Eureka! (?)

I *think* I may have solved our nursing issues!!

Yesterday I furiously googled the interwebs and combed the La Leche site for any advice that might seem to pertain to my situation. And I finally found a description of a problem that sent all sorts of bells of familiarity ringing in my head - Oversupply and Fast Letdown.

Behold the checklist of signs of oversupply and/or fast letdown:

• Baby cries a lot, and is often very irritable and/or restless - Check. Miles always woke up from naps screaming for food, and was often fussy between feedings.
• Baby may sometimes gulp, choke, sputter, or cough during feedings at breast - Check!
• Baby may seem to bite or clamp down on the nipple while feeding - DINGDINGDINGDING!!
• Milk sprays when baby comes off, especially at the beginning of a feeding - No spraying, but lots of dripping.
• Mother may have sore nipples - OH GOD YES.
• Baby may arch and hold himself very stiffly, sometimes screaming - Check.
• Feedings often seem like battles, with baby nursing fitfully on and off - Check.
• Feedings may be short, lasting only 5 or 10 minutes total - No to this one... they usually went on and on.
• Baby may seem to have a "love-hate" relationship with the breast - It was more like love-angry.
• Baby may burp or pass gas frequently between feedings, tending to spit up a lot - Yep.
• Baby may have green, watery or foamy, explosive stools - No green, but very watery all the time.
• Mother's breasts feel very full most of the time - Eh, not so much.
• Mother may have frequent plugged ducts, which can sometimes lead to mastitis (breast infection) - Not yet.

I also noticed that when I pumped I easily got the amount needed for one feeding out of each breast, another sign of oversupply. Mainly it was the clamp-down that rang my alarm bell. That's exactly what he was doing. And he would often scream while eating, which was so baffling and frustrating for me. They say that babies/moms with this issue are frequently misdiagnosed as having a milk-soy allergy because baby is so fussy and spitting up so much. Another sign of this problem is that baby gains more or less weight than he needs to, and Miles did gain a lot of weight in one week last time I checked.

The solution is block nursing, which means you only offer one breast for a certain amount of time - starting out with two hours, and if that doesn't work move up to four, etc. I wasn't timing each feeding per breast like some people do, but if he let go, or seemed to be chewing, or my breast seemed soft, or even if it just seemed like he'd been on there a long time, I did usually put him on the other breast. That works fine for some people, but with oversupply and/or fast letdown, it means you just keep putting the baby to a breast that is full, spraying hard, and it also keeps triggering both breasts to make more and more milk that is not needed.

Another thing I realized in retrospect is that we were starting to do well just before the growth spurt. Part of the purpose of cluster feeding (frequent nursing) during a growth spurt is to bump your breasts' milk production up to the next level for baby. It would appear that it worked all too well for me and that's when nursing started getting increasingly painful again as Miles kept trying to basically staunch the flow with his bony little gums!

And the other ill effect of the oversupply issue and switching boobs all the time is that your baby just keeps drinking foremilk. Breasts produce two kinds of milk: first a more watery foremilk which is thirst quenching and hydrating, and only when that's been consumed comes the hindmilk, which is fattier and more satisfying. Miles was probably hardly ever making it to the hindmilk, which led to the watery poop, twenty billion wet diapers a day, fussing between feedings, and waking up ravenous. It was as though he was subsisting on saltines all the time - filling only in the short term.

So I started block feeding yesterday afternoon. I will only offer one boob per 2 hour period. If he stops eating and I pause to burp him or change him, then he still seems hungry, I put him back on the same breast. There are a couple of other techniques I use like pinching the boob a little to slow the milk down, elevating his head above the boob, and letting his lower body be lower than his head.

Of course the change in the pain factor will be gradual as my nipples recover, but he's already latching better and it hasn't been nearly as painful to nurse.

But the most surprising thing is the change in his personality! It's nothing short of astonishing. He used to always wake up from a nap yelling angrily with hunger. I thought he was just a hungry man and that was normal. But since I started he wakes up gently, maybe fussing a bit, but often waking up smiling and looking around. AMAZING. His alert time has increased after feedings, he seems more interested in his surrounding and in us, and he's smiling up a storm! He is also going down for naps better. It is just the craziest thing. The poor little guy must have always just been a little peckish, if not downright famished, at all times, because he wasn't getting enough hindmilk.

I'm still going to go to the LLL meeting but I think we're on to something here. Fingers crossed!