Stressed!!! Overactive let down, colic, bad latch

[Tonks]

I'm so stressed out. Every night the same routine happens. From 6pm to 10pm my daughter has a lot of trouble with Feeding. I exclusively breastfeed and she is 9 weeks. For the first 7 weeks I had a massive over supply, like I could feed her and then pump 11 ounces in five minutes!! Yea it was massive. This was very stressful for her but it's how she learned to eat with big gulps and lots of milk fast. Once my milk regulated I still have. Very heavy let down, but the over supply issue is better. Anyway now my daughter struggles quite a bit with the let down, gagging and crying and pulling off then wanting back on but if I express first so she doesn't have to deal with it she won't latch right and gets nothing. I have plenty of milk there she just won't pull it down. All day she handles my letdown then suddenly in the evening she cannot take it. So I tried expressing and she suckles but no swallows and then gets very frustrated because she is starving. I give her a minute to calm down and put her back on the other side which I have not expressed the let down hits and she gets mad. It's a cycle. I think she learned to eat lazily cuz with my oversupply she barely had to suck, same with my let down, then once it's past she just dry sucks. She is getting enough over all she is in the 97% in weight but that's because she feeds every hour taking just the letdown. Until evening in which case she pretty much is starving and colicky because the issue I iust described. I have tried all the nursing positions recommended for heavy let down but in the evening nothing works.HELP!!!

 

[noon_child]

If she handles your let down during the day then it may be that she doesn't really want the milk in the evening - maybe she's comfort sucking to try to get to sleep so a big let down is too much but she can't quite get to sleep if she has to work hard to get any milk at all.

I know some people don't want to use any bottles, but have you thought about feeding her your expressed milk in a bottle? If she won't take it you know she isn't really hungry and if she is hungry it will be midway between no let down and a fast one.

If you don't want any bottles - which is fine - maybe you could start introducing a bedtime routine at about 5:30 including relaxing baths, or baby massage, low lighting, limited noise etc. and see if you can get her to fall asleep about 6:30pm. An overtired baby can show all the symptoms you describe regardless of letdown.

 

[Maxy1]

Do you need to feed her so often? Every hour is a lot and will be keeping your supply higher than needed. If your LO is only feeding off the let down, she is probably not getting enough hind milk. its the hind milk that has a higher fat content which keeps LO's fuller for longer. Just keep offering your LO the same breast during a 2.5 hour block. Don't alternate. She needs to learn to empty the breast properly and it might help with retained gas.

Overloading on foremilk might be causing your LO to be colicky in the evening.

 

[noon_child]

Do you need to feed her so often? Every hour is a lot and will be keeping your supply higher than needed.

Feeding frequently is recommended for over supply because it prevents the breasts from becoming engorged. LO will take less milk more often not more milk in total, so it shouldn't increase supply.

If your LO is only feeding off the let down, she is probably not getting enough hind milk. its the hind milk that has a higher fat content which keeps LO's fuller for longer.

Actually there is the same amount of fat (actual grams of fat) in all milk, it's just that because milk at the beginning of a feed is a bigger volume and towards the end is a smaller volume the % of fat in the milk gets bigger. It is perfectly possible to satisfy a baby's need for fat off any breastmilk - it is a bit of a myth that babies need to feed for x amount of time to get "enough". If OP is struggling with the frequency of feeds I agree that encouraging each feed to be longer could help, but only if LO i stalling asleep before she is satisfied. If she stops because she is full, getting her to stay on longer may just end up with LO throwing up the excess milk. Breast compressions can encourage a lazy baby to keep feeding as they can cause milk to flow more quickly towards the end of a feed. BUT pumping off a feed and then encouraging LO to feed will definitely increase supply - it was what I had to do when my LO wasn't feeding enough to get my supply up.

Just keep offering your LO the same breast during a 2.5 hour block. Don't alternate. She needs to learn to empty the breast properly and it might help with retained gas.

I agree, staying with the same breast will mean less forceful letdowns on that side and encourage your breasts to make less milk. When finally swapping sides and getting a very forceful letdown from the full side, try unlatching LO at the point of letdown and catching the excess in a cloth. When the flow slows a little, but the milk is still freely flowing, relatch LO. Unlike pumping this shouldn't encourage supply and also should help LO not to gulp down air along with milk.

 

[Tonks]

If she handles your let down during the day then it may be that she doesn't really want the milk in the evening - maybe she's comfort sucking to try to get to sleep so a big let down is too much but she can't quite get to sleep if she has to work hard to get any milk at all.

I know some people don't want to use any bottles, but have you thought about feeding her your expressed milk in a bottle? If she won't take it you know she isn't really hungry and if she is hungry it will be midway between no let down and a fast one.

If you don't want any bottles - which is fine - maybe you could start introducing a bedtime routine at about 5:30 including relaxing baths, or baby massage, low lighting, limited noise etc. and see if you can get her to fall asleep about 6:30pm. An overtired baby can show all the symptoms you describe regardless of letdown.

Thank you, I'm not sure I want to use the bottle just yet. I have tried a passie though and she refuses. I have started a routine. A nap at 4:30-5:30 then bath time at 8. This has helped some. I know she was overly tired because she doesn't nap anymore during the day unless I hold her and rock the entire time. I know she needs more sleep so I've been doing an hour or two nap at noon and then at 4:30, I just hold her a rock the entire time, But I sm not familiar with baby massage techniques any suggestions of where I dan learn these?

