My son and I finally seemed to be getting the hang of nursing when he started having horrible bouts of gas. I've eliminated dairy from my diet and it seems to have helped a little bit. I read an article about hyperactive letdown and was wondering if there is a way to tell whether or not it may play a part in my son's digestive troubles. When he first came home he nursed for at least ten minutes on each breast, every hour and a half. Now I'm lucky if he nurses ten minutes on one breast every two or three hours. He seems to be healthy otherwise and has lots of wet diapers and regular BM's. Any thoughts?




 

Dear Heather,

If your baby followed the usual pattern of losing a little weight in the beginning, then gained back to birth weight by about 2 weeks---then he has gained about 4 pounds in 5 weeks. That is excellent weight gain! This information accompanied by the fact that he is able to nurse for such a short period of time yet continue to gain well tells me that you have a very large milk supply. "Hyperactive letdown" usually accompanies such an abundant supply.

Do you find that your baby is choking at the beginning of the feeding during the letdown and/or has milk pouring out of his mouth or nose? That is often a sign of hyperactive letdown. What can cause the gas is the amount of lactose the baby gets. When a mother has a lot of milk, the baby may get larger amounts of lactose. Limiting the baby to one breast per feeding can help because it encourages "emptying" of the breast. (I put the word "emptying" in quotes because the breast is actually never empty.)

You may have heard the terms "foremilk" and "hindmilk." At the end of the feed, the baby will get a higher fat milk (hindmilk) which will trigger a full feeling and cause the baby to quit feeding. With a very abundant supply, the baby may drink more of the foremilk, thereby getting more lactose, before finally getting to the hindmilk. It sounds like you are already only feeding one breast at a time. You might consider going to one breast per period of time (i.e. 4 hours). Example: Feed your baby as often as he wishes, but limit feeding to the right breast from 8-12 am, then the left breast from 12-4pm, etc. If you start feeling full and tight on the breast that isn't being emptied, hand express or pump just enough to relieve the tight feeling--but no more. This will not encourage more milk. Whenever just a small amount is taken out of the breast, it is a gentle signal to the brain to reduce supply somewhat. That is what you are wanting to do. Hope this is helpful!

Cher Sealy, RN, BSN, IBCLC, LLLL





 

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