Oversupply and Fast Letdown
The following conversation took place between Jana and a reader. Some of you may have had similar issues. Is there anything you would add?
I am having issues with overactive flow and fast let down. When my breasts are very full, my baby has a difficult time latching; we get a lot of ‘popping off’ and nipple sucking. My baby coughs and pulls off my breast frequently.
I am quite often engorged and uncomfortable in the mornings. I almost never feel “empty”. My baby is gaining weight well/above average.
An overactive or fast letdown can make breastfeeding difficult.
The first letdown is usually the strongest; you may need to slip her off the breast, and wait a few minutes, before putting her back on. Some moms stimulate the first letdown by hand expressing or pumping for a few minutes before feeds. With a bit of trial and error, you will discover what works best for you.
You may want to try breastfeeding in positions that help your baby cope with the fast flow. You could try nursing with baby sitting upright or lying on top of the breast while you lean back in a recliner. Some moms find that lying down to nurse works best.
I wonder if your baby would be less frustrated if you decreased your milk supply a little. ‘Block feeding’ can help to decrease your supply a bit. Offer the same breast, anytime baby wants to feed, for a block of time. Start with a 2 to 3-hour block. It can take a bit of time for your supply to adjust. In more extreme cases, mothers may have to increase the length of the “block”.
How can I make sure my baby gets hindmilk and not only just foremilk?
If your baby is gaining weight and not overly fussy, don’t worry about foremilk and hindmilk. Babies who are getting too much foremilk usually have consistently green stools and are fussy. You can read more about foremilk and hindmilk here.
If I pump my breasts for relief, will it tell my body that baby drank that milk and it needs to produce that much again? Would it be better to pump only a little for relief? If I pump only a little, will I increase my risk of mastitis, as my breast is not completely “drained”?
You could pump a little when you are uncomfortably full but yes, you are correct; your body will keep producing an oversupply if you pump lots in addition to baby being at the breast.
I would suggest pumping off partially, just to take the edge off when you are very uncomfortable. Watch for signs of mastitis. If a reddened area or a hard lump appears in your breast, then you (or hopefully your baby) will need to “drain” it a bit more. Nothing drains a breast better than a baby!
Good luck. Enjoy lots of snuggles with your baby! Nothing better. — Jana
Cindy and Jana are Registered Nurses and International Board Certified Lactation Consultants who have assisted over 20,000 families.
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