Fast flow... Suggestions...

So DD is 10 weeks. After a rough start we are doing ok. But the milk flow is quite fast to start with and she often spits up or vomits after feeding. I think she drinks it too fast, cause she has too. I don't feel any letdown but after a few sucks it spurts everywhere. Uncontrollably.

I've done a bit of reading and tried lying back and expressing a bit first, which helps a little. But she's upset and hungry so it's hard to do that. I can also hear her tummy processing the food too. Is that usual?

The paed saw one of her vomits at a routine checkup and said she has a little bit of reflux...

Anyway. Just wondering what suggestions or thoughts you guys have.

How have you managed this. Anything else I could do. Am I missing anything? What are your experiences?

10 weeks already!
So how is baby going?
When you lean back, how far to do you recline? Positional feeding is one of the best ways to deal with this. Expressing a little to get the 'worst' of the letdown out of the way first, also. So you already know the basics.
When you say rough start, what's been going on? Any attachment issues? Any possibility of tongue/lip tie?
Sometimes inefficient feeding (caused by ties, for instance) means babies overcompensate and mum ends up with an oversupply and/or fast letdown. And it may also make it harder for them to deal with.
Usually, this sort of thing sorts itself out over the first 2-3 months, but that is not always the case. It's probably worth doing a little extra investigation.

When my flow was really fast, I'd express a bit first, to ease it up a bit before bub went on.

I generally only needed to do that for the first big feed of the day, unless I'd skipped one, and ease feeling really full.

I also found they were less refluxy if we fed in a more upright position, or a football hold, with the legs angled down (again to get a less horizontal line).

Good luck!

My fast flow was linked with oversupply. I did multiple feeds from a single breast in a row to try to empty that breast completely before moving on to feeding from the other one for as many feeds as it took to empty it. In the mean time I'd express off just enough to keep the other breast vaguely comfortable. In hindsight I think a less extreme version of this would have worked better. But it did sort out my oversupply issues after a week or so and with that the fast flow as well.
I was also expressing a bit first and feeding in a upright semi reclined position.
I know it's hard but I found even when DS was hungry and upset it was better to take a minute to express a little first than to have him struggling with the really fast initial let down which would also make him frustrated and cause more issues later.

Good luck with it!

She had a tongue tie cut on day two. At the start she was hard to latch although we thought it was okay. It wasn't until she lost 500g by day three they made me top up with formula. Then left it that way. I saw a lactation consultant when she was 11 days old which helped enormously and we stopped formula after that. LC helped with the latch and it's been much better. She recommended football hold... I use football on the left and cradle on the right - it's just easier for me to latch and manage it that way. I was pumping as well for the first month, but then there was so much milk I stopped so I didn't make it worse.

My breasts are large and I have to mean forward to latch. I try to lean back so DDs head is higher than my breasts, that does help. It's been like this for weeks though. So much irony that we struggled with supply the first weeks and now I have heaps. She seems to chuck up so much milk after a feed. I generally only offer one breast each feed and make sure she drains it fully, unless she's super fussy. I'm never sure whether to put her back on after she chucks and because of those early weight issues I generally put her beck on until she really won't take anymore. So I'm probably shoving her full of food too.

She's well and putting on weight. Averaged 145per week at two month check. Generally happy and healthy so I know we are doing ok. I just wish BFing was a smoother process. And less messy (but I know that won't change for a long while :) )

Myturn, I had pretty much the same issues. My milk didn't come in till day 5 and dd was starving! I expressed after feeds for weeks and then i had so much milk I was leaking everywhere. From memory I kept a spew cloth on hand always (the ****ies terry towelling nappies are great) and would let the first bit out on that. DD also spewed constantly and after almost every feed. It all came together by about 3 months and it settled. Just be consistent, I had dd feeding at pretty much the same times by 3 months and my boobs would start leaking within 10-15 minutes of the usual feed times :lol: They knew!

How often is she pooing?
Sounds like you're doing well to get on top of everything.

She poos every nappy... Although just yesterday I realised she has one big poo in the evening and all the other nappies have a small poo or a skid mark essentially. It's a nice bright yellow, so I know she's doing okay there.

Thanks Tasha. I kept hoping that as her head control got better things might just "work". And they are. But sometimes, I just wish it was easier. I have no plans to stop before 12 months, and it's certainly manageable the way it is... But...easier would be nicer...

