Oversupply and forceful letdown

[*beannaithe*]

More questions from me. So as the title suggests, I have loads of milk which comes out like a firehose. I have been feeding reclining but this is only effective to a point. I've found the best thing is expressing first then feeding and the girls feed so much better, much more settled too.

My question is, isn't the fact that I'm expressing to begin with further contributing to the oversupply and is there another way around this? Particularly at night, I feel like they were filling up on foremilk and it wasn't lasting them very long. Any suggestions?


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[damprye]

People still joke how they needed an umbrella to escape the bazookas back with MrJ. I also coped a fair few people with Tman. They were like "Oh no, not the bazookas again lol"
I found what helped me is feeding on my back. They still choked but not as often. I would also go to bed with no bra or shirt and just let the girls free to do their thing, which would relieve the pressure.
It does get better, your body will eventually regulate to what your body needs to feed your babies. Noone can really say when that will be as it is different with each of us but mine was around 10-12weeks. HTH

[OceanPrincess]

Hey there

Expressing at the start of a feed is meant to just relieve the initial pressure and force of the letdown, to enable your girls to feed without having milk coming at them at a great rate of knots

Does that make sense? You're not going to over-stimulate your supply if you just express a small amount right at the beginning because then the girls finish off that feed.

Try not to worry too much about fore milk and hind milk - it is just a reference to the fat content of the milk, as they work through the feed the fat content increases, there isn't a point at which t switches from fore to hind milk, rather it's a gradual process, so I wouldn't worry about it just now.

It sounds like you are doing the right things! How are their nappies? Are they having lots of wet and dirty nappies? What sort of poos are they doing now?

How are their weight gains?

[buffy1]

What OP said - hand expressing initially should just relieve pressure. I found that it was expressing after or in between feeds that made my supply go crazy.

Also, when I was at sleep school (or baby rehab as I affectionately call it) with my then nine week-old DD, the nurses told me not to worry about the whole fore milk/hind milk thing. Apparently once your letdown occurs they mix, then the milk gets gradually richer. BB ladies and Barb, correct me if I'm wrong!

Having an inbuilt fire hose is frustrating, hopefully it settles down soon hon.

[OceanPrincess]

Also, when I was at sleep school (or baby rehab as I affectionately call it) with my then nine week-old DD, the nurses told me not to worry about the whole fore milk/hind milk thing. Apparently once your letdown occurs they mix, then the milk gets gradually richer. BB ladies and Barb, correct me if I'm wrong!

Sort of! It's a bit more complicated than that! Kellymom has a great article on it for those that are interested - google Kellymom foremilk hindmilk and it should come up.

[HotI]

OP- would reverse pressure massage (i think that's what its called) help here?

[Barb Glare]

Hi
the good news is that this won't last forever. It is normal for women to have more milk that their babies need. Tell me, how are your little ones growing? Do you know roughly how much weight they are gaining each week? Were they prem? When your babies are first born your milk supply is driven by high levels of the hormone prolactin in your body. Over time your prolactin levels naturally decrease, but the thing that drives supply then is demand. How much milk is being removed from the breast. Generally it is recommended that mums just express a little to get that first let down and soften the breasts. How much are you getting off do you think? Babies are very good at protecting their airways, so they will often come off and seem to choke - it's a good thing really! Just awkward when you are trying to get everyone to eat together. I agree the whole foremilk/hind milk thing can seem a bigger issue than it should be. Relatively speaking, the milk at the end of the feed is higher in fat, and at the start of the feed higher in water and lactose - but if it comes out of your boobs it's good stuff

[OceanPrincess]

OP- would reverse pressure massage (i think that's what its called) help here?

Reverse pressure softening could help - that helps relieve the pressure caused by excess fluid (not milk) behind the breast. It's a good trick in those first few weeks.

Melissa, you could give it a try, check the ABA website here:
https://www.breastfeeding.asn.au/bf-...um/engorgement

That's got some info on reverse pressure softening.

[*beannaithe*]

Thanks ladies. The girls have both had awesome weight gains and have never lost any. They were born at 37w5d, weighing 2.46 and 2.54kg and at 8w5d were 5.17 and 5.07kg (porkers!!!!) so no problem with weight gain. Loads of wet nappies daily and giant big yellow bf poos at least once a day.

