Over supply and stopping expressing

[the100yearsofchristmas]

Hi.

I think I have a problem with over supply and/or fast let down and it had been causing my LO (14weeks) a few problems. I've managed to tame the feeding down a little by block feeding, which seems to have helped.

My question is regarding expressing. I've been expressing for the milk bank (as I had an abundance of milk which wasn't being used by my LO) and usually express between 200 and 280 ml from both breasts in total in one sitting, then managing to feed my LO straight after if she needs some and still have milk available! I'm wanting to stop the expressing. I've done over 5ltr of milk for the milk bank and now feel it's time to stop doing it for various reasons. What do I do about either cutting down the expressing or can I just stop? I'm slightly worried that by just stopping I'm going to have massively engorged boobs in the morning and this seems to make the let down even faster until I've expressed. Or do I express a smaller quantity bringing it down to none over the course of a few days and only expressing if and when my LO has a bottle of EBM from my partner? I have a couple of litres worth in the freezer still, so don't need to do it at the moment.

Many thanks in advance for your help and thanks for reading.

Sorry if you reply and I don't respond immediately, I am in the middle of a load of things, I will look back when I have a minute next :)

[TruthSweet]

If you have oversupply you can do the less and less pumping route slowly dropping how much you express/how long you express for until you are able to drop whole expressing sessions.

If you just stop, it will almost certainly hurt and you may well get mastitis/plugged ducts (not a guarantee of course just a likely consequence).

Does baby have difficulties feeding at all or is it just that you have so much milk not an overactive letdown?

[the100yearsofchristmas]

I've had no problems feeding her until recently, she latched on straight away and have never had any pain. And to be honest I don't have 'problems' feeding her now, I just feel like she is not enjoying the feeding as much as she's started fussing more recently, and pulling off the breast. She's started being a bit more burpy and bringing up more than she used to. She also ends up hiccupping, and sometimes coughing mid feed like 'there's bones in it' (that's what I have always said!) She also has had a mouth full of milk sometimes when she pulls off and this just comes out. If I feed lying down she feeds better, but there is always a big wet patch afterwards. I thought she was just a 'messy feeder' She's also clamped down on my nipple a few times now, which I thought was teething, but having read stuff realise this could be when the milk is letting down a lot as I can feel the let down. She sounds a bit gully at the beginning of feeds. My boobs always feel full and do spurt when she pulls off at times! She's also started to take a lot shorter feeds than she had then seems hungry really soon after that after a burp/little sick. I thought initially it could be reflux but she isn't crying in pain, can go straight on her back without a problem after a feed or anything else I've read about reflux, other than some of the 'symptoms' are the same.

She always feeds well and calmly after I've expressed.

To be honest I'm not 100% sure of what it is, I am a bit confused, it may well be reflux but I don't feel like it is and her feeding has been a bit better since I've stopped swapping breasts so often, she seems to have calmed down a lot with it, so I think the let down thing is a bit better now, but I still feel it. I had been swapping sides when she was fussing but read this could make the supply increase and let down more. So I've made sure I don't swap so often or give the other breast until she's fed for a proper amount of time on one side.

The reason I'm writing about this now is because I've noticed a LOT more engorgement now, I never got any until recently. And I was just wondering about the lowering of expressing, I think as you suggest that I will drop the amount I express in a session. I only do it once a day in the morning, so will reduce the amount I express and see how that goes.

[TruthSweet]

It could well be overactive letdown/oversupply that is causing the fussing, clamping down and reflux-y type symptoms. The link has lots of info on dealing with it as well as how to identify if it is, in fact, oversupply or overactive let down (aka forceful let down).

I hope this helps and you get back to the nursing you had before.

[the100yearsofchristmas]

Thanks truth. It's very interesting. I seem to have bypassed the one side per feed thing it suggests as a first thing and gone straight into block feeding. Mind you I didn't really swap part way through a session I just tended to use the other one if she wanted another feed soon after. I'll prob try a mixture of both. I'll stick to side feeding when I can esp if I feel engorged.

I just read through my other message and it had auto corrected gulpy to gully! Wonders what gully would sound like!

I'll also slowly decrease the expressing.

Thanks for your help, it's kind of what I thought so glad my instincts aren't too far out.

[TruthSweet]

I did wonder if 'gully' meant noisily or voraciously

I think your instincts are spot on! By the way a big thank you from me for expressing so much for the milk bank I'm not able to do so (too many meds rattling around in me) so it's fantastic to hear of someone donating SOOO much milk. I can't even begin to imagine how many prems could be fed for a day with 5l of ebm. You are fantastic!!

If block nursing doesn't work I do know of something else to try but it is a bit last ditch rather than the first thing you try. So if nothing else works (and I'm sure it will) I'll send you the details though it would be best if you had the support of a BFC/IBCLC while you did it.

