Fast let down, oversupply? and gassy baby as result :(

[2pink1blue]

Hello-

I'm a FTB'r (single side) and have a question. My daughter (4 weeks) seems to get very gassy about an hour after a feed. When I let down, I can hear her chugging and gasping the milk down and can almost feel the gas bubbles going down her poor little tummy. Sometimes she will cough and choke. I've tried pulling her off at this point and burping her, which results in her screaming (and not burping), and milk spurting everywhere! I've tried Mylicon before, in the middle and after a feeding. No help. 've tried gripe water (which works great when she takes a bottle of BM at night from DH, but doesn't work in combo with the breast).

I try to burp her after feedings, but particularly at night, I don't get anything out of her (again, on the breast. With the bottle she'll let out great burps). She's usually too relaxed and asleep after feeding on the breast. The main problem is that she will wake an hour after a feeding, screaming in pain. I know it's gas b/c when she co-slept on my chest, I would feel her scrunch up, she would scream and cry until she passed the gas. Unfortunately it's not just one little toot - it's hours worth of gas, which means she gets very little sleep toward the end of the night and starts the day overtired.

My question is - is there anything I can do to help her manage my letdown? I also think I'm producing a lot of milk (although I can only get 2-3 oz when I pump), because she seems overfull and uncomfortable sometimes with a swollen little belly, and she also seems to want to eat every 4 hours instead of every 3. When I try to enforce 3 hour feedings, she again gets overfull, uncomfortable and very gassy/poopy. Thoughts on this as well? I think 4 weeks is a little early to go to feedings at 4 hours, but 3 hours isn't really working for us either! (She was 6 lbs 11 oz when born, 6 lbs 4 oz at 5 days, and I'm guessing about 7.5 or 8 lbs at 4 weeks, although we go to ped tomorrow).

Any advice would be appreciated! I have 2 other children (and BW was a huge help to me when they were little!), but didn't nurse either of them, so this is new to me! I just want her to be more well rested and not so uncomfortable! She's a great sleeper when the gas is not an issue!

Thanks!

[shivi]

hi there

big hugs}}}}}}}}}}}{{{{{{{{{{{{{
I have "suffered" with fast letdown and oversupply my whole nursing relationship this time, with DD aged just over 10 mths.
To add to that we had an undiagnosed tongue tie till 3 mths and didn't have it snipped till almost 5 so we had MAJOR issues with gas, supply, unhappy baby and unhappy toddler-preschooler (my now 3.5 yr old DS) who had to sit downstairs while I fed DD in dark room upstairs!

BUt what I did/do to combat the fast let down (now its only from one side, the left, that its too fast) is I have a muslin at the ready and I catch the sprays as they come, then put D on when it slows down.
She then copes much better.
The other thing you could do is pump off (I just had to hold the electric pump with the suction working without actually pumping to get a letdown) or just collect off....I did this from around 6-7 weeks when the left supply was still huge and the right more normal...I would feed from right, collect off from left and then put DD on left for the second, slower letdown.

hate to say it, but dd is still gassy, despite being able to sit, stand alone in cot etc....and esp so after bedtime feed...she hasn't reflux though I did wonder in the early days, its all about her not being able to cope with the letdown. I still soak a muslin from left if I feed first from right, even now at 10 mths.

I would say stop any attempts you are making at making MORE milk, so any supplements, any pumping after feeds etc (instead of a feed if you have collected off is fine I think) as this will hinder your body in its attempts to match demand and supply.

In my case I think partly the oversupply and overactive letdown may be emotionally/hormonally linked...and this is hard to overcome. I fed DS without batting an eyelid (seriously, nothing got in our way - no cracked nipples, no issues right along) till he self weaned at 16 mths.
I have always had hyper prolactinemia (too much bfeeding hormone) which prevented me from getting pg and ovulating without treatment while TTC so this is a factor too...
but with DD and her weight gain issues early on and the fact that she is "my last" and that I "did it once can do it again" not to mention the tongue tie ....its like my body is producing more milk than DD needs because my psyche needs it as well!!!

good luck

S x

[Whatbit]

One suggestion I was given for fast let-down is to lean back as much as posible when nursing so that my LO is leaning more onto me.  That way the milk isn't just pouring into his mouth and he gasps less.  It has helped the gas and the spitting up.
Best of luck!! 

[A pair of Charlies]

Great advice here 

My LO was really gassy in the early months. I found Infacol to be our saviour. Given before every feed it really helped with the gas - DS gave up the burps easily and heartily, whereas before we'd get a few but he'd still be really really uncomfortable.

The other thing I would suggest is popping over to the Reflux board and checking the symptoms there, just to be sure. It's better to be sure we these things. 

This might have some info: http://babywhispererforums.com/index.php?topic=117061.0

[2pink1blue]

Thanks ladies! I'm fairly sure it's the letdown - I compared the symptoms and it seems to be a better fit. Plus, I can pump off an ounce in about 2 minutes or less - depending on time of day.

