Engorgement and Nipple Confusion

laurenlalap

So breastfeeding was going great... for about a week. 

My little man loves to cluster feed all day, every day. He'll latch and eat for 10 minutes, then fall asleep and eat 45 minutes later for another 10-15 minutes. Everything was going great (minus the lack of sleep) until I developed BAD mastitis, as my breasts had apparently become so engorged because they were never emptying properly. Also, because my son was feeding so often my body was making way too much milk.

On the advice of an LC, I started pumping every 4 hours on the dot. I have so much milk than in 10 minutes of pumping, I would easily get 7-8 ounces from each breast. I am freezing most of my milk, and have been bottle feeding my son the rest. If he wants to eat close to pump time, I will let him, but I have been not told to let him breastfeed outside of the 4 hour pumping window as it will make my over-producing problem worse.

He was very gassy today so I wanted to let him nurse just prior to pumping... but now he won't latch  It seems he only wants a bottle now, and has no interest in my breasts anymore. 

Did I completely screw up, or do you think my son will eventually go back to the breast and ditch the bottle? 

I was told that within 4 weeks of pumping exclusively my over-supply / engorgement problem will be gone as my supply will be established and I can go back to feeding him from my breast whenever I wanted.

I am going back to the LC, but my appt. is not until Friday...

jmama1611

I don't know the answer to this, but I found the following resources helpful:

Kellymom website.

La leche league. Many have regular meetings or peer support/coaching.

Other breastfeeding mums you know that are friends.

Facebook breastfeeding groups for advice.

I also think there's a speciality breastfeeding group here on the bump too.

MrsBigTime

I wish there was one way to solve all nursing problems! I'm sorry it's stressful!

From what I understand, block feeding is really helpful for oversupply and will help regulate. Kellymom has great information about it and I would consider them to be the best source of breastfeeding information. 

Its confusing to me that they would  have you pump primarily rather than nurse, especially if nursing is what you'd like to continue to do (rather than exclusively pump). 

Id suggest reading kellymom, seeing a differenc LC (as many as it takes until you and baby are confident with your nursing relationship!) and putting baby to breast more than pumping. 

I am by no means an expert, but I battled oversupply last time and would offer one breast a feeding, but first had to hand express a significant amount of milk in order to soften my nipple enough for DD to latch. Then, if she took the whole breast, I'd offer the second, or just express to comfort, not to empty. Cabbage leave for 1 hour four times a day is helpful, too. 

I hope that is helpful and not just making a complicated situation moreso. I hope you guys are able to figure out something that works well for you!

Muscatmommyof4

I wouldn't give him the bottle anymore so it forces him to latch again and pump when your supposed so you don't get engorged and store it until he's a little bigger. My neighbor is a LC and I had a long talk with her about BF and she said the best way to control your supply is to nursing only don't time and no pumping. I nurse and pump since I have 4kids but she told me to try not to give him a bottle before 4 weeks because they can get lazy and refuse to nurse.... But try not to stress your self out it's something that can be fixed you didn't screw anything up it just make take some time to fix! 

hollowway

I had an oversupply with DD because she was a NICU baby and was ng tube fed and I had to pump every 3 hours. When we were finally able to nurse, I had an oversupply and overactive letdown. She also didn't want to latch because they started her on bottles instead of letting me nurse. I'm not an expert, but we worked through our issues and she didn't wean until she was 2.5yo!

Oversupply/over active letdown: Stop pumping completely. Hand express before latching baby, to soften your nipple and relieve some of the engorgment, also to prevent from drowning baby with your letdown. Feed baby on ONE BREAST for 4 hours, and then the other breast for 4 hours. Yes, the breast you don't use will become very engorged and leak and be sore. Hand express enough for comfort, but don't pump or nurse on that side. After a week or so your body will get the hint and supply for the demand. When you use a double pump, you're telling your body that you are feeding twins, so it produces more. When you block feed and feed on only one breast at a time, you tell your body there's only need for one baby. I'd invest in a lot of breast pads for the leakage in the mean time. 

Nipple confusion: We ended up using a slow flow nipple shield for about a week. It allowed baby to nurse at the breast, but use a bottle like nipple (also helps when you're engorged and worried about baby Mr being able to latch). After she nursed for a few minutes and my nipple was larger and "out" more, I removed the nipple shield and would attempt to latch her without it. Be sure to sandwich your breast so that as much of your areola gets in baby's mouth and you get a nice wide latch. We'd finish the nursing session like that and slowly weaned off the nipple shield until we weren't using it anymore. 

