Forceful letdown but low milk supply - possible? (Long)

pb_bride · January 2013

DS is 8.5wks old and I EBF.

When he was younger, BF was enjoyable. After he's done, he has the "milk drunk" look on his face, and he would have no trouble napping for 2 hours afterwards.

Around 5-6 w, things changed. DS started gulping, and 1-2x/day he coughed and choked. After he eats, he doesn't look "milk drunk" anymore, but often grunts, arches his back, bops his head. I think he's gassy but he doesn't always burp. He doesn't cry but just looks uncomfortable. I go to a BF support group and the LC said I have overactive letdown and oversupply. She suggests I only feed on one side per session, and try reclining position.

I've been following these suggestions for 3 weeks now. DS still gulps but rarely coughs and chokes. He has learned to pop off the breast when the flow is too great, catches his breath, then goes back on. I don't spray milk when he pops off; if I try to spray milk into the burp cloth, DS screams - he is so impatient that he wants to latch back on immediately. After nursing, he still is uncomfortable grunting etc.

However, for the past 1 week I've noticed:

1) My breasts no longer feel full, even the overnight hours. They used to feel quite uncomfortable overnight.

2) My L breast makes less milk than the R. When he nurses from the L, he will only actively swallow for a few minutes then falls asleep (still comfort sucks but no swallows). I let him comfort suck/nap for another 5-10 mins then I unlatch him. However, he wakes up and goes frantic looking for the nipple. If i latch him back on, he'll do a couple swallows then falls back asleep/comfort sucks.

3) DS was sleeping 4-hr stretches the first part of the night for weeks. But the last few nights he is waking up every 2.5 to 3 hrs to nurse.

4) I started having some old blood spotting - is this a sign of my period returning?

All the things I listed made me thinking if my supply has dipped due to me nursing on one side per feed for the last 3 weeks? I'm wondering if DS is not getting enough milk from just one breast, esp on the left. And is my period returning b/c my body thinks I'm weaning???

Last night I decided to let him nurse from both sides. After he ate on the left (15 minutes), I put him on the right and he ate for another 15 minutes! I feel like my L isn't making enough milk; but the R still has a forceful letdown (he still pops off at times when nursing on the R).

Any thoughts/suggestions?

alie78_80 · January 2013

1. Your supply is probably starting to regulate, which is normal.

2. I would think that your LO is just getting used to falling asleep sucking and when he wakes up and its not there he isn't happy. You can either continue what you are doing, try a pacifier, or try getting him to sleep without sucking (rocking, etc). I wouldn't suggest sleep training this young, but I've heard of some people who have done it as young as your LO.

3. Babies "typical" changes all the time. Just when you think you have it down they like to change things up on you. I would suggest at least offering both sides now that your supply has probably regulated more. If LO takes it he's still hungry if not then he's not (you can't overfeed a BF baby).

4. It could. My first ppp (when DS was 4 mo) was very similar to AF before I got pregnant. But, everyone is different. Only time will tell if AF has returned.

CLLDLL · January 2013

pb_bride:
1) My breasts no longer feel full, even the overnight hours. They used to feel quite uncomfortable overnight. This is totally normal around 6-8 weeks. It means your supply is regulating to equal LOs demands. From now on you won't feel full/engorged unless you go longer than normal between feedings. Welcome to the "easier" part of BF'ing!!
2) My L breast makes less milk than the R. When he nurses from the L, he will only actively swallow for a few minutes then falls asleep (still comfort sucks but no swallows). I let him comfort suck/nap for another 5-10 mins then I unlatch him. However, he wakes up and goes frantic looking for the nipple. If i latch him back on, he'll do a couple swallows then falls back asleep/comfort sucks. This is also totally normal. First LO gets way more efficient at BF'ing around 6-8 weeks. So a shorter session can result in the same amount of milk it was taking him twice as long to get. Also most women have a dominant boob that makes more than the other one. As long as LO is still having lots of wet diapers and at least one poopy one a week you're fine. If LO doesn't seem satisfied after around 15-20 minutes on the left boob you can always offer the right. Now that you're supply is regulating you can probably shorten or quit doing the block feeding since LO seems to be tolerating your letdown now.
3) DS was sleeping 4-hr stretches the first part of the night for weeks. But the last few nights he is waking up every 2.5 to 3 hrs to nurse.Again, unfortunately totally normal. It's either a growth spurt or LO getting more aware of his surroundings and wanting to spend more time with you. Take it as a compliment. And remember everything a baby does is a phase. Before you know it he'll be sleeping 10 hours straight and you'll miss the nightly nursing sessions!
4) I started having some old blood spotting - is this a sign of my period returning? Could be. Or it could just be the last bits of lochia getting out. You really won't know until AF either shows or doesn't.
All the things I listed made me thinking if my supply has dipped due to me nursing on one side per feed for the last 3 weeks? I'm wondering if DS is not getting enough milk from just one breast, esp on the left. And is my period returning b/c my body thinks I'm weaning??? Some women EBF and still have AF return at 8 weeks PP. It doesn't necessarily mean your body thinks you're weaning. AF returning can cause a temporary dip in supply each month, so that could explain some of your symptoms.
Last night I decided to let him nurse from both sides. After he ate on the left (15 minutes), I put him on the right and he ate for another 15 minutes! I feel like my L isn't making enough milk; but the R still has a forceful letdown (he still pops off at times when nursing on the R). This is exactly what my LO does pretty much every night. He's 3 months old, and my supply is still going strong. I think my supply is just lower at night and therefore LO has to nurse longer to get satisfied. Also he likes to cluster feed so he gets really full before his long stretch of sleep. That might be what your LO is doing too.
Any thoughts/suggestions? To ease your mind, I highly recommend doing a weighed feeding with an LC or even renting a scale and doing 24 hours of weighed feedings. You could weigh LO (with a clean diaper on) then feed from the left only. Weigh again (with the same diaper on, even if he wets/poops). This will tell you how much he ate from the left. Then let him eat more from the right if he's still hungry and weigh again to see how much he's eating total. I suspect he's doing just fine, and you just happen to have the perfect storm of supply regulating/AF returning/LO's growth spurt/LO's maturing going on to cause your worries!! Keep up the good work mama!! You're almost to the 3 month mark where I think BF'ing gets enjoyable instead of painful or tolerable!

TJ1979 · January 2013

I agree with CLLDLL, especially the weighed feedings. That's the only way to know how much LO is getting. If LO is having enough wet and poopy diapers and weight gain is good, you could also just not worry and assume all is ok. LO will let you know if something isn't ok. GL hon.

pb_bride · January 2013

Thanks ladies for your thoughtful and helpful answers. They make a lot of sense and also put an ease to my mind.

I do go to a BF support group where there is a scale for us to do weighed feedings. I plan to go this week and hopefully it'll work out that DS can nurse on the L first and I can weigh him, then nurse on the R and re-weigh.

FWIW, I have been offering him both sides today, and (maybe it's my imagination) he seems a lot more content. He even smiled at me at the end of a session, instead of his usual grunts. I also haven't been drinking as much water as I should the last few days, so I'm making an effort to drink more today.

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