Should I be worried about a foremilk imbalance at this point? Her poops are explosive and frequent (sometimes as many as 6 a day), but definitely mustardy. Shivi - when you collected from the left (and fed from the right), did you save that expressed milk? Or was it too high in foremilk and do you need to pump and dump?

I tried pumping off about an ounce before feeding her earlier, and positioning her differently and it did seem to help! I'm going to try pumping off less and less before each feed until it regulates, and am also going to try 3 hour block feeding.

Thanks again! If anyone else has any other suggestions, please let me know!

[shivi]

no, I used what I had collected, (didn't really pump, just held one of those pre-sterilised avent cups up to breast) to top emma off after 7pm feeds....(for which, I had undersupply or at least underactive letdown.....during the madness of getting two kids incl a newborn to bed alone....after full days,....).

I would say, don't dump it...its too precious!
freeze if all else fails....or if you don't need it....in deep freeze can last (-24 degrees) I think 6 mths! So good for early solids!

[Whatbit]

My LO had the explosive poops too!  Two times it even came out of his diaper and onto my lap! 6 poops a day sounds pretty normal in the early weeks- Mine for sure did that and still does about 4-5 now at almost 6 weeks.
Keep up the great job!

[2pink1blue]

Another question, ladies ... should I abandon all pumping (except up to letdown)? I had been feeding DD first thing in the a.m., and pumping the other breast simultaneously, thus starting the day "empty." Same thing for the last before bed feeding (between 7-9p, depending on day) - going to bed "empty." Am thinking this may be contributing to my problem...

Would love to keep pumping at least 3 oz a day so that hubby can help with one feeding overnight (since she's up every 1-2 hours with gas, it's too much for one person at going on five weeks!). But am not sure how to achieve this without adding to the engorgement/oversupply problem (and therefore an even stronger letdown). But am thinking that I should forget about pumping, at least for a few days...

Advice?

Thanks - you've all been so helpful. The new positioning does seem to work. Still not a lot of luck with burps - if I lay her flat on her back and then burp her, I might get one. I've been trying to do this once in the middle and then at the end of each feeding. Not sure that's really making a difference...

[A pair of Charlies]

Would definately see if you can get hold of Infacol or similar for the burps. Sometimes when the air bubbles are small and many, it's hard to get them out and so they can really cause discomfort. Infacol / similar products magically get the air to form larger bubbles which are then more easily passed, with a much happier baby as a result - not in pain / discomfort so easier to settle. 

TBH, I would pump if you need to increase supply or in place of a nursing session, i.e. if giving a bottle of EBM, pump that nursing session instead. Other than that, if your supply is fine then I wouldn't pump. It is nice to build up a little bit of a stash in the freezer, yes, but the composition of BM changes over time in line with your baby's needs so what your body is making now might not be what she needs in a few months time, IYKWIM.

As for poop. Yeh, can be explosive. Colour and consistency are the indicators and sounds like your LO is doing really well. If you're interested in what is normal, what's not and what you might see at some point, try: http://babywhispererforums.com/index.php?topic=159015.0

HTH
Charlotte

[knackered]

I had similar issues with both mine. Position was key - in the early days I reclined as much as I could. Lying flat on your back with the baby on top works quite well. The other thing that helped my body to regulate the amount of milk it was producing was block feeding. So basically you feed from the same side for 2 feeds, then feed from the other side for 2 feeds. This sends a message to your milk making bits to slow down on the production.

On another note - I found that eliminating wheat from my diet helped enormously. Do you think there might be a dietary element to your LO's gas problems?

Anna xx

[fellsfeline]

Oh really?  Wheat?  I have a fast letdown & often times my darling Amelia coughs while the milk comes pouring out like hose.  I am very careful about what I eat but have not cut wheat out.......interesting.

[2pink1blue]

I've not tried cutting out wheat ... at this point I'm so confused as to what to attribute it to! I am seeing the Lactation Nurse at my ped's office tomorrow ... maybe she can shed some light. The confusing thing for me today was that she's not gained a sufficient amount of weight. The ped is willing to give her another month to 'catch up,' but he said if she's not 10 lbs by her next appt, he wants to discuss what we can do to get her gaining weight. But she has many sopping wet diapers and many poopy diapers every day, so I don't get it! Ugh.

Whatbit - that's funny about the poop. Several times Zoe has shot it right out the leg of the diaper and it's ended up all over me, but the diaper was perfectly pristine! I don't know how she does it.

Charlotte - is Infacol like Mylicon here in the states? A drop to relieve gassiness? We've tried that, but if there's another product out there that might be better, I"m willing to give it a shot! I don't remember seeing that on our shelves here though...

Thanks again ladies! It's so nice to have support and resources for all my questions!

[fellsfeline]

We have used Mylicon but there are no proven results for Mylicon.  In studies, it worked just as well as a placebo although some people swear by it.  I have heard Gripe Water works very well.