[the100yearsofchristmas]

Thanks again truth. I'll see how this goes, it does seem a bit better, now at the end of day 3 of block nursing. So I hope I don't need the other info but I'll contact you if I do if that's ok and get a BFC if so :) and thanks re the milk bank comment, something I had planned on doing while I was still pg if I could and glad I have been able to. I'd carry on for ever if I could but circumstances have changed slightly and it's not as easy now.

[TruthSweet]

Incidentally, I have heard of mothers block nursing for up to 24hr on one side but that is an extreme and very unheard of thing! 3 - 6 hours on the one side is quite common I believe. You can combine it with just a tiny bit of hand expression if the 'other' side gets too full early into the block.

[the100yearsofchristmas]

Thanks

[ssmileWithFairylights]

Hi 100 its incredible the volume of expressing for milk bank well done. A lot of the symptoms you describe the yanking and bitting I've been getting too. Its partly an age thing our Lo are similar age, my let down is also vfast (babe feeds in 5-8mins mostly). I find she having a mini growth spurt around every 12days with increase feed, fussing, spurting. I hope the block feeding helps and you can reduce the expressing gradually to avoid blocked ducts/mastitous, gd luck.

[the100yearsofchristmas]

Thanks ssmile and thanks for popping over. Hadn't noticed any pattern to it but likewise she feeds in 5-8 min chunks sometimes slightly more and feeds often, but she had been having longer before I started to feel fuller, unless I'm remembering which came first wrongly and she started slightly shorter feeds then I felt fuller which seems to have made the let down a bit greater. It's hard to remember all these things when it's not till she's very fussy that you put two and two together. But also thanks re the it's the age comment, it's all new to me so wasn't sure if this happened at this age, must just be more aware of everything around her and wanting to be nosy!

[ssmileWithFairylights]

I do remember with first babe this patch it got vhard work feeding with other people or noise about in daytime as babe keeps yanking off to look around forgetting they are supposed to be feeding! I did use a muslin over her head for abit till she settled down but this Lo doesn't like that so I try to sit somewhere quiet or position her so she is looking at a blank wall or curtain so its not distracting her :o it does pass.

[falalalalagirl]

This is fascinating as I have experienced all the symptoms on the kellymom link too! DS was a massive comfort feeder but DD is always finished in under 10 mins and I spray her at every feed! She bobs on and off constantly and, like ssmile, I was putting it down to her being 3 months old and having better vision and being more interested in stuff but perhaps it's a combination of the two things. I only ever do one side at each feed anyway but I'm going to give block feeding a go too. I'll def be comparing notes with you if that's OK

And I think it's bloody amazing what you've done for the milk bank

[the100yearsofchristmas]

Gah. Feel like I'm fighting a battle feeding at the moment. I might be wrong with what I thought the other day. I don't know. Still seems to tick all the boxes but it's feeling quite hard just now. Have had a few tears with it all. Going to ring someone to chat about it.

[TruthSweet]

Sounds like a great idea to talk it through with someone. Let us know how you get on (hugs)

[ssmileWithFairylights]

Oh hugs 100 hope you can talk it through with a BF counsellor. Do let us know how you get on. Last wk I had rough time felt like I'd gone back a step with lots of night feeds, so I've upped freq of daytime feeds and last night was my best ever. I too read the kellymom site had some interesting stuff on it helped me understand bit more about how breast milk prod works.

[the100yearsofchristmas]

Well I rang LLL and spoke to someone. I'm still non the wiser over whether it's an over supply / let down issue. But it helped to talk. Some of my doubt over LO's feeding comes from a comment made by a hv when I got her weighed last time re her thumb sucking. But LO is happy. Chilled out most of the time. Not screaming in hunger and sleeping longer at night without waking for a feed so I have to trust she's getting enough. I could get her weighed on Friday to make sure. If she's not put weight on then I'll speak to docs about things and if she has then I'll just take it that she's going through a phase and try and relax a little about it.

The LLL lady said that they also become more efficient feeders as they get older so this might be why time wise she appears to be having less food. Poss taking same amount or right amount yet she's getting it quicker. As the time she's been feeding has gone down which has bothered me so I've tried to feed her more but she then refuses more if that makes sense. Since the hv said about her thumb sucking I don't trust my judgement on her being hungry as much as I used to, but I have to think of the fact she's a happy baby who is chilled and seems quite content so I can't be doing too much wrong with the feeding.

Gah it just feels more difficult just now, I'm sure it'll get better.

Re the expressing I've tried lowering the minutes I'm expressing for, dropped down to 7 mins each side this morning. Still pumped 180 ml! I'm going to try 6 mins tomorrow. But I was physically leaking before I pumped this morning. I know I'm lucky having loads of milk and i haven't had problems up till now so I should be singing and dancing but I'm just feeling a little off with it.

