Forceful letdown vs Reflux (or both?)

miniray

DS2 is 2.5 weeks old.  He is EBF and gaining well, lots of wet/dirty diapers.  I know I have a forceful letdown, I had it with DS1 too.  DS2 will unlatch and choke on the milk so I spray into a towel and feed him upright to help as well as burp him after each letdown.  I also make sure he empties one breast before offering the other to avoid foremilk/hindmilk imbalance.

The thing is he becomes fussy during and after nursing, especially in evenings.  He will nurse, unlatch, burp then start crying, grunting, straining, pumping his legs, and rooting around wanting to nurse again.  I latch him again and same thing.  It's like he wants to nurse for comfort, but the extra milk is hurting him.  He then overeats and ends up projectile vomitting. 

He doesn't spit up, but he has projectile vomitted a few times after overeating like I explained above.  He hates to be put down and is happiest upright in my Moby wrap.  He likes to be held with his head/neck arched back.  He will sometimes make this face like something in his mouth tastes bad.  He will have wet burps where it sounds like he spit up but he hasn't.  He also gets what looks like gas where he will grunt, squirm, strain, pump his legs, like he is trying to fart or poop.  His poop has looked like normal EBF poop until today when there was some traces of green poop.

I'm not sure if the issue is my forceful letdown, or if he has reflux or maybe my letdown is causing reflux?  I just don't want to start him on meds for nothing.

Any advice?

Eta: DS1 is MSPI so I'm already on the MSPI diet as a precaution for DS2.

vszapp

I could have written this myself. No easy answers for you as I'm in the exact same boat. Sounds like your LO may have silent reflux that is exacerbated by your letdown. I m meeting with a LC next week and will let you know if I learn anything. Hang in there!

ncbelle

I would "tame" your overactive letdown before considering reflux.  Everything you describe could easily be attributed to overactive letdown/oversupply.  Personally I would try nursing on just one breast per session and see if that helps.

TeacherVicky

miniray said:

He doesn't spit up, but he has projectile vomitted a few times after overeating like I explained above.  He hates to be put down and is happiest upright in my Moby wrap.  He likes to be held with his head/neck arched back.  He will sometimes make this face like something in his mouth tastes bad.  He will have wet burps where it sounds like he spit up but he hasn't.  He also gets what looks like gas where he will grunt, squirm, strain, pump his legs, like he is trying to fart or poop.  His poop has looked like normal EBF poop until today when there was some traces of green poop.

I'm not sure if the issue is my forceful letdown, or if he has reflux or maybe my letdown is causing reflux?  I just don't want to start him on meds for nothing.

Any advice?

Eta: DS1 is MSPI so I'm already on the MSPI diet as a precaution for DS2.

The bolded part would definitely make me think it's reflux. The green poop could be a sign of a foremilk/hindmilk imbalance.

Both my kids had/have reflux, both medicated. Maybe you should talk to your dr and see what they say. I would be open to trying meds for a few weeks to see if there is any change.