Being a first-time parent is like being a detective in a mystery novel. When a problem arises, you have to sort through a million seemingly minute and unconnected details.  Usually in hindsight the solution seems obvious, but when you are going through things for the first time, nothing seems to make sense.

From his birth, I was worried about how quickly Scribble nursed. I was horrified when the lactation consultant told me to expect to nurse for 25-40 minutes per feeding.  He never took both breasts at a single feed and would hardly eat for more than ten minutes before popping off the breast, seemingly satisfied.  Every time I nursed him I would stare at the clock, anxiously willing minutes to go by.  Every time he made a sound I offered the breast. I woke him to feed and obsessively tallied his wet and soiled diapers.

So imagine my surprise when he exceeded his birth weight at two weeks!

Despite his stellar weight gain, our nursing sessions were stressful. After a few minutes of eating he would pop off the breast and shriek. Our feeds were a terrible cycle of nursing, screaming, spitting up, burping, then trying to nurse again. I never knew when he was full, because so often our nursing sessions ended in tears. Even after the initial engorgement period, I leaked all the time and my breasts were never soft between feedings. Baby’s latch seemed to get shallower every day.  And the most disconcerting issue: his stool was dark green and smelly.

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Still, he was gaining like a madman! By his two month appointment he had almost doubled his birth weight.

For a while I blamed C.O.’s green stool on antibiotics I was taking to treat a nasty bladder infection. I also suspected he had GERD. But some late-night research indicated that I had a case of oversupply. My body was making too much milk for baby to eat; as a result his nutrition was compromised.

Mother’s milk contains less fat at the beginning of a nursing session and more fat toward the end. The thin, watery milk she produces at first is called foremilk.  It contains more lactose than the fatty hindmilk that comes in later. When a mother has an oversupply problem, her baby fills up on foremilk instead of hindmilk. The increased lactose in the milk makes baby gassy and changes the color of his stool, and the reduced fat content keeps baby from feeling satisfied.

Due to my oversupply my letdown was extremely forceful. Scribble was swallowing quickly to keep pace. This forced him to gulp in air, which increased his gassiness.  He developed a shallow latch in order to handle my flow.

Research offered two suggestions: pump off the excess or block feed.  I wanted to solve the problem quickly, and pumping seemed like the fastest solution. Unfortunately, since nursing operates on supply and demand, pumping increased my oversupply in the long term, even as it gave us short-term relief. Pumping might have worked better f I expressed a set amount every day at the same time with no exceptions.  But I didn’t want to rely on pumping to relieve my engorgement; I needed a way to regulate my supply instead.

I had better luck with block feeding. To block feed means to nurse from the same breast until that side is empty. The engorgement you experience in the unoffered breast will train your body to produce less milk, while feeding on one side will ensure that baby eventually gets the hindmilk he needs.  Most literature suggests feeding from one breast for as long as 4 or 5 hours, but I found I needed to feed on one side for 12 to 24 hours to achieve results. My breast never felt “empty,” but after long stretches of block feeding I began producing richer milk.

The unoffered breast was heavy and knotted. Fearing the pump, I started hand-expressing milk to relieve the pain and to keep from developing an infection. At first I expressed into a towel, but eventually I started saving the milk in a bottle. I only hand-expressed to relieve the immediate tightness; any more and I risked engorgement.

Block feeding was rough.  At times Scribs refused to nurse, even though I knew he was hungry.  I was squirting him in the face every time he ate; sometimes the milk would stream out and onto the floor before I even had the chance to bring him to the breast. I let my initial milk spray into a burp cloth or bottle, but as soon as he latched  he would choke and howl. It broke my heart.  Although I did not supplement, I often wondered if offering formula would be a more humane choice.

In the meantime I learned some valuable coping mechanisms. I fed baby in his sleep when he was calmer. (Here are some more suggestions for how to calm your baby before nursing.

I also found that pinching the areola tightly at the base of the nipple helped to slow my flow. Many articles suggested positioning baby above my breast, forcing the milk to flow against gravity. That didn’t work for us, but I am sure it would for others.

Oversupply is not a problem that goes away quickly; it must be managed long-term. Scribble is still gassy, although he usually passes yellow stools. In order to avoid engorgement I have to nurse as often as possible.  And when he drops feedings my oversupply threatens to return. I have only started pumping in the past week or so and I only pump once a day so that I don’t start the cycle of oversupply all over again.

In spite of these issues, I think the worst is behind us. If you are battling some of these symptoms, perhaps my story may help you to put the pieces together and start focusing on solutions!

What has been your biggest nursing challenge?

Breastfeeding Problems part 11 of 13

1. Pumping Supplies by Guides
2. Mastitis Misery by mrs. wagon
3. Elimination Diet Adventures by Mrs. Superhero
4. Tips & Tricks When Baby Refuses the Bottle by Checklists
5. Breastfeeding Woes by breastfeeding
6. Clogged Milk Ducts (and How to Treat Them) by Mrs. Bee
7. Probiotics for Preventing Thrush by Mrs. Bee
8. Mastitis by Mrs. Bee
9. The Shield Between Us by Mrs. Hopscotch
10. Too Much of a Good thing (or dealing with an oversupply) by Mrs. Superhero
11. Battling Oversupply by Mrs. Sketchbook
12. Unsolicited Breastfeeding Advice for New Moms Part II by breastfeeding
13. Mastitis by Mrs. Chocolate