Fast let down and over supply

[sezzolou]

Can anyone please offer any advice on fast let down and over supply. Lo is 12 days old. We are managing ok during the day with 2-3 hourly feeds feeding with me in a reclined position so lo is working against gravity and with lots of winding followng a feed. But now hes doing longer stretches between feeds of around 4-5 hours at night it means let down and over supply is more troublesome during the middle of the night feed. He gags, chokes and coughs throughout the feed and despite a good 20 mins winding and being kept in a upright position for half an hour he still spends the remainder of the night struggling with wind and reflux often gagging and crying in his sleep. I have been doing a dream feed around 10.30, previous feed around 6/7pm. Should i miss this dream feed? Should i express a little prior to his Night feed - would this slow the flow a little or end up producing more milk?

Thanks x

 

[noon_child]

The two issues, fast letdown and oversupply are often lumped together as they can have similar symptoms however there is a slight difference in approach if you just have fast letdown to if you have too much milk.

If letdown is tricky to manage, increasing frequency of feeding can help (like you said, during the day it's more manageable) as milk volume doesn't build up as much and baby can cope better, chokes less and pulls back less. However if you are actually producing too much milk you MAY need to reduce the frequency and duration of feeds. (This is not usually advisable with very young babies without consulting a Lactation Consultant) So two opposite approaches to something often seen as one problem.

Sounds like you are already doing good things with the reclined feeding. This info might help, although good to talk through it with a breastfeeding counsellor/peer supporter/Lactation consultant in order not to feel too overwhelmed Too Much Milk and Oversupply - La Leche League GB

My thoughts are that if baby is doing longish stretches and seems satisfied by feeds then you probably don't have a problematically high milk supply as he is still able to access hight fat milk and he doesn't just get full of watery milk. Sounds like maybe forceful letdown is the main culprit. In which case it may be that expressing off small amounts prior to night feeds, or letting down in to a towel, so that he is more comfortable and taking in less air would work for you. As long as you don't express more than the initial letdown, it shouldn't cause increased supply. As baby grows he'll manage better with it, and as you reach growth spurts, if you do have a slight over supply these growth spurts should help, as his appetite catches up with production.

The key with both approaches is to ensure he is definitely feeding effectively. If all he's doing is drinking letdown but not actively sucking, he wont be getting what he needs (and he'll probably take more air of not latched well). Do you have any face to face support?