When you hear about breastfeeding in the world and the blogosphere, usually it’s either to educate women on the merits of breastfeeding, or to discuss women’s right to breastfeed in public, or to promote breastfeeding in general, or lament the low breastfeeding stats in our country. We all know that breast is best, but you don’t find much about the actual act of breastfeeding itself—the details of it which can make it so challenging. And trust me, breastfeeding is challenging! Despite it being the most natural, obvious thing in the entire world…it’s not instinctual. It’s a learned behavior, and something which each breastfeeding pair must learn together. I didn’t quite understand this until now. I just took it as a given that we would breastfeed (because OF COURSE we would), but the how-to of it wasn’t ever something I even thought about. Until now.
I took a breastfeeding class last week. Yes, I actually took a class. And I’ll be attending it again this coming week as well. This from a midwife, someone who has taught countless other women about breastfeeding, and who has helped countless women get a good latch with their brand new baby. But there’s a big difference between helping a newborn (as in, minutes-old) baby latch for the very first time versus addressing the myriad difficulties and complications which come up over the course of time: the engorgement, the first growth spurt, and then what happens after the first growth spurt. There’s much to be said for getting a baby onto the breast in the first hour of life, but as a midwife you’re not doing much lactation support at 3 weeks of life. Maybe a bit more at the 6 week postpartum check-up, but in between birth and 6 weeks, a lot of breastfeeding happens, and a lot of challenges arise.
Case in point: for me, my challenge is oversupply. I have a huge oversupply problem! Who would have guessed that I would be such a milk goddess?? Whenever I thought about potential breastfeeding snafus, I always thought about undersupply. It didn’t even really occur to me that oversupply could be a problem. But it can indeed be a problem. A very challenging problem, in fact. So, I will speak to this for a bit, since I now have first-hand experience with it (and maybe someone else wants to write a guest article about first-hand experience with an undersupply problem?).
This is what oversupply looks like: ever since my son’s growth spurt, my breasts have been painfully full. When he tries to latch, he has a hard time getting his little mouth to even indent the breast, and then when he does, the milk flows down so quickly it completely overwhelms him, and he ends up pulling back and choking. This has made his latch very painful for the past few weeks. In an attempt to stem the overwhelming tide of milk, he’s been pursing his lips and using a much smaller latch than he was the first two weeks, which has led to him sucking little grooves into my nipple and turning the nipples black and blue. I keep trying to get him to use a wider latch, but inevitably he closes his mouth to a smaller diameter again, and I can’t really blame him. I would do the same, too, if the milk was flowing so quickly into my poor mouth. During let-down, my let-down has been so forceful that I have actually sprayed him in the face with milk, like a shooting milk geyser! Poor guy, how is he supposed to drink from a breast that is out to get him like this? Every feeding has become a wet and sticky mess. By the end of it, I’m covered in milk, he’s covered in milk (bring on the baby acne!) and my clothes are covered in milk. Forget trying to nurse in public at this point, there is no way we can be discreet at this point. Every feeding feels like a pitched battle against the exploding milk fountain of doom!
Then, there are the digestion issues. Because the milk is flowing so fast, he ends up gulping a lot of air. Despite frequent burp sessions, his little belly is full of air by the end of the feeding. He’s also become a really fast drinker to try to cope with the let-down. He may finish the breast in about 10 minutes, but it hasn’t satisfied his urge to suck yet, so he continues to try to suckle at the breast for another 20 minutes or so. And because he’s drinking so quickly, and filling up so quickly, he’s not always getting to the hind-milk at the back of the breast, which comes at the very end of the feeding. I just found out that hind-milk is crucial to improving his digestion. If he’s getting enough hind-milk, he digests everything more slowly, and the poop is mustard yellow and much easier on his G.I. tract (less gas, less explosive poops, less fussing). If he’s not getting enough hind-milk, everything digests much too quickly, with a lot more gas and fussing involved, and comes out green instead of yellow.
I went to a breastfeeding class last week, and this is the advice I was given: first, try more upright feeding positions, where he’s sitting up or across my chest but I am leaning back so that his head is over the breast, rather than under it. This will make the milk have to work against gravity, which might help slow the flow down. I was pumping a little bit before feeding him to try to soften the breast somewhat and make it easier for him to latch. The lactation consultant advised to stop pumping immediately, because this was just encouraging more milk production! Instead, I can manually express just a bit, if I have to, but if at all possible I should just let him eat directly from the breast, and supposedly that will help regulate our supply/ demand more quickly. She advised I continue with the frequent burpings, and that if he finishes the breast quickly but still wants to suck, I can offer him a pacifier or clean finger to suck on instead, since continued sucking helps with his peristalsis and may also help him digest the milk more easily and spit-up less. She suggested that I could also try block feedings if I wanted to in an effort to make sure he gets enough hind-milk (this is where I offer him the same breast for 2—or more—feedings in a row, so that I know for sure that the breast is completely drained and that he got the hind-milk before moving on to the other breast). However, other advice is suggesting that maybe block feedings are not the best idea, since this increases the risk of mastitis and may eventually lead to undersupply (see the link below from Nurtured Child).
I’ve been looking up some other resources about oversupply on the web. This is what I’ve found so far, which has been very helpful:
Kellymom.com – great resource for all things Breastfeeding. I just added it as a permanent link under the Breastfeeding section.
Nurtured Child: Managing Oversupply (written by a LLL leader), which discusses frequent switching of sides rather than block-feeding as a way of dealing with it.
At the moment, we’re skipping the block feedings, I’m doing manual expression when needed, and just letting the little guy eat directly from the breast when he’s hungry. And hoping that the supply/ demand issues will sort themselves out soon. But no, it’s not easy. Even with too much milk, there are still challenges. I will keep you all posted!