I don't know if any of this helps, but it's what worked for us. Feel free to ask questions and I suggest getting the book, "The Womanly Art of Breastfeeding". So much information. 

laurenlalap

Thanks everyone. I really appreciate it! Unfortunately I developed bad mastitis again yesterday and I'm just ready to GIVE UP. I see the LC later this week, so hopefully they will have a solution to this nightmare. My breasts are so distorted, engorged and painful I just want to cry. 

hollowway

Hot showers. They'll relieve the engorgment and soreness without pumping. Make sure you keep nursing or the mastitis will get worse. It won't hurt baby.

mrsmoose5

Ugh, I am 2.5 weeks postpartum and dealing with oversupply and over-active letdown as well. I've been block feeding for about 24 hours and it seems to be helping somewhat, but my main problem is that baby girl is SO gassy and colicky. I have never been able to get her to nurse for more than 5 minutes on each breast since she was born. Most of the time she will nurse for a minute or two, then unlatch and either fall asleep or just act like she's not interested. Then, a few minutes later she' s crying and rooting and acting like she wants to nurse again ... so I nurse her again and same thing. This goes on for HOURS most days. I feel like the fact that she will not take a full feeding in one sitting and is constantly on and off the breast for hours at a time is contributing to my oversupply and is also making her gassy because she's getting so much foremilk and inhaling a lot air. It's so hard to deal with, especially because I have a toddler to take care of ... I feel like I can't spend 4 hours at a time feeding her while she latches, unlatches, cries, and dozes off and on. When she's in the midst of one of these cycles I can't even put her down for a second to change my son's diaper or make him lunch without her screaming and wanting to nurse. Please tell me there's a light at the end of this tunnel. I nursed DS for 15 months with few issues, but right now I just want to give up 

hollowway

@mrsmoose5 when she starts to doze off, tickle her cheek to stimulate the sucking reflex again. It should help keep her awake to finish eating. She's also probably going through her 2 week growth spurt so will be nursing more for about a week. Hang in there momma!

PrettyPalomino

@mrsmoose5 Another trick to keep them awake is to feed them naked (the baby,
not you), the cold can help.

leighry

Another good trick is to change them right before they eat. it usually wakes them enough to stay awake for a full feeding.

kvruns

I thought feeding was going ok in the hospital but now home it isn't. I definitely felt my milk come in and I had been using a shield to help him latch at the hospital bc he gets so insane he wouldn't latch right. I can see in the shield he is getting some but maybe they are too engorged and he isn't really latching well bc it never feels empty and I finally gave up and told H to try a bottle of formula at the next feeding and he sucked down the entire thing so obviously he wasn't getting much from me despite nursing for a while. Hoping to talk to a Lc - at the hospital each time the person came by it was right after a good feeding so I never got much help bc it would seem to be working at that time. Also going to try pumping to store some for him and maybe it will help it empty fully for once?

MrsMaryK2016

@kvruns Have you considered calling a Doula or lactation consultant to come to your house? The Doula who did my birth class also does home visits for lactation. There are so many resources out there if this is something you feel strongly about. 

MrsBigTime

@kvruns Make an appointment with a LC and go back as many times as you need!  I thought weighed feedings were so helpful to put my mind at ease and tell me that baby was actually getting  good feeding from the breast!
If your breasts are too engorged, he may not be able to latch. Try hand expressing into a cloth until you feel your nipple soften (I would need to express A LOT sometimes) and he will have an easier time latching. Babies too get frantic, and sometimes that means we missed their early hunger cues, but we just need to encourage them to keep trying at the breast. I found that if this babe gets too crazy, I just pick her up, talk calmly and sweetly to her (which also helps calm me down because it's stressful for me too!) and then when she is calm (she'll often stop and stare at my voice) and then try again to nurse, this time in a different position. We're 3 weeks in now and it's definitely easier, but she still sometimes panics and has trouble in the middle of the night. 
You are doing a great job! Breastfeeding is hard for many reasons, but if you are able to work through the tough parts in the beginning, it's so worth it! Just know, that you are awesome and whatever you are doing for your sweet boy is the very best and he is so lucky to have you as a mama!

kvruns

thanks @MrsMaryK2016 and @mrsbigtime it is funny bc I did not have strong feelings toward BFing, it was like ok I will try but if it doesn't work, no biggie. I figured I would hate it but I actually didn't. But since it felt successful in the hospital I was bummed it didn't work so well at the house. I have pumped twice so far with decent results and now they don't feel so huge so that is good. I'm going to try to nurse him later to see if it is better although I already told my H that middle of the night will be a bottle bc it is just too stressful. If that bottle is BM, great; if it needs to be formula I'm ok with that too. All of this is on top of a baby who refuses to sleep unless held so I'm picking and choosing my battles!

