Breastfeeding Question--Am I engorged?

M

Manmohini

Cathlete
How do you know if you are engorged? I think that I might be producing too much milk. Is there something I should do about this. If my baby sleeps doesn't feed for three hours, my breasts become huge and swollen--I can see the veins in them. Milk starts to spontaneously drip from them usually after a sharp, tingling sensation--one of the most bizarre sensations I have ever felt. Anyways, is engorgment a problem? Should I be pumping some of this off. Little Tamal seems to have no problem latching on to my breast when it's like this, but sometimes the stream of milk nearly knocks him out. Poor guy--his face gets covered with milk.

I have heard that engorgement can lead to breast infections. Is this true? I feel I have enough milk in there to nurse another kid.
Manmohini
 
Manmohini, good to hear from you! That's a happy problem to have, over supply.:) I'm not quite making enough. But when Sienna is asleep or not hungry b/c hubby has fed her in the late night or early a.m. (formula or breast milk) I pump, esp if I'm engorged and dripping. I also pre-pump my right side for her or she refuses it....too hard for her. I guess she's a lefty!

To respond to your other post, I too have been overwhelmed & lucky to get a shower. Sienna eats constantly and catnaps while nursing, so she's awake when she's finished...sometimes will sleep for 10-20 minutes post feeding but that's it. At night she fusses with gas pains (2-3 hours)and needs to be burped, bounced, walked, or given a warm bath, etc. It's grueling after a day of carrying her nursing trying to get cards out and make lunch/dinner, do laundry. My back has been killing me as a result & my whole body feels fatigued. I'm going to try Gripe water tonight for her gas, I'll let you know if it works.

The good news is that she's sleeping for longer stretches at night now , probably b/c she gets so little deep sleep during the day. At night it's been 5.5 hours and then sometimes 2-4 hours after her early a.m. feeding. This has happened the last 2-3 days -- I'm beginning to feel human again! She seems happier too, she's a doll. Up to 6.7lbs now...almost a normal newborn size at 1 month. She's fighting a cold but doing well otherwise, she has such a cute & funny personality. :)

What's Tamal up to these days?

Steph

btw, I have a small laptop where I nusre her...only way I can keep up w/email..getting better at 1 handed typing...this message is all 1 hand.
 
Dear Steph,
I don't know if you have seen this or not--"The Happiest Baby on the Block" by Harvey Karp, M.D. It's an excellent video that teaches five techniques for how to calm the crying of a high needs baby. It saved our life. Tamal still has his moments, but with these techniques, we're usually able to keep him from going around the bend with stress and crying. The first few nights he was home, he was incosolable for hours. I felt devastated by this because no matter what we tried,nothing seems to work. Your bouncing, walking, and warm bath are good strategies. We're just waiting to be able to give Tamal a bath--the doctor wants the umbilical stump to fall off first, and we're still waiting for that little booger to fall.

Yes, it is all overwhelming, especially the colic. The Chinese refer to it as "the hundred days crying." Oh well, 75 more to go! Most parents of colicky babies that I've spoken to say that it just suddenly ends at about 3 months. Tamal definitely suffers this misery. Other than this, everything seems to be healthy about him, and when he's not colicky, he seems happy.
Manmohini
 
When nursing, the breast are conditioned to nurse at certain intervals. If a feeding is missed, you will leak. I used nursing pads for awhile. It is your decision to pump or not but it doesn't seem as if you are getting over engorged. With DD#1 I became so engorged my chest was rock hard and huge, and baby couldn't get any milk they were so full. They also hurt like anything.
 
I always had a lot of milk and I would pump off the extra and freeze it for later. I'd nurse on one side and pump on the other with an Avent handheld, especially at the 7 and 10 am feedings. Sometimes I had a lot to pump, other times not. If I questioned whether I had enough "extra" milk, I'd pump only after feedings. GOod luck.
 
Thanks, ladies. I think I will visit my lactation consultant for a follow-up. At first, she instructed me to feed on baby's cue and to alternate my breasts--left breast at one feeding, right breast at the next. I am thinking now, however, that maybe I need to offer both breasts at each feeding. I certainly need to learn the art of pumping as well.

