too much milk

[eva026]

Hi Ladies!

I am back again with an entirely different issue, you were all so helpful in getting us over a nursing strike and I am hoping for some advice for this too:)

 I have been pumping in order to build up a stash for when I go back to work but unfortunately it looks like I am very sensitive to pumping and now have oversupply and get engorged.   
I really don't know how this happened (2nd time already) because I was being very careful, following all the pointers from FAQ: pumping one breast (the one baby doesnt have) straight after the NF, just 50ml though, not till empty and adding a pumping session directly after the 1st morning feed, 50ml a side, not till empty either. The only other pumping I do is at 10.45pm, just enough to fill a bottle for DF (60ml a side, not till empty).
Despite being what I thought was very careful, I am engorged almost all the time now, baby is only taking one breast (she used to do this only during the NF) assuming it's because she gets plenty on the one side AND poor DD is coming off the breast crying and spitting up a ton!

My question has two parts:

1. How do I build up a stash and avoid creating oversupply - or do I just have to get used to the idea that I will be dealing with this every few weeks ?

2. I managed to get the oversupply under control last time through one sided feedings for a while and just pumping enough to relive pain, the problem went away after 1-2 days. This time I have a MONSTER supply and pumping enough the relive pain gives me 80ml! I am also currently battling the 45min nap with the ladies from the Nap forum, so our EASY is all over the place and I guess this helped make the problem worse as my body can't get used to set times. 
DD has also started going longer without feeds at night and waking for a NF at 5am often instead of 4am so that doesn't help either as I am up at 4am to pump for pain relief and make sure she doesn't get flooded and then surprise, she gets up an hour later and by then I am full all over again.
Today I woke her at 4.20am after I pumped to avoid getting engorged again and having to deal with a baby throwing up at 5am. Should I continue doing this or is it silly to wake her an hour early in case I create a habitual waking?

I have read all the FAQ's and kellymom articles but was wondering if anyone has had this problem before and can give me some practical advice.

Thanks!!

[Fiver]

There are some ladies around who have had ongoing problems with oversupply.  Hopefully one of them will be along to give you some good tips.  Would hand expressing a bit off rather than pumping make a difference?

[eva026]

I hope so, day 2 of being in pain:(
Do you mean hand express and not use the pump at all?
Right now I hand express between feedings for pain relief - to be honest I hate it, it hurts and makes me feel like a cow. It is good for "targeted" expression of only the ducts that are swollen.

[becj86]

Hi, I had some amazing engorgements... Ate a bowl of porridge one cold morning and next day I had boobs two cup sizes bigger than the day before and nipples were stretched flat

I really found that babyled attachment helped with latch issues. Lying back helped with the flow and block feeding helped with the supply. I ended up feeding only off one side for the day (WU and day feeds) and the other side during the night (cluster, BT and NF's). This continued for a good week or so before it made a difference and I had to do it after every growth spurt. Still have to block feed occasionally now

When it was really bad, I fed DS in the bath... easy cleanup and the water relaxed him.

I found expressing (even just for comfort) stimulated more milk and kept the issue going. I checked for red spots and massaged blocked ducts but had to really be conscious of not expressing unless necessary to prevent infection. I even reduced my water intake for a few days to reduce my supply - not a good healthy thing to do but desperate times sometimes call for drastic measures. Don't do it long term though!

Having a full breast releases a hormone that tells the body there's enough milk and not to make more. Downregulating a supply as big as yours will take time. Cabbage leaves in your bra are good for pain and are actually milk production suppressants. Most people have to be careful about how long to leave them in but I don't think you'd have that issue so you could leave them there all day if you're ok with smelling like cabbage Change them out frequently though so the cold is helping (unless you get vasospasms as well...).

[eva026]

I went to the gyno today to get checked out as I had a hard lump and she told me about the cabbage and to reduce water intake - will definitely try that then.
Another thing she said was to empty the breast I used after every feed to prevent blocked ducts... now isn't that all wrong???
I am trying hard not to express the breast I didn't use and alternate every 2nd feed but it's seriously painful, almost to the point of tears. Is it ok to take paracetamol?
DD is handling all this well but she has started getting hungry more often - due to all the foremilk I guess. Unless we have a GS on the way - then I'm in serious trouble!

It took a week to get your supply under control.... man that worries me. Staying faaar away from porridge!!

[Fiver]

I'd be wary of trying to get more out of your breast if you're having an OS and getting engorged as that is a signal to your body to make even more milk (is your gynae a LC/BF specialist??)

When I suggested hand expressing it was so as to avoid the pump.  With the hand, like you said, you can be more targeted to the more painful spots and will normally not have such a great impact on increasing supply as a pump as you will be able to stop as soon as you're feeling a little more comfortable rather than perhaps not noticing as soon with the pump.

As for pain relief, paracetamol is usually deemed safe to take, or you could try ibuprofen (unless you have had reactions to it in the past or are asthmatic or have any of the other contraindictions for taking it)

(FYI, Bec, FIL (Feedback Inhibitor of Lactation) isn't a hormone - it's a small whey protein contained within the milk )

[becj86]

Another thing she said was to empty the breast I used after every feed to prevent blocked ducts... now isn't that all wrong???