Thanks for listening.

[ssmileWithFairylights]

Grrr HVs! They gave me SO many doubts first time around with conflicting or incorrect "advice" I respect they have a difficult job to do but I didn't find the team in my town vuseful. You know your baby better than anyone and if she is putting on weight its prob ok. Both my girls have been very fast but frequent feeders. I was wracked with doubt first time around as a 5-8min feed wasn't "deemed" long enough, but this second Lo is doing exactly the same! My first is a vrobust 4yr old and babe is bang on 50th percentile. I think your doing brilliantly from your other posts. The other thing that could be impacting is I noticeably felt my hormone levels dropping last wk and felt weepy &tired. It could be the 3-4mth dip impactin too. Gd luck sure you feel better in few days time :)

[the100yearsofchristmas]

Thank you both for listening to me earlier and thanks falala comparing notes would be fine if it is in fact an over supply thing :)

I'm going to book an appointment to see the doctor, after casually reading through active discussions earlier I read a thread someone had put about a latch problem and someone put a link up to Tongue Ties, I've read through that link and some symptoms are the same, I know my LO has a tongue tie (I was told this when she was less than 24 hours old), but as I had had no problems with latch etc early on I kind of presumed it was OK. One of them is actually that it can 'give an appearance of oversupply' Now I really don't know what is wrong with my LO, if I'm just over thinking a lot of it and reading more into it than I need to and am worrying over nothing and she's probably fine. But I'm not able to let it go from my head at the moment, so I think I need to physically see someone to get her checked, get the TT assessed, discuss the possible over supply/let down thing and go from there. I may just be making a mountain out of a teeny tiny ant hill (it possibly isn't a big enough problem to call it a molehill) but I'm a bit concerned that it just doesn't feel 'right' at the moment.

Not sure when I'll get an appointment, what with it being Christmas in a couple of days. Might need some hand holding while I get through the period between now and when I get to see someone. I might also have self diagnosed several other potential things in the mean time and go for some other diagnosis - although I'm really hoping I don't look at anything else. I really ought to stop reading threads or googling x, y or z. It may be it's normal and as soon as I've seen someone my LO reverts back to her normal non fussy feeding. So many of these things seem to have symptoms that could be several things.

But I am going to see someone, and I'll ring the doctors tomorrow and see when I can have an appointment, and I'll probably still go to the BF group on Friday, get her weighed and speak to (hopefully) the good BF Health visitor that is there and not the one who gave her throwaway comment.

I'm sorry I've mentioned several different things in this thread, I'm just a new mum, never been through this before, having a slightly hard (it's no where near as bad as I know others have it, so I feel bad for whinging, I know I've been very lucky) time of feeding at the moment. When it had been so fabulous and it feels wrong and slightly stressful at the moment.

ssmile, I may also be making it feel worse in my head because of hormones, I do suffer with them at times. Like I say it could just be an ant hill problem, but by mulling it over and not doing something about it I won't know.

[TruthSweet]

Oh 100, it is difficult when there is so many things that it could be and no-one to tell what it actually is. If by 'the doctor' you mean your GP, I would be very surprised if they know about TT affecting bfing, let alone were able to do an assessment of baby's oral cavity. Try going through the Post-natal ward and asking for the TT clinic. If it's on baby's notes they have a TT then you should get a referral straight away so that you can speak to a specialist MW/Paed.

Unfortunately that's the difficulty with internet forums, if we were sitting down and having a chat (and a nice cup of tea and some good chocolate biscuits) it might be different info I'd shown you as we might have talked about things in a different order (I usually ask about the birth/newborn period first).

Glad I hadn't posted the 'final solution' to oversupply as that might have put the kibosh on things!

Hope you can get things sorted before the New Year.

[the100yearsofchristmas]

Thanks Truth. I can def see her TT but like I said I thought as things had been ok up till now that it wasn't a problem. It still might not be a problem. As i said it might just be something she's going through just now and will be fine soon. I'll do some ringing around tomorrow and see where I get.

Really appreciate being able to chat and (sort of) work things out by posting.

I will post more once I've spoken to someone. Have checked notes and it is on the baby discharge summary so I'll try the hospital first and see who they say to contact.

[TruthSweet]

As she's 14 weeks it would be worth getting it sorted soon (it gets a bit more complicated as they get older due to nerves growing into the frenulum after 4m+).

I saw a well respected MW/BFC who runs a TT clinic in London do a presentation on TT and she said that some babies have a tiny tie and it makes huge difficulties and yet other babies can feed fine with a massive tie (well she used technical terms but you get the gist!) so it may be not related or it may be related. There might be a point having it snipped due to the other health implications of TT or you may decide against it - it really is your choice but the TT assessor should help you with which way is best in your DD's case.

