Too Much of a Good Thing
by Karla ° Monday, February 5, 2007
I keep meaning to find time to finally write about my birth story and Nate’s experience in the NICU and the part where I ended up with a spinal headache that felt like I had been shot in the head with a bazooka and that I took codeine while breastfeeding because that seemed a lot safer than digging another hole into my spine to fix the first hole that was left behind from the spinal medicine with a patch of my own blood, but just when I think life with baby is starting to settle down and I can share the gory details of spinal fluid leaking into my head, I find out that I have an oversupply of milk.

Considering most women worry about not making enough, you would think this is a non issue, but of course, nothing can be that simple. Because milk changes throughout a feed from sugary to fatty, when there is too much stored in the breast, the baby can’t drink it all and he fills up on the thin, high-sugar milk and never gets to the more filling and satisfying higher fat milk. The high-sugar milk empties quickly from a baby’s stomach and all the excess lactose irritates their poor little digestive systems, which results is a very fussy and gassy baby with explosive green poo and an unbalanced diet.

All of this because I upset the delicate cycle of supply and demand when I started pumping so Mark could feed the kid and I could get more than 3 hours of sleep in a row.

At least someone is getting use out of this lonely king sized bed now that I officially don’t sleep anymore and Mark is bunking on the futon in the office.


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You poor thing. Best of luck getting some rest. It does get better and if nothing else you become very adept at functioning on little to no sleep. Then one night they sleep for 11 hours and you feel truly human again for the first time in months. Good thing the dog is getting his much needed rest....
Posted by Anonymous Anonymous :  February 05, 2007
 

Love the picture of Samson all curled up in that big bed of your's! Sorry you aren't getting the sleep you so need! I know how I feel minus a good nights sleep so I can only imagine that mutliplied over & over again. Hope you are able to get some much needed sleep soon! Hugs from Ohio!!
Posted by Anonymous Anonymous :  February 05, 2007
 

Oh, bummer! That doesn't sound like much fun at all... at least you've discovered the problem. :)
My twins are nearly 2 now, but I remember how difficult those early months were. Hang in there. It does get easier! :)
Your birth story sounds tough too! :( Yikes! I've never heard of a spinal headache, but it sounds awful.
Posted by Anonymous Anonymous :  February 05, 2007
 

That is such a cute picture of Samson! He is truly the cutest dog ever.

Sorry to hear about the lack of sleep. But I pumped for the very same reason - we did split shifts at night. He took the late night shift and I took the early morning shift. That way I could get about 5 hours of sleep.

Sorry to hear about your spinal headache. Yikes, that sounds awful!
Posted by Blogger Kate :  February 05, 2007
 

Wow, that doesn't sound to good. I have never heard of a spinal headache.
That is one cute picture.
Posted by Blogger Tammy :  February 05, 2007
 

I did exactly the same thing as you and ended up with an oversupply. I quickly fixed it by offering from one side only per feeding. Worked like a charm for us and the explosive green poos quickly turned into nice yellow ones.

Good luck!
Posted by Anonymous Anonymous :  February 05, 2007
 

How do you fix it!?!?!?
Posted by Anonymous Anonymous :  February 05, 2007
 

Sleep is good and hopefully you will get more soon. You are being such a strong mother to your boy.
Posted by Anonymous Anonymous :  February 05, 2007
 

I wish I could give you some wisdom on the oversupply problem. Unfortunately I had the complete opposite problem.

I know it doesn't help hearing this as tired as you are now, but all of a sudden little Nate will start sleeping for longer and longer periods over night. And then he will sleep through the night, and you will forget all about how hard it was at the start.

Good luck
Posted by Blogger Cate :  February 05, 2007
 

Any way to get an RSS Feed for your blog? I have a serious blog reading habit and I check yours constantly! I love the pictures and the colourful vocabulary!
Posted by Blogger cinnalily :  February 06, 2007
 

Well I hope you can find a solution to your milk supply. All these trouble when us women are just trying to feed our sweet little guys with the best thing for them! I tell ya....it is worth it=)
Posted by Blogger Donna :  February 06, 2007
 

Just when you think you've got it all under control... My heart goes out to you. I'd loan you some sanity if I had any of my own. Spinal headaches are the very worst.
Posted by Blogger Laura :  February 06, 2007
 

my friend has a babe born nov 18/06 and she slept over 9 hours more than twice in one week!! and she has been sleeping for at least 4 hrs at a time at night since birth!

she is sooooo friggin' lucky.

i hope when my little girl comes that she will be like that!

good luck geting so more zzzzzz's
 

It makes you wonder how they breast-fed babies back in the old days, when they had not as much information as we do now.

I hope you get some sleep soon!
Posted by Blogger Gina :  February 06, 2007
 

I asked and I got it. Pictures pictures everywhere. Eeek he is so cute and the birth ones made me cry. Karla, you keep making me get all sappy and turn into a cry baby. You are such a beautiful family and if I haven't said it enough I am so very very happy for all of you.
 

I had no idea that was even possible.
Posted by Blogger Christi :  February 06, 2007
 

I came to your site through a friend. She was blown away, because after talking she realized that we have like stories. I have/had the EXACT same problems. I had the spinal fluid headache(Only I did the dreaded blood patch and it will probably continue to be the worst mistake of my life!).. I started pumping because our baby was in the NICU for 10 days. I wanted her to only get breastmilk. Each time I would pump I would end up having about 16 ounces of milk after only a few minutes on each side. I have been trying to figure out why our now three month old baby is crying ALL the time and I think you finally gave me an answer. How do you or did you solve this problem? I want to keep breastfeeding, but I also want our baby to be healthy and happy!
 

Hi Smittle Momma
Wow. We totally do have the same issues don't we?

