Expert: Sally Wendkos Olds - 9/27/2004

Question
Sally:
I have a five week old baby and have breastfed him exclusively since birth.  He began deveolping some problems with feeding about three weeks ago.  I took him to a breastfeding clinic on the weekend and was told that I have an overactive letdown reflex.  He has all of the common symptoms.  It was suggested that I only nurse from one breast at a time and that I try different nursing positions.  I have been doing this since his birth.  I have also cut dairy out of my diet, tried "Oval" gas drops, and gripe water.  The other suggestion was to increase the frequency of feedings but one of our problems with nursing is that he was nursing so often.  He would eat for 5-10 minutes, spit out the nipple and refuse to go back on.  He would fall asleep for 10-20 minutes and then wake up screaming for food.  This pattern repeated over and over (in fact, it's why I took him to the clinic).  I can't get him to stay on for more than 15 minutes at a time and he seems to be taking in more and more foremilk which is making him worse.  
Do you have any suggestions that may help?  Will he eat more at one time as he gets older?  Will my body adapt?  
Thank you in advance for your help
Kristie

Answer
Dear Kristie,

First, congratulations for giving your son the best start in life by breastfeeding. I am attaching an excerpt from my book that relates to your situation, of an overactive letdown reflex. I hope that some of these suggestions will help.

Good luck!

Sally Wendkos Olds
author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters.
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  IF YOU HAVE "TOO MUCH" MILK
Abundance is wonderful, but occasionally a woman has such a forceful let-down that her milk flows too quickly into her baby's mouth. The baby will gulp noisily, gasp, choke, gag, and sputter during the feeding. He may stop nursing after only a few minutes, only to burst into loud wails of hunger and frustration. A baby forced to drink too quickly from such abundance will swallow air, have uncomfortable air bubbles, hiccup, spit up, and be unable to satisfy sucking needs. Ironically, with all this abundance, he may not get enough suckling comfort.
  This is easy to correct in one or more of the following ways:
  * Express the first torrents of milk until it starts to come in a steady drip.
  * Offer just one breast at a feeding. If your other breast becomes uncomfortably full, express or pump your milk, and save it for relief bottles.
  * Try lying on your back or leaning back in a recliner, with your baby lying on top of you. This allows the force of gravity to reduce the flow of milk from your breast and lets your baby control her intake more easily.
  * If your baby starts to choke or spit up during a feeding, remove him from the breast, let a little milk go into a cup, and once he has calmed down, bring him back to the breast.
  * Be sure your baby is latched-on and properly positioned. Some babies slide down a firm full breast and clamp down on the nipple, resulting in sore nipples for the mother.