This will tell your body you need all that milk! Not a good idea in my book... but I'm not a doctor. Yes, you need to ensure if gets emptied, but block feeding will achieve that if the blocks are long enough. I understand its painful, I was in tears calling up the BFing hotline in Australia and they said take paracetamol, get some cabbage leaves, feed as needed (for your comfort as well), keep an eye out for blocked ducts (I massaged the breast near the chest wall before each feed to help loosen some of the fats into the milk (helps with foremilk overload which is nasty for the poor bubba's tummy) and also helped ensure the ducts were draining properly. When things were bad, I also hand expressed just by doing compressions - so get the letdown going, then squeeze the breast itself (gently - don't bruise it!) but don't touch the areola. I think that's the least stimulating way to get the milk out - no sucking and minimal milking action. You may need to do that before the first feed on each side for a bit just to allow LO to latch and to prevent the foremilk situation getting any worse for her.

She may not actually be hungry - as they get gas and their gut is damaged from foremilk overload, they can act hungry but feeding more frequently can make it worse. Keep an eye on her poos - you want yellow seedy poos. Foremilk overload poos get green, sometimes mucousy and eventually grassy (colour and texture). LO's can be in some serious pain and can take time to heal from the damage, so block feeding is helping your LO get enough fattier milk too. You're so oversupplied, you're unlikely to notice a growth spurt. Most people notice because LO drains both breasts and wants to feed more often than usual. Your LO should be able to just take an extra few swallows of milk

Sweet, thanks Amanda Learn something new here every day!

[eva026]

She's an obgyn so one would think she should know these things.... honestly I have gotten so much bad advice from "professionals" that if it wasn't for these forums I would have been giving formula ages ago.

[Fiver]

An obgyn may not be trained sufficiently in BF.  Many HCPs have brief "training" in BF related issues, but unless they've spent a good amount of time solely study BF, they often have big chunks of knowledge/information missing, especially if they've never BFed themselves.

I can see what she's trying to say (you don't want to end up with mastitis, after all), but an OS and then pumping to "empty" the breast is just going to send your body the signal to produce more milk, which is the last thing you're aiming for right now.

Are there any options where you are to donate milk for local neonatal units?  If you've got a lot to give, perhaps harnessing that is another option?

[eva026]

I looked into that and while there has been talk around about creating a milk bank, we don't have one yet so I am just freezing what I get.

She may not actually be hungry - as they get gas and their gut is damaged from foremilk overload, they can act hungry but feeding more frequently can make it worse. Keep an eye on her poos - you want yellow seedy poos. Foremilk overload poos get green, sometimes mucousy and eventually grassy (colour and texture).

So far the poop has been normal, but I will continue to block feed a while. Is it ok for me to express a little before feeding DD to make sure she doesn't get only foremilk?
I manage only 2 feeds per side but I do think I see a difference after 2 days of doing it.
By the way, the cabbage leaves - AMAZING ! Survived without painkillers. I had heard about that before but honestly I thought it was just an old wives tale.

Porridge has gotten me thinking..... I know that oatmeal increases lactation so I stay away from that BUT I have been eating buckwheat for breakfast for a few days now.
I found this info under a heading:
Herbs that stimulate milk production or quality
•    Fagopyrum Esculentum (Buckwheat).  Buckwheat contains rutin, useful for decreasing blood pressure. Buckwheat also limits the spikes in blood sugar.

Does anyone know if buckwheat could also increase milk production?

[Fiver]

I have absolutely no idea regarding the buckwheat.  I found the article you quoted on the 4th page of a google search and could find nowhere else that suggested that it made a difference to milk supply.  If you feel it's having an effect, you could always have something else for breakfast for a while and see if it seems to make a difference to you.

[becj86]

That's great that the block feeding is starting to have an effect!

Is it ok for me to express a little before feeding DD to make sure she doesn't get only foremilk?

Yes, just stimulate the nipples/areola as little as possible and keep in mind that block feeding will help her get more hindmilk (at least in the 2nd/3rd feedings on each side.

I'm so glad for you that you're aware enough of your own body to know you've got too much milk. I had a massive oversupply but DS was not putting on weight and I was told I didn't have enough milk for him despite being engorged almost constantly.

[eva026]

Problem half solved and not nearly as painful as it was:)
I am still doing 2 feeds per side and the unused side is only half ballooning.
By that I mean the top ducts that used to fill up are ok now but the bottom that used to be ok are filling up. Is that normal?

[becj86]

By that I mean the top ducts that used to fill up are ok now but the bottom that used to be ok are filling up. Is that normal?

Have you changed her feeding position? That would be explained by those ducts being drawn from more effectively when the breast is being emptied... Maybe you're just noticing the bottom ones now the top ones aren't as bad? I don't remember that specifically, sorry

[Fiver]

Glad you're seeing some progress.