MrsBigTime

@kvruns You are doing great! That pesky milk is both a blessing and a curse. They want (and need) it so badly, but it can be so overwhelming! I hope things continue to get easier! As far as sleeping only while being held...my Miss Evelyn is the same way and as die-hard I was about "I'm gonna put this one down to sleep drowsy but awake" sheer exhaustion took over and she sleeps right next to me most of the night. This short (and exhaustingly wonderful) season is all about survival and whatever it takes to keep the whole family sleeping is most important! 

MrsMaryK2016

@kvruns I completely understand and actually felt the same way. If we hadn't figured out breastfeeding by now I would have switched to bottles without looking back. I will say though that talking to a few different LC's got me completely different advice from each and I have been able to put together what works from each one. We also had the BEST first feeding and then things got crazy difficult so I can relate to the frustration. Either way this baby is obviously loved and you're doing what's right for you both. Good luck!

Knottie1458416769

@MrsMaryK2016 that was basically what I said too in my discussion thread that got deleted! Completely diff advice from diff professionals. I just wasn't smart enough ftm to decide which ones worked better for us in week 1. 
I try to be vigilant about safe sleeping habits, but like last night I dozed off while bfeeding him in bed - he was fine and not squished or anything but I was so mad at myself for having fallen asleep in the same bed while holding him. I try so hard and sometimes it still feels like I'm doing everything insufficiently 

PrettyPalomino

I also was not totally hung up on BFing (FTM too) and it was one heck of a process to get started!! The nurses were hand expressing my colostrum for me into a cup to put into a syringe because she wouldn't suckle the first day and a half. She would kinda latch but not suckle. Even DH got in on the hand expressing when I was in tears with frustration from so much work/pain for so few drops. 

What finally worked for me on day 1.5 was actually a nipple shield, because it would hit the roof of her mouth and activate her suckling reflex. I used it 2 or 3 times and then my nipple was enough to make her suckle (as long as I could point it to the roof of her mouth). She got some colostrum and I guess it was enough to motivate her to keep going, along with being naked/cold/freshly changed. 

Now my milk is in as of yesterday, but I was engorged today for the first time which caused her to not be able to latch on the left, which was basically bursting with milk. She was getting really frustrated and panicking, I tried hand expressing but my nipple was still so flat, so I pumped for like 3 minutes and it fixed my nipple shape, and the day was saved! SO crazy, so much to think about.

I am so shocked at how much I love it, I feel so proud to be able to provide for her, it's nice to be close for such a long stretch of peaceful time. Plus it's free and portable. 

Don't give up on trying different things for the different challenges, but don't put pressure on yourself to force it to work either. Do what feels right good luck!!

kvruns

@PrettyPalomino your experience sounds very similar to mine. I tried to get him to nurse after I pumped yesterday but he didn't do much. I know there was milk but he just isn't latching well. I could try the shield after pumping I suppose 

PrettyPalomino

@kvruns definitely get in with a LC if the shield doesn't help with latching. Or yeah, regardless. But also remember the pump is a double edged sword, it will make you more engorged at first which will make latching harder, and the vicious cycle might continue. I'd say just try to catch his earliest hunger cues so you're not trying to make him latch while he's freaking out. Or just try to put your boob in his mouth when he's alert and calm in general. 

Fingers crossed for you!

MrsMaryK2016

Honestly guys, breastfeeding is one of the hardest things I've ever done. And the worst part is that there's no one way to do it, you just have to try a bunch of stuff and find what works all while dealing with cracked/sore nipples, lack of sleep, sore privates/c-section pain and a freaking out baby. I know all these moms and their "breast is best" and "I love breastfeeding" mantras and more than once this week I've wanted to punch them repeatedly in the face! It definitely doesn't feel fair that after you cook the kid and push him out that feeding him is so freaking hard! 

leighry

@MrsMaryK2016 agreed!!!

SandNStarsNJ

MrsMaryK2016 said:

Honestly guys, breastfeeding is one of the hardest things I've ever done. And the worst part is that there's no one way to do it, you just have to try a bunch of stuff and find what works all while dealing with cracked/sore nipples, lack of sleep, sore privates/c-section pain and a freaking out baby. I know all these moms and their "breast is best" and "I love breastfeeding" mantras and more than once this week I've wanted to punch them repeatedly in the face! It definitely doesn't feel fair that after you cook the kid and push him out that feeding him is so freaking hard! 