I'm actually having DD3 assessed for TT soon and she is 2.2y but she has speech problems and has asthma (if anything helped her breathe easier I'd do it though the asthma is not related to the poss. TT). Trouble is now it would be an op under general anaesthetic not a quick snip and straight on the breast . Her weight gain was shocking and she has only now tripled her birth weight at 2y when she should have done that at 1y (double at 1y instead of 6m) - that was always put down to her bronchiolitis/asthma but now I am not so sure.

It can be horrible the self doubt and guilt we carry as mothers (and as fathers do too). It seems sometimes we can't make the right decision as they are all wrong! Oh for a magic wand

[ssmileWithFairylights]

Gd luck with getting babes TT assessed. I would second contactin hospital too if its in babys notes. Our hospital has TT clinic as my friend had boy done recently under general as they didn't do it as babe. It's vtough being a mum, and first time round its extremely tough I found my confidence went through the floor a few months in as exhaustion &crashing hormones kicked in. Mumsnet as place to chat is really helping me this time let of steam :o hope u feel bit better making a plan of action even if u are unable to talk to someone before Xmas.

[the100yearsofchristmas]

I had her weighed last week as an extra to her normal weighing ins, I had been taking her at her jabs, and in 12 days she had only gained 3oz, when I was expecting about 7 or 8, then she did a massive poo(3 day's worth - normal), so might have lost 1 of those oz she had gained! Her weight gain had been brilliant up until last week's weigh in(about a week after her bitty feeding started), which may have prompted me to look at why, or maybe doubt that things are OK. I'm going to get her weighed tomorrow just to be double sure(I know it's early from the last weigh in) as that alone might stop me worrying so much over Christmas, alternatively if she's not gained then I'll be worse possibly(but will at least have hard facts), but if I don't go I won't know! I have rung my MW from when I was pg and she gave me the contact for a mw who specialises in lactation and works alongside a local(ish) TT clinic, so I have rung the lady and left a message asking for her to call me back. My MW also said the HV I saw 3 weeks ago at the BF group is really good with TT, so while I'm getting her weighed I'll see if I can discuss the problems if I've not heard back from the MW I left a message for.

Truth I hope that you yourself get some help and things for your DD3 get better.

ssmile, yep confidence currently at level 1 re feeding, level 9 re loads of other things!

[TruthSweet]

100 - That sounds like you have got a really good set up where you are - use it to the full . Try not to worry about your DD's weight gain too much, feeding as she cues for it, keeping her close and responding to her needs will all help. Have you stopped block nursing now?

On the DD3 front - I'm a peer supporter (graduated just before DD3 was born) and active in our local group yet when DD3 clicked during feeding for months on end it just got put down to one of those things even when we knew she had a bubble palate!

I always have known there was something 'funky' going on with all 3 DDs mouths (all have high arched, narrow with a bubble) but didn't know until DD3 was about a year that these things can be connected with TT.

I've a LOT on my plate over the last 18m and haven't really had the strength to fight one more battle but I know I do need to get it sorted one way or another especially after her really rather poor 2y check.

I just wish DD1 had been checked at birth for TT as her feeding difficulties were immense and we were very lucky to be able resurrect bfing at all, let alone go to self weaning. As well as wishing I had refused the not necessary induction and the cascade of interventions that followed culminating in DD1 being forcefed 2oz of formula every 2 hours due jaundice....

Oh, the ways we can twist ourselves to apportion guilt on our own heads! Well I am legendary for it anyway

Have a great First Christmas with baby.

[the100yearsofchristmas]

I'm still half block nursing, as in if she has only had 5 mins and wants more within a short time then I'm offering the same boob, but if she's had more than about 10 then when she appears to want food then I'm offering the other breast. Because I know there is still loads in the one and I think at 5 mins she might not be getting enough of the good stuff before swapping over, but it's kind of how I had done it before. The trouble is, now she is thumb sucking it's harder to recognise the cues, although I think I have spotted the difference between her sucking that she does a lot of the time and her hungry thumb sucking.

The BF MW rang me back, said to go to BF group tomorrow, speak to a specific HV and if she thinks it's a TT issue then ring her back and she'll be able to help me (after christmas) and if it's not then I'll be able to have an idea. She said that sometimes a TT problem doesn't become apparent till this sort of time because the milk is more settled and so with a TT it's harder to get it out than it was initially and a milk TT can cause as many problems or more than a big tie which is what you said in your post above.

Might give her a bottle of EBM later see how she goes with that, not that it really shows any thing, but I think it will help me to not do one feed - although I'll pump when OH does it.

Sounds tough for you, I think it's great that you are helping others even though you probably have more than enough on your plate to deal with your own things and am very grateful to you.

On with today and wait for tomorrow at the clinic. Maybe it will all just right itself overnight! (we can dream)