Wednesday, December 19

My milkshake is better than yours: Tips for managing "enthusiastic breasts" (everything you wanted to know about overactive letdown & breast milk oversupply)

*For my actual, serious tips on handling breast milk oversupply and overactive letdown, you can scroll down to the red headline.*

This post would be better with photos, but including photos would mean showing my milk factory to the whole Internet, and I just don't see getting enough extra ad revenue to make it worth the loss of dignity. Because thanks to my four year old who knows how to operate the camera, highly undignified photos of my milk factory do exist.

Instead, let me give you this photo of the Neptune Fountain in Piazza Maggiore:

Much less awkward, right?

How about some unrelated outtakes from our Christmas photo shoot?

Moving on.

As part of my genetic code, I've inherited what La Leche League euphemistically refers to as "enthusiastic breasts." My nurse sister-in-law, on the other hand, more accurately if bluntly explains my situation by saying "you could feed the whole block."

Since I'm breastfeeding Oliver, I have to deal with my surplus of milk as well as what is known as overactive letdown. A newborn just can't deal with the resulting amount of milk and speed of milk flow, although he has tried valiantly. He inevitably ends up coughing, sputtering, gagging, and later on, tooting up a storm. Hahaha! Now we're talking about gas!


Ethan, my little scientist, has been very interested in the whole breastfeeding/pumping process. It all started when Oliver was three days old and Ethan asked, "But what happens if Oliver is hungry and he's with someone with no milk in their boobies?" When I first began pumping, Ethan picked up the breast shield/bottle contraption and asked, "What does this honker do?" Good questions. I'm pretty sure at this point he could function as a part-time lactation consultant.

Noah, on the other hand, gleans a great deal of entertainment from my breastfeeding. One of his favorite jokes is tossing a receiving blanket over my entire head and upper body when I call for a modesty assist (at the doctor's office, at our friends' house, etc.). He also enjoys doing the shock-and-awe routine, as in "I'm shocked and awed by your milktating gazongas and can only gape and giggle while in your presence."

He adds some much-needed comic relief to the equation, truth be told. And he's also been a champion baby burper and diaperer, since this time around he doesn't get to do any of the feeding (with Ethan I pumped and we fed him breast milk in bottles). I'm so grateful Noah has the ability to stay home with us for a few weeks, not just for the help he gives me and how he's stepped up to manage the household, but because we can enjoy our new family of four every day for a month, all together.

Of course, he's not totally a suffering servant. Case in point: When we renewed our Costco membership  the other day (the diapers! the wipes! the gallon-sized tubs of Nutella!), Ethan got an Angry Birds pillow, Noah got a fancy book on The Hobbit film's design elements, and I, well. I got some tank tops for breastfeeding at night and stool softeners. So.

On a briefly serious note, here's my tips for anyone dealing with this issue:

Back in the 50s, when Nanny had her children, the hospital used her surplus breast milk to feed premature babies who desperately needed the nutrition. I'm looking into donating my excess milk as well. If anyone out there reading this has surplus milk, I'd urge you to consider donating: But we still have our own babies to manage, so here's what I've learned:
  • Try "block feeding," or only offering one breast to your baby each time he needs to eat within a set number of hours before switching to the other breast for another set number of hours. Doing so helps the baby fully empty your breast (preventing blocked milk ducts and mastitis), as well as accessing the all-important hind milk that's full of fat and nutrients. (The milk available at the beginning of a feeding is fore milk, and it's got lots of vitamins but not enough substance to keep the baby full and keep his digestion healthy). Block feeding also allows your breasts to take turns being a bit too full, thus sending your body the message to make a bit less milk. You can express or pump a small amount of milk to relieve any discomfort while feeding from the opposite breast.
  • In extreme cases, like mine, using an electric pump for a few days can actually help. Emptying the breasts as completely as possible once or twice a day, then block feeding, can assist your body's adjustment to baby's needs by starting from scratch, so to speak.
  • Even after your milk production is more regulated, a forceful letdown can still happen. If the baby isn't desperate, I recommend allowing the initial letdown of fore milk to flow onto a clean burp cloth or towel before letting the baby latch. That way, when baby begins to suck, there isn't a preexisting strong milk flow for him to get choked up on. If the baby still has trouble, or needs additional help coping, I recommend using a nipple shield. Nipple shields are tricky, because the decreased stimulation owing to the silicone barrier can decrease your milk supply, but for me that's not a problem. Nipple shields are mostly used for women with inverted nipples or babies who have difficulty latching, but they can also act as a catchment for a strong milk flow. The baby has much more control over the flow of milk, because he *must* suck in order to receive milk.
I'm very blessed to be able to breastfeed when many women struggle to produce enough milk or can't provide their babies with breast milk, but that doesn't mean having an oversupply is easy to deal with. It can be frustrating seeing the baby struggle while trying to eat, it can be a mess when you get into a Neptune Fountain situation, and it can make leaving the comforts and privacy of home a challenge. We're still working on figuring this out, but I'm doing my best to persevere. Articles I found on La Leche League's website were especially helpful.


Jenn said...

Omg the picture is just too much! Glad you are figuring out all of this breastfeeding stuff and keeping your good humor in tact as well. ;)

Jenn said...

Also, Sam takes me "honkers" and holds them up to his face like an old-timey telephone. One to his mouth, one to his ear. Bless him.

Anonymous said...

Your boys are so cute. Which I'm sure you know. Ethan's hair kind of makes me giggle in a couple of those pictures. I'm impressed you manage to keep it "managed" being long on an active little boy!

Fox in the City said...

Oversupply is a tough thing to deal with. I struggled with both of my kids and actually ended up giving some of my pumped off extra milk to my cousin who was struggling but wanted to give her newborn breast milk.

Adrienne said...

I, too, had enthusiastic breasts. We used to joke that my boobs were actually trying to drown my babies. I found that side-lying was a help, so that gravity was a bit less aggressive with the whole breasts-as-firehoses phenomenon. And yeah, block feeding was great. Only one initial letdown per feed.

Good luck! My boobs never really settled down till my babies were something like 9-10 months old. Hopefully you won't have to endure it so long!

Tim and Heidi Huber said...

Thank you for your wonderful post. I chanced on it and am so glad that I did. I also had a very good supply of liquid gold for both of my children. My poor son had continual eye-fulls of milk and I wondered why I had never heard about it before -- now all I hear is about those with too little milk. I had a friend who was having issues having enough to nurse her baby, so I made sure to load her up. I got fresh produce and baked goods out of the deal. Win-win. -Heidi

Emily said...

I SO wish I would've seen this post when I was trying to breastfeed. I had the same problem and ended up getting horrible cases of mastitis and eventually quit. The lactation consultants just kept telling me that it would regulate...but it never did. They didn't have any of these helpful tips though!

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