Gaining, Gulping, Grimacing?

Is your baby thriving… but nursing is a struggle?  See if many of these sound familiar:

  • My baby chokes and gulps and splutters when she nurses, especially at the beginning.
  • My breasts always feel full, or they spray when they let down.
  • My baby “wrestles” with my breast, pulling off, coming back on as if she’s starving, pulling away and crying, backing off once she has the nipple in her mouth, arching.
  • My baby has lots of wet and poopy diapers, perhaps even with streaks of blood.
  • My baby is colicky, or gassy, or spits up frequently.
  • My baby sometimes – or always – has frothy or greenish stools.
  • My baby is gaining rapidly, or grew fast at first with weight gain dropping as fussiness increased.
  • My baby rarely falls asleep at my breast; nursing is an athletic event rather than a peaceful one.
  • My baby will nurse only for food, not for comfort.
  • My baby grimaces when she nurses, as if there’s something wrong with my milk, or she frequently seems to have uncomfortable intestines.
  • I try to make a point of nursing on both breasts each time.
  • If it’s been less than two hours, I look for some cause for fussiness other than hunger.

Those can be symptoms of a baby who’s getting “too much soup, not enough cheesecake.”  When our babies are born, our bodies may be prepared with lots of milk… just in case.  And it can take a while for our supplies to drop down to what our babies actually need.

The milk that builds up in our breasts between feedings tends to be a lower-fat milk.  The milk that the baby pulls down during breastfeeding tends to have a higher and higher fat content, changing gradually from “soup” to “cheesecake”.  When she finishes nursing, the fat that was pulled down near the nipple but not used gradually withdraws, to be pulled down at the next nursing after the baby gets through the newly-accumulated lower-fat “soup”.

If we have a lot more milk than our baby needs, she may not be able to get through all the soup at one sitting.  If we switch breasts partway through the nursing “to make sure she takes the other side”, or if we try to space our nursings out to two hours or more, that can mean the baby plows through a whole lot of soup and never gets much cheesecake.  She grows fine.  But the higher-fat milk is an excellent stomach-settler, because it slows the passage of milk through her intestines.  Without the extra fat, milk travels through her intestines without breaking down fully, and can ferment in her large intestine, causing gas, discomfort, and frothy green stools.

And then there’s the fire hose effect.  If there’s a whole lot of milk in your breasts, it can squirt into your baby’s mouth faster than she can handle it, and make her feel she must swallow or drown.  Not much fun.  Like anyone else, your baby wants to take in food at a comfortable rate that she controls herself.

You may find your baby is happier and more settled if you just “nurse like a mammal.”

We tend to expect babies to nurse only for food, at predictable and widely-spaced intervals.  Babies tend to think otherwise.  If we offer only when we think they ought to need it, using other distractions when we think they “can’t be hungry”, we’re much more likely to see breastfeeding falter, or end before we wanted it to.

Other mammal mothers nurse for “baby-led” reasons – whenever their baby want to nurse, even if it’s been just a few minutes.  But they stop or change sides when they have an itch, or want to stretch, or want to move somewhere else, or any other “mother-led” reason.  We can do the same.  No need to sit pinned to the sofa until your baby lets go… so long as you nurse again whenever she wants.  If you stopped too soon, she’ll nurse again soon.  If she was almost full, she’ll probably wait longer.  A healthy baby can manage her own intake just fine, if you let her.

If you feel you’re still having oversupply problems, you might want to try one of these ideas:

  • Try making a “breastmilk shake”. Breastfeeding specialist Dr Christina Smillie suggests a deep, thorough, bread-kneading breast massage before nursing, to help re-mix any milkfat that might have separated out between feedings.  It can help your baby get a mix of soup and cheesecake, which can mean he’s satisfied sooner and is less uncomfortable.  At the same time the smaller volume he needs will help build a little extra pressure in your breasts from unused milk, and that’s a powerful signal to your body to cut back production to the level your baby wants.
  • If that doesn’t work for you, try the opposite, using just one side until it’s nice and soft, even if you have to use it for more than one nursing to soften it. The building pressure on the other side will help cut back on production until you use it again.  You may find that using just one side for a couple hours is all it takes.  If your “oversupply” has been dramatic, or your baby is really fussy, you may find you need to spend 4 to 6 hours on one side before using the other.  If you get too overfull on the other side, you can nurse or express just enough to relieve it a bit, then go back to the side you’re trying to soften completely.

As your supply settles down you may worry that you’ve “lost your milk.”  You may be so accustomed to heavy breasts dripping and spraying, and to seeing your child splutter, that a quiet, calm nursing from soft breasts feels wrong.  But you’ll probably notice that those diapers are still very wet, and that your child nurses contentedly, with a more relaxed body, letting go gently when she’s full or dozing peacefully at your breast.  Those are all signs of an ample – but not overfull – milk supply.  If she wants to increase your supply further, all she has to do is ask to nurse more often, or fuss to go to Side Two after Side One is completely soft.  Trust her to know her own needs, like any other mammal baby, and trust your body to respond like any other mammal mother’s.

If things aren’t getting better, check with a breastfeeding specialist.  She’ll have additional ideas and can “walk with you” on your way to an easy breastfeeding relationship.


©2013 Diane Wiessinger, MS, IBCLC

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