobes, noses, etc. BUT, if you do find that your LO is having nipple confusion, then definitely speak to a lac consultant. We had a great lac consultant on Pickle's recommendation. It really made all the difference in the world. xx

[MOP72]

I also had a lot of problems with a forceful letdown. It can be very difficult but it does get better with time. Others have already mentioned the things that helped me most. I resorted to feeding him lying down (sideways), somehow this seemed the best position for us. If I had to do it sitting down I would slouch a lot so he was almost coming at the breast from the top and if he would pull away when too much milk was coming I would let it come out until it was manageable and then he would come back on. My son did have a period of refusing the breast but it didn't last too long with persistence (I am still breastfeeding and he's over a year now!).

The breastfeeding cafe at Townley Road Clinic was very useful. Once he got older and I started feeding him less often the problem paradoxically got better. I wonder if I was feeding him too often keeping my supply higher than needed. I think he was a bit of a snacker. I don't know anything about expressing as I never got around to it but I wondered when reading your post whether your supply could have gone up even more because of expressing? You've probably have already thought of that but thought I would say it just in case.

My son also had really bad gas issues. I tried Infacol and Gripe Water but none of it seemed to help. Something that did help was to keep him upright after feeds for as long as possible. I think someone recommended an hour after each feed which I typically didn't manage to do but even 15 minutes helped. Lots of burping after feeds as well. I found that at times going up and down the stairs helped too! All the wind issues went away once he started rolling over and began sleeping on his tummy or his side.

Whatever you decide to do about breastfeeding/expressing/formula don't feel guilty! You need to do whatever works best for you. Happy mummy equals happy healthy baby. Good luck!

[mrs f]

I had the same issue, my 1st was a v hungry boy & wasn't bothered by it but my daughter really struggled, just like you said gagged a lot etc... I didn't know what was wrong with her, she was all windy & would cry for no apparent reason.

It was pretty tough but I found letting the milk spray into a muslin helped & sitting leaning back.

She did grow out of it & by 6/8 weeks things were getting easier & now at 4 months is more than happy feeding

So although perhaps not that helpful, it will get easier as they get older