Here's another concern: If my son doesn't cue me after 2 or 3 hours, I experience a let down--a sharp tingling sensation before my milk begins to leak. (It doesn't matter where I am--driving down the road, shopping in the grocery store. Some women have told me that when I experience the let down, it is a signal that I need to breastfeed my baby soon because if I don't, a message will be sent to my brain to slow down milk production, and this could ultimately lead to a shortage. Is this true?
Manmohini
 
Hi Manmohini,

Great thread here, I have a lot of the same questions. Thanks for the book recommendation too, I've heard of it but haven't read it yet. The Little Tummies Gripe Water has helped Sienna when she's been hiccuping or gassy. It causes her to "release" the gas right away, so be warned if you try it with Tamal! :)

I've been confused about the foremilk vs hindmilk w/Sienna. I know hindmilk is more fatty and rich, so I've been wondering if I should pump off the foremilk so she gets to the rich stuff faster. She's small and takes a long time to nurse, esp if she gets sleepy. I want her to be satisfied enough so she can sleep a bit more during the day. Sometimes I think she expends too much energy (calories) nursing most of the day...if she slept more she'd gain more easily & we might not have to supplement w/formula. I have to call a lactation consultant about this & see what they say.

I'd love to hear what your lactation person says about your letdown question and whether it may lead to a shortage. Keep us posted. Also, below are some links that may have helpful info for you. It's about foremilk/hindmilk, but the sites have lots of other good info too.


http://www.babies.sutterhealth.org/breastfeeding/bf_production.html

http://www.kellymom.com/bf/supply/foremilk-hindmilk.html

Take care and happy holidays to you,

Steph
 
Thanks for the links, Steph. I was a bit neurotic last week about the foremilk/hindmilk issue. I was worried that Tamal was getting only foremilk, but when he shot up to 9 pounds at 2 weeks, my lactation doctor said I shouldn't at all be concerned because this meant Tamal was getting plenty of hindmilk. If Sienna is up to 6.7, it sounds like she too is getting the hindmilk. I've heard that it is the hindmilk that makes them gain the weight.

I am working with an M.D./pediatrician who runs a practice called Breastfeeding Medicine of Kansas. Two weeks ago, this doctor spent 5 hours working one-on-one with my husband and me--teaching us everything about breastfeeding from proper latch to how to regulate feedings. While I was rooming in at the hospital, I worked with the hospital's lactation consultants. They were instrumental in building my confidence and reassuring me that I was doing everything correctly. But it is my lactation doctor who has given me the most. I really had to pay for her services too because my insurance wouldn't cover it. Still, I wanted the best in order to get the breastfeeding off to the right start (especially after the C-section fiasco). You're in Boston, right? If I were there, I would look up the best lactation doctor in town and go for a visit. I'm sure Mass. is much more progressive than Kansas, and that your insurance (if you have it) would cover it. In fact, I have so many questions now that Tamal is almost 4 weeks old that I am going to revisit her for a follow-up. Also, she will sit patiently with me and teach me how to use the breast pump. I so much prefer that to learning out of the manual.

I'll let you know what the lactation doctor says about the let down issue and whether not acting on the let down can lead to a shortage. My doula told me that it could.

We tried some gripe waters but not the Little Tummies. I'll look into that. Tamal gets incredibly cranky at night. We haven't had much luck with the other products for gas. Once he gets cooking on a crying jag, it's hard to bring him back around.
Manmohini
 
By the way, Steph, I loved the analogy of the hot water faucet in the link you sent me. It helped me to understand what is really going on with foremilk/hindmilk. It also confirms that I shouldn't wait too long between feedings. In the days, I wait 2-3 hours, but sometimes Tamal takes a power nap of 4-5 hours, and I can barely wake him. He usually takes one power nap at night as well. I don't like to wake him up when he is peaceful, so I have been confused about this issue as well.

Who knew that mothering was so challenging and that it required so much knowledge and expertise? I have a newfound appreciation. In fact, I told my colleagues the other day that being a mother was much harder than being a college professor! One mother/professor quipped that she comes to work to de-stress. Of course all the men were agog, since they are overwhelmed by the demands of the professsion, and most of them don't contribute to mothering their children.
Manmohini
 
I've nursed for almost four years (over the span of three boys). What worked for me is to either (1) wake baby up and feed him or (2) pump until empty--keep in mind you may cycle more milk, as your body gets reinforcement to produce milk or (3) pump/express only until comfort.
Good luck, and great job with nursing. Your milk is best for baby!