Poos do often slow down after 6-7 weeks. Just wondering if with the vomitting you might have an oversupply driving the problem. You're happy that her latch is good now? No more problems there?
If you're happy that she's getting plenty, you could try block feeding for a bit and see if that helps? Just till your supply adjusts down enough that things slow.

Latch still isn't perfect. Especially on the right side. Which I feed using cradle hold. Sometimes the nipple comes out a bit flat and it can hurt a bit. She still seems to get enough and it's not all the time. So I've just been sucking it up. There's no damage.

Yes I thought the vomit may be related to the speed and supply. Didn't really think of it as oversupply though... Although I am very full in the AM, and I did stop pumping cause they are fuller and spurting more a day or two after I do. Sometimes I push her to feed more cause I worry she hasn't had enough if she's on,y feeding for a short while, but I should stop doing that cause it probably makes it worse. I just worry she won't put on enough weight if I don't.

So to block feed, I use the same side for a few feeds in a row.. How long?

Well I had heaps of milk and was still feeling really full after a feed on one side only. When I started block feeding the LC said to just use the same side for as many feeds in a row as needed to actually empty the breast. At first that took me over 24 hours of feeding from one side only and in hindsight I think that was a bit extreme and caused some imbalance in supply after that.

Sounds like you're managing to empty a side in one feed though, so maybe just do two feeds from one side in a row and see how that goes.

If latch is still not great, I'd suggest first looking at that as a cause of the oversupply/fast flow. It does happen that way. Baby's overcompensate sometimes when they can't feed well. Was the LC helpful, could you see them again? Sometimes ties regrow or need further attention.

For block feeding, you pick a period of time and feed on one side only for the duration. 3-4 hours, or whatever. But watch the other for signs of blockages just in case. And always, always watch the baby to be sure that she's still getting plenty of milk. You just do it for a few days or so till supply settles then go back to feeding however baby wants.

At 10 weeks she can probably feed very quickly. The caveat is, as always, that you're getting those indicators of good intake - wet nappies, alertness, weight gain, etc. If she's ok, then she's ok and you're doing well. :)

It can be a bit of a muddle at first, but that's no different to any other aspect of parenting! You just figure it out as you go and very often it's not perfect. That's just life. Doesn't mean you're not doing a great job.

Yeah I feel mostly empty on each side after a feed. Possibly two feeds would do it. This morning I was so full on the right I has to express it off. She stirred earlier and I got up then because desperate to feed. But took and extra half hour to wake. I reckon I filled a flat nappy with milk there was so much. Doesn't help my cause but I was so uncomfortable.

The LC was great. I've been considering calling her. Maybe I'll leave her a message today I think she works tomorrow and that might help.

While I'm at it.... Tips for improving latch...? I know that's probably almost impossible... But... How can i get her to take in more of my areola... I'm quite sure the problem is that she's not taking enough of it in her mouth.

To get more boobie in there, I suggest this:-

1. tickle her cheek / lips to get her to "flare" her lips, like the < in the Special K "K" (so a big and wide opening)

2. while you're doing that, press your areola gently between your thumb and index finger, to "flatten" it a bit

3. when the K is wide open, shove your nipple in there quickly, pushing down with your thumb, to knd of squah more in the front of her mouth ... it's a bit odd, manoeuvring it like that, but you get used to it.

Hard to describe ... but easier to do!

Good luck!

I get it peanutter. My LC gave most of those instructions. Her mouth doesn't open very wide and I think that's why I struggle.

DS2 continually tried to feed with this little :o mouth ... this tiny little o, when I needed an AAAAAAAAAAAAAAAAAAAAAAAAAAAH style "O"!

It was pretty frustrating, but he did learn to flare more - and the more he found that got him more milk, the more he did it :) Just by pinkie fingering to break the seal, pop more boob in there, then continue. Repeat.

I hope that your DD's latch improves :)

Is there a way to get more of the underside of the areola in? I think we do okay at the top, but underneath there's still heaps.

I can't see a damn thing easily though my boobs are ginormous and my tiny nipples point down.

Yes. Big boobs. Small nipples. Stupid.

Other than just tucking it in there (gently, lovingly, milkily) I'm not aware of any ...

That's ok. If I've done all I can it's good. I'll just keep trying.

I'd get the mouth looked at again.
And go laid-back nursing to use her natural instincts to latch.