 

[Tonks]

Do you need to feed her so often? Every hour is a lot and will be keeping your supply higher than needed. If your LO is only feeding off the let down, she is probably not getting enough hind milk. its the hind milk that has a higher fat content which keeps LO's fuller for longer. Just keep offering your LO the same breast during a 2.5 hour block. Don't alternate. She needs to learn to empty the breast properly and it might help with retained gas.

Overloading on foremilk might be causing your LO to be colicky in the evening.

Yes I believe it is too often, lol but I'm not sure what to do when she is clearly hungry and wanting to eat. She used to empty a Breast when I had an oversupply then nap for a few hours. Since my milk flow has changed she refuses to suck other than flutter sucks after the letdown, the naps have also gone away probably because her belly is not really full, and also probably why she is constantly wanting to feed. I have read the foremilk does not keep the baby as full as hind. But I'm not sure how to teach her to stay sucking when she won't. I unlatch her and relatch on sane Breast trying to drain it before changing breasts but it doesn't work. Right now I'm trying to work on the napping hoping it will help if she is better rested. How do you think I can teach her? Thx

 

[Tonks]

Do you need to feed her so often? Every hour is a lot and will be keeping your supply higher than needed.

Feeding frequently is recommended for over supply because it prevents the breasts from becoming engorged. LO will take less milk more often not more milk in total, so it shouldn't increase supply.

If your LO is only feeding off the let down, she is probably not getting enough hind milk. its the hind milk that has a higher fat content which keeps LO's fuller for longer.

Actually there is the same amount of fat (actual grams of fat) in all milk, it's just that because milk at the beginning of a feed is a bigger volume and towards the end is a smaller volume the % of fat in the milk gets bigger. It is perfectly possible to satisfy a baby's need for fat off any breastmilk - it is a bit of a myth that babies need to feed for x amount of time to get "enough". If OP is struggling with the frequency of feeds I agree that encouraging each feed to be longer could help, but only if LO i stalling asleep before she is satisfied. If she stops because she is full, getting her to stay on longer may just end up with LO throwing up the excess milk. Breast compressions can encourage a lazy baby to keep feeding as they can cause milk to flow more quickly towards the end of a feed. BUT pumping off a feed and then encouraging LO to feed will definitely increase supply - it was what I had to do when my LO wasn't feeding enough to get my supply up.

Just keep offering your LO the same breast during a 2.5 hour block. Don't alternate. She needs to learn to empty the breast properly and it might help with retained gas.

I agree, staying with the same breast will mean less forceful letdowns on that side and encourage your breasts to make less milk. When finally swapping sides and getting a very forceful letdown from the full side, try unlatching LO at the point of letdown and catching the excess in a cloth. When the flow slows a little, but the milk is still freely flowing, relatch LO. Unlike pumping this shouldn't encourage supply and also should help LO not to gulp down air along with milk.

Thank you you seen very knowledgable. My oversupply has gotten better since 7 weeks and I think it's a fairly normal supply now just with hard letdown, I don't know, it feels like less of an oversupply in no longer engorged ever and my breasts feel soft and squishy. But I do notice if I don't feed every two hours I get slightly engorged again and have even more forceful let down. Do u think I could still have an oversupply and not know it? I'm a bit worried about techniques to reduce supply because I'm aftaid of creating an under supply, if I in fact no longer have an over supply, could this happen?

 

[noon_child]

My oversupply has gotten better since 7 weeks and I think it's a fairly normal supply now just with hard letdown, I don't know, it feels like less of an oversupply in no longer engorged ever and my breasts feel soft and squishy. But I do notice if I don't feed every two hours I get slightly engorged again and have even more forceful let down. Do u think I could still have an oversupply and not know it? I'm a bit worried about techniques to reduce supply because I'm aftaid of creating an under supply, if I in fact no longer have an over supply, could this happen?

Oh right I see, so your supply has settled but fast let letdown either means your LO refuses to drain the breast now, or refuses the breast altogether. You are right to be wary of techniques to reduce your supply.

So in the day your LO can handle your letdown but is lazy and snack feeds.
Breast compressions (look on Kelly Mom for techniques) when the sucking gets fluttery or slow can stimulate milk and get a baby suckling more effectively.
If she will only take the letdown, positions to help with fast letdown will frustrate her more (like lying back) as she'll have to work harder. I think as she gets older and her tummy bigger and her attention span longer she'll feed longer and less frequently.

If her behaviour changes so radically in the evening I'd be inclined to believe that the issue is something unrelated to feeding, so tiredness, colic, just random baby witching hour stuff. Sounds like you are doing great with the naps btw. My LO was an awful napper (there was a two month period of hell where she DID NOT TAKE A SINGLE DAYTIME NAP through over tiredness!). My only suggestion would be maybe to try to make them all a bit earlier, so a nap mid morning, depending on when she gets up, then one about 2pm.

Her lack of napping in the day might be more to do with brain development than lack of a full belly. She is more aware and alert and may fight sleep. Then tired she doesn't want to make the effort to feed fully, and that doesn't help her sleep and it is a cycle. By evening she hasn't a clue what she wants, so she goes for what all babies know - boobs - and when that doesn't work she gets upset.

You are doing well it sounds like. Do not feel like you are the only baby who becomes a nightmare in the evening. I think it is the norm more than the exception.