I have been in contact with a La Leche League leader and here is her response to my inquiry.

I hope it helps:

Dear Karla,

It's absolutely OK to contact me again - that's what I'm here for!

You're right that it sounds like either hindmilk/foremilk imbalance, or sensitivity to something in your diet. Is he fussy or gassy at all? How frequent are his bowel movements?

Some sensitive babies can react to things in the mothers diet. Dairy, for example, is tops on the list of sources of food sensitivity and fussiness in babies. The protein in cow's milk passes into a mother's milk, and if the baby is sensitive to this it can cause fussiness. It may take ten days to two weeks to eliminate cow's milk protein from the mother's system.

A few other things that can contribute to gassiness: Is baby taking a vitamin supplement or oral fluoride? Does he eat anything other than mother's milk? Does he take bottles of anything? Has the baby or have you taken any medications?

These LLLI FAQs also discuss food sensitivities in the breastfed babay and might help you decide if it's happening in your case: http://www.llli.org/FAQ/allergies.html and http://www.llli.org/FAQ/avoid.html.

As for the possibility of hindmilk/foremilk imbalance, the thing we usually suggest is to nurse one one side only at a feeding, switching to the other side for the next feeding. But it sounds like maybe your baby is already doing that! You might like to read this LLLI FAQ about hindmilk at http://www.llli.org/FAQ/foremilk.html. It contains a couple of links that are also helpful.

Usually, hindmilk imbalance is linked to an oversupply of milk, sometimes with a forceful let-down. When this happens, baby is usually not happy while nursing - he gags and chokes while feeding, as the milk sprays out too quickly for him to swallow. The following are some of the other markers of oversupply:

* Baby acts like he is starving and breastfeeds ravenously and frequently.
* Baby refuses to breastfeed at times and goes on nursing strikes; he fusses or cries at the breast.
* Baby is fussy, gassy and colicky.
* Baby will not comfort-nurse; he only breastfeeds for food.
* Baby has green, frothy, explosive bowel movements.
* Mother gets frequent plugged ducts and mastitis.
* Most babies whose mothers have oversupply gain weight very quickly (although it's also possible for the baby not to gain weight well.)

Not every mother with oversupply has all of these symptoms, but they usually have several of them.

La Leche League International has a terrific FAQ about oversupply of milk. It has lots of detailed information about this issue and how to deal with it. You can find it here: http://www.llli.org/FAQ/oversupply.html.

Why are babies whose mothers have too much milk so fussy and unhappy? One reason is because the milk often flows too quickly. Baby doesn't enjoy nursing because the fast flow of milk causes him to gag and choke.

The second reason is because baby gets too much sugar and not enough fat. Milk that is stored in the breasts (often called "foremilk") becomes thin, watery and high in milk sugar (lactose), while the milk that is freshly made (hindmilk) is higher in fat. The trouble with oversupply is that there is so much stored milk in the breast that the baby can't drink it all. He fills up on the thin, high-sugar milk and never gets to the satisfying, freshly made, higher fat milk.

The high-sugar milk quickly empties from baby's stomach, and soon after eating he acts like he's "starving" again. Also, the excess amounts of lactose irritate many babies' digestive systems, giving them gas and making them very fussy.

So, what can be done? The first step is to increase the amount of fat baby receives and reduce the overall volume of milk he receives so that he is happier. The long-term goal is to reduce the milk supply to a level that meets your baby's needs, but isn't excessive.

To increase the amount of fat baby receives, when you breastfeed him, take him off the breast when the milk begins to flow and let the first let-down run out into a towel. Then put him back to the breast and let him finish nursing. Nurse only on one breast per feeding. The letdowns that happen later in a nursing session are not as forceful as the first letdown, so this helps to prevent choking and gagging from the forceful spray of milk. It will also help baby receive the high-fat milk he needs to stay satisfied longer, and will be easier on his digestive system. This is a good short term fix, and many mothers find that it makes things somewhat better right away.

Nurse frequently. This seems like a strange suggestion, because normally the more often you nurse, the more milk you will make. But by nursing frequently, before your baby is extremely hungry, he may nurse more gently instead of like he's "starving." Frequent nursing also helps him to get the higher-fat milk, because the fat content decreases the longer milk is stored in the breast.

Here are some suggestions to reduce the amount of milk you are producing. This is a long-term solution, and it takes time and patience.

* Avoid pumping unless you need to pump because you are away from your baby. If you need to pump, pump only enough for his needs.
* Breastfeed only on one breast per feeding. The other breast should become somewhat full in between feedings. When your breast becomes full (engorged), and stays that way for a while, it sends a message to the milk-producing cells to reduce the amount of milk they are producing. You need to be very careful not to become *too* engorged, or you may get plugged ducts and mastitis. If you become too engorged between feedings, pump just enough milk to relieve the pressure, but don't empty the breast.
* Some mothers find that breastfeeding on only one side per feeding and discontinuing pumping are enough to regulate their supply. However, many mothers have to do more. They need to breastfeed on one breast only for 3 hrs, 4 hrs, or longer. Some people call this "block nursing." When baby wants to nurse, breastfeed him on the right side only, if he wants to feed again any time within that 3 hour period, keep putting him to the right breast only. After that 3 hour block of time is up, breastfeed only on the left side for the next 3 hours. Again, you need to be careful about engorgement. You want the breast that is not being used to get somewhat full, but not so engorged that you get plugs and mastitis. If blocks of 3 hrs isn't enough to regular your supply, you might do blocks of 4 hrs, or longer.

Over time, these measures should make your supply more manageable, and you and your baby can enjoy breastfeeding!

I hope this information helps you decipher why your baby is having green stools. Please feel free to contact me again with any further questions.

Warmly,
Michelle

Posted by Blogger karla :  February 08, 2007
 


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