4 day old, engorgement - help!

[Wink's Marmy]

Hi there. DS is 4 days old and I'm suddenly super engorged as over the past 24 hours, my milk has come in completely. He had no problems latching until last night and then getting him on my super hard & round nipple has been quite the challenge. My Doula came today to watch me nurse and she helped me get a good position. She felt I was nursing him too much - very on demand - he wasn't getting real full feeds. Anyway, she helped me get him latched on properly and encouraged me to space feedings 3 hours from when the last one ended. So I did that 3 hours later and my breasts had become so engorged, that everything went down the tubes again and regardless of what she showed me earlier, he still has trouble latching. It's not that he can't latch at all - it's just lots of fighting it, then once he finally latches, he chokes from the let down. I've tried burping, burping, burping. Sometimes it works and he burps and then latches.

Anyway, these are my questions:

I tried pumping a little before feeding him - don't know if it helped and how much should I pump anyway?

I had to pump afterward because my breasts hurt. How can I minimize this awful engorgement? I want it gone PRONTO! Help!

[anna*]

Beware of pumping too much because as you probably know it will actually cause more supply! I would try hand expressing a little right before you feed, just until the breast is a little softer to see if that makes it easier for him to get a latch. If you can express until you get a let down, that should make the flow easier for him to deal with too.

Honestly I would let him feed at 2 or 2.5hrs if that is what he wants - it is very common at this age for feeds to be much less than 3hrs and that will help with the discomfort too. Feeding should definitely be on demand at this stage, this is all about regulating demand/supply of milk.

If your boobs are really uncomfortable between feeds, I would try cold wash cloths and if that doesn't give any relief then hand expressing just a very small amount, just enough to relieve some of the pressure. When little one is feeding, if you have any hard lumps and bumps in your boob, putting a finger on the lump while he is feeding should help the milk to release and the duct to go soft again. This WILL pass, but it will take a couple of days while your supply adjusts to how much milk he is taking. Keep a strict eye out for any flu-like symptoms or fever you ahve, and get seen to straight away.

[Roseii]

Ouch I remember this sooo clearly, I was in agony and DD2 refused flat out to feed from my left side for the first week or so. As Anna says be wary of pumping, you'll only encourage your supply (great in time, but not now lol!) I hand expressed a bit, warm flannels on my boobs and took paracetomol. It will pass quickly hun, I know how painful it is though, I can almost feel it now my memory is so raw of that time!!! (((hugs))) xx

[Wink's Marmy]

Thanks for the advice. I have pumped a little off each breast before each feed and he is finally latching well. He has gained 5 oz. in 48 hours, since the milk came in!    Which is great for him!

DD came out of the womb not wanting much milk. Nursing was like a horror story until she was about 3 months old. To this day she picks at her food and doesn't want to eat anything (except chocolate). All I have said about this baby is that I hope he eats. So I guess I got what I hoped for! (Fingers crossed)

I got some advice from a nurse today to pump AFTER the feed as well if I'm still uncomfortable in order to avoid mastitus. She told me to pump 15 minutes if I had to. Just pumping before the feeds, I pump about 2 minutes and get an ounce off each breast - this to me is too much. Her advice made me seriously question her knowledge of BF. Why is there so little medical help for BF moms? You have the pediatrician for the baby, the OB or midwife for the mom, but not many for the boobs. Where I live, we have so few lactation consultants. Currently waiting for a call back from one now, but it's hard to even get that.

[anna*]

((((hugs)))) I know, it is so, so hard and so frustrating. My maternity hospital makes a great big deal about supporting WHO recommendations, but so many of the midwives and health visitors seem to know so little.

I really, really, REALLY (really ) would not pump 15 mins after a feed. Pumping after a feed is an excellent tactic to increase your supply, but that's not what you want to do right now. You need to pump as little as possible, so that your baby and your breasts can work together to get the right level of supply. I'd agree to pump if you are seriously uncomfortable (if warm/cold washcloths and tylenol won't fix it), but only to hand express and only enough to relieve the immediate engorgement.

[C&B&E]

would have to agree with anna - pumping after a feed is the advice given to mums who want to *increase* their supply!! 

kellymom.com is a great website that had so much thorough advice about breastfeeding, you might want to check it out
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