When I express to begin a feed, I will get between 80 - 150ml in less than five minutes though what I get off is really really thin looking. And being out and about for feeds (when I have to discretely hand express) is super messy and I'll soak a spew cloth. Girls def do choke a lot more if I have to hand express.

Might give that rps a go, see what effect it has


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[Barb Glare]

To be honest, I think 80mls- 150 mls is too much to express off. That's pretty much a full feed and will be exacerbating your milk supply. Try to wind it back - just 50mls and then 30. Real milk (human milk) is normally palish. Cow's milk is "too white" - so don't wait around to get milk that doesn't look thin!

[*beannaithe*]

Ok will try less. It's just been coming out so fast that I literally get distracted for a few mins pumping and I get that amount. Would hand expressing be better? Probably?

Thanks v much


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[OceanPrincess]

Yes, hand definitely! You are a milk machine - expressing 100ml or so and then feeding a full feed (or two??) straight after! Go you!

The good news is it'll settle relatively quickly. Just express a little bit, to take the hardness off, and hopefully soon enough you'll be making exactly the right amount for your lovely girls

[~ Mylitta ~]

Try not to worry too much about fore milk and hind milk - it is just a reference to the fat content of the milk, as they work through the feed the fat content increases, there isn't a point at which t switches from fore to hind milk, rather it's a gradual process, so I wouldn't worry about it just now.

Thank you thank you thank you! I was going to write exactly that. I'm always amazed at the misconceptions surrounding the terms "hind" and "fore" milk, and the belief that at some point during a feed it magically swaps from one type to the other. We only make one type of milk, but the fat globules tend to stick to the wall of the alveoli and ducts, so between feeds as the milk is produced and travels toward the nipple it is leaving a lot of the fat behind. After you get letdown and as the breast is fed from, the fat is dislodged and starts coming out in a higher concentration. So the start of the feed often has less fat than the end.

If you express a little before feeding you're likely to be removing some of the milk with the lower concentration on milk. This pat is often like the "drink" part of the meal. The milk with a higher fat concentration is sort of like the "meal" part. You may find that sometimes the girls may pick and choose what breast they want to drink from because babies seem to have an instinct that tells them if they want a drink or a meal, lol. There's nothing wrong with expressing a little milk away, and that "drink" milk is great to store in the freezer for a "rainy day" or even to offer when they are a little older as a drink on warm days, or in their first foods (like porridge/cereal etc). I've even got a couple of litres in the freezer thta I have kept in case one of the kids gets a skin irritation so I can put it in a bath for them. I've always been really happy that I have a great supply because I love having a milk store in the freezer, and I've also donated EBM to 3 precious bubs as well.

[*beannaithe*]

I actually never really gave much thought to when foremilk miraculously became hindmilk!!!!!! But that is so good to know, thanks.
Mylitta, loving having a stash in the freezer here too. If only these girls would drink it but no, gotta be straight from the booby here

[~ Mylitta ~]

Lol, mine would never drink it from a bottle either. Over the years about 20litres has gone to other babies to drink. The most I've actually used myself is in a bath when DD1 had a heat rash, hehe

[Sagres]

I know some one who had a significant oversupply issue and took sage tablets to help ease the problem (under the guidance of a LC of course). From my understanding it doesn't stop the supply dead in it's tracks, just knocks it back a few pegs and then around 8-10 weeks when things settle down a bit she cut down the tablets over a few days until she was no longer taking them. If you get desperate perhaps talk to a LC about sage and see if they think it might be helpful to you.

[*beannaithe*]

I may have to look into something like that. I've stopped pumping and am just letting the jets flow into a spew cloth. But the last few days, the girls have turned into milk monsters and are each feeding for 45mins to and hour every feed and as a result, my supply has got even bigger. What's with that? They aren't having a wonder week/growth spurt that I'm aware of. I've just fed them and the squirty sprays that threaten to drown them have soaked an old cloth nappy.
Help!!!! Wondering about assigning a boob to each girl - Barb, is this going to be my best bet so that each boob is making enough for that particular twin? I have had a few bouts of mastitis, one severe and I'm really scared of this happening again.


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