It really is and I remember that feeling when I was a FTM. There's this indescribable body exhaustion (I mean, come on, even peeing gets more complicated) and on top of that what feels like negotiations with an infant when all you want to do is keep him/her alive. If it's any consolation, unless there are extenuating circumstances, you'll start to adjust and figure out your needs, which you need to make sure you're doing first and foremost. All those judgy moms can go to hell - if you can swing it and you want to and you're happy BF-ing, do it; if you're stressed and sore and miserable, don't - because how can you expect a baby to be happy and enjoy you if you're not enjoying you? You know?

That being said, I'm now a STM and it's easier to manage these first few days ONLY because all those learning curves as a FTM have been conquered, but DH and I fully acknowledged this morning that it is only because we "suffered" through all that the first go-around.

Stay strong and you do you. Screw those judgmental people.

MrsMaryK2016

@SandNStarsNJ 100% agree. Those people are just extra annoying now that I'm actually breastfeeding. It makes me think they secretly sneak their babies formula because no one could possibly think this is easy and completely awesome, right?! Or maybe they have magic nipples that never cracked or bled lol 

atcwag

STM who BFd DS1 until 2.5 and still on the struggle bus this time around. 

SandNStarsNJ

@mrsmaryk2016 haha! They've probably all forgotten... My in laws are the "why don't you just use formula?" people - the complete opposite!

kvruns

How much are your kids eating , if you know? I switched to pumping and hes been eating a ton, almost 3oz many feedings. At his first pediatrician appointment today I asked the Dr about how much he should be eating and she said 1.5-2oz per feeding she seemed a little alarmed when I said he was eating 3. Were not force feeding him or offering bottle as the first comfort measure we try other stuff but when he is chewing his hand and looking like he's rooting around he seems hungry. 

atcwag

kvruns said:

How much are your kids eating , if you know? I switched to pumping and hes been eating a ton, almost 3oz many feedings. At his first pediatrician appointment today I asked the Dr about how much he should be eating and she said 1.5-2oz per feeding she seemed a little alarmed when I said he was eating 3. Were not force feeding him or offering bottle as the first comfort measure we try other stuff but when he is chewing his hand and looking like he's rooting around he seems hungry. 

Are you pace-feeding his bottles? Very important for BF babies. 
The general rule is 1-1.5 oz. for every hour, so if he eats at 10 and then again @ 12, he needs 2-3 oz. However, infant bellys are very small, so 3 oz. is a lot. My son took BM until 22 months and maxed out at 4 oz. portions (caloric content of BM changes over time, so large increase in amount isn't necessarily like with formula). 
Have you checked out kellymom.com?  It's the BF bible. 

kvruns

atcwag said:

kvruns said:

How much are your kids eating , if you know? I switched to pumping and hes been eating a ton, almost 3oz many feedings. At his first pediatrician appointment today I asked the Dr about how much he should be eating and she said 1.5-2oz per feeding she seemed a little alarmed when I said he was eating 3. Were not force feeding him or offering bottle as the first comfort measure we try other stuff but when he is chewing his hand and looking like he's rooting around he seems hungry. 

Are you pace-feeding his bottles? Very important for BF babies. 
The general rule is 1-1.5 oz. for every hour, so if he eats at 10 and then again @ 12, he needs 2-3 oz. However, infant bellys are very small, so 3 oz. is a lot. My son took BM until 22 months and maxed out at 4 oz. portions (caloric content of BM changes over time, so large increase in amount isn't necessarily like with formula). 
Have you checked out kellymom.com?  It's the BF bible. 

I was reading about it on that site which seemed a little more liberal with amounts than what my Dr said. I do think my H feeds him more often than he should when he is inconsolable because he feels like no other comfort measure will work 

atcwag

kvruns said:

atcwag said:

kvruns said:

How much are your kids eating , if you know? I switched to pumping and hes been eating a ton, almost 3oz many feedings. At his first pediatrician appointment today I asked the Dr about how much he should be eating and she said 1.5-2oz per feeding she seemed a little alarmed when I said he was eating 3. Were not force feeding him or offering bottle as the first comfort measure we try other stuff but when he is chewing his hand and looking like he's rooting around he seems hungry. 

Are you pace-feeding his bottles? Very important for BF babies. 
The general rule is 1-1.5 oz. for every hour, so if he eats at 10 and then again @ 12, he needs 2-3 oz. However, infant bellys are very small, so 3 oz. is a lot. My son took BM until 22 months and maxed out at 4 oz. portions (caloric content of BM changes over time, so large increase in amount isn't necessarily like with formula). 
Have you checked out kellymom.com?  It's the BF bible. 

I was reading about it on that site which seemed a little more liberal with amounts than what my Dr said. I do think my H feeds him more often than he should when he is inconsolable because he feels like no other comfort measure will work 

https://blog.nurturedchild.ca/index.php/2010/12/10/baby-led-bottle-feeding/