~Melanie~

Jadon born 11/23/05
Justin born 1/17/04
Jory born 4/9/94
 
I nursed my son for over 2 years and faced this problem myself. There are many ways to handle this. One is to give extra milk to the hospital. They are always in need of donors for premature babies. In doing this you may save a life while making yourself more comfortable.

I always hand expressed the milk and froze it for a babysitter so my husband and I could go out occasionally. This makes it easier for your baby to feed and encourages extra milk production.

Your body is likely just making adjustments so you have just the right amount of milk for your baby. This problem will likely be short lived.
 
Manmohini,

You sound EXACTLY like me about 3 months ago - when I was trying to figure out this whole nursing thing . . .

That tingling sensation you are feeling is milk let-down. That's when your milk literally lets down in order to feed your baby. You are lucky that your baby gives you 2-3 hours at a time to rest. My baby wanted to feed every 1-2 hours. She gave me a break at night, but that's when I got engorged (like you).

Here's my advice: Keep feeding on cue like you are doing. Yes, alternate the starting breast each time. Feed your little one as long as he wants on the first breast, burp and then offer the second breast. He may/may not take it, but it's normal either way. Then next time, start with the other breast.

At night, when you feel really full, take out your pump and pump off just enough to make yourself feel comfortable again. If you pump too much, your body starts to think that your baby needs that much, and it keeps making a lot. Unfortunately, you may have to do this a few times at night until your body regulates itself (and it will - but it takes a good 12 WEEKS!!) At about the 3 month mark, your body's hormones start to stablize, and so will your milk supply. It's such a relief when your body regulates!!!

For breast infection (which I also was soooo lucky to experience), the biggest thing is to keep your milk flowing - meaning, don't try to "skip" a feeding. Keep feeding on demand. Unfortunately, if you're going to get mastitis (breast infection - which I got), you're going to get it because of the bacteria that is naturally found on everything (you, your baby, your clothes, etc.). The biggest thing is to keep your stress level down, get rest and eat well. Really take care of yourself so if that bacteria DOES get in your nipple, your body is better able to fight it off.

Whew! I would agree that kellymom.com was a GREAT sight for me to get advice about nursing.

If you have any questions, feel free to ask or e-mail. I have learned SOOOOO much about nursing in my first four months of it. It gets sooooo good once you hit the 3 month mark!!! Keep up the great work!

Chrissy
 
Thanks, ladies, for all of your great advice. Chrissy, my experience does sound a lot like yours. My lactation doctor pretty much told me the same things you said as well. Thanks for the link. I've saved it to my favorites and will return to it for referene.

May lactation doctor recommended against pumping at this point since I'm not going back to work until March. She said pumping could stimulate my body to produce even more milk. She said the imbalance was a result of two things--my being a big producer, and my baby being a fast, active, and big eater. At the 4-week mark, my baby had already gained almost 2 pounds over his birth weight (1 lb., 14 oz., to be exact). The little guy loves to eat. She told me to just keep offering one breast at a time and to feed him on cue. She didn't think I was in danger of infection or becoming too engorged although she said I might hand express milk if I really needed to. Usually, if the pressure gets to be too much, my body starts spontaneously shooting the milk out--and this brings relief.

My baby does often feed in a frenzied and rapacious manner, and this has concerned me. He will bring my milk down by the third suck and finish off the breast in 5 minutes. Then he tries to latch on again either to this or the other breast, and he is so tired from the effort that he can't make the latch. This frustrates him and he starts crying or swiping his little fists against my chest. My lactation consultant thinks that this might be happening because he finishes in 5 minutes and it takes the brain 20 to learn that the belly is no longer hungry but full. Anyone have any experience with this? During the first two weeks, breastfeeding used to put my baby to sleep. Now it does this only if he is in a sleepy mood to begin with when he feeds. If he's not sleepy, he's rapacious and quickly grows angry at the end of the feed.
Manmohini
Manmohini
 
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