This is the third child I've nursed. And it's still having it's ups and downs. We still get days of green poo. K is still really wary of nursing when she doesn't want to. She will SCREAM if you put her in cradle position when she doesn't want to nurse. I have to remember to nurse on the emptier side for a bit, til the letdown passes, THEN switch to the full side... which is different than nursing on both sides... cause I spend hours on each side nursing what feels like over and over again and it's still full... but then it settles a bit, then all of a sudden the other breast is bursting and I have to switch, but if I nurse her on that side and she has the full letdown things go down the toilet. Esp when it's nap time, and she wants to comfort nurse. But how to switch at all then. Cause if I go back and forth the flow just gets worse and worse.
It's a double edged sword.
But it's WORKING!
I'm starting to see out the other side. She nurses to sleep. She has good non-gassy days. She doesn't scream all evening.
Even my DS2, N finally nursed contentedly after about the 4 month mark. And nurses for many months afterwards. It's coming.
And nursing an older baby / toddler is the best thing in the world. It's so worth it. Just have to keep going through these rough patches!
A couple weeks ago I had a fat contented lovely baby. Now I have this.
She's got a weird rash, and flaky things on her face. Her neck gets sore spots in between the fat rolls. She's gassy, burps a lot, and has a red bum around her rectum. And green poo.
She screams at me. During nurses, after nurses, all evening.
She hates me, and nursing is making her ill, fat, and spit uppy. I'll just stop now, and give her something that's "better" for her."
Not this time, but I have in the past thought all those things. I've also heard them on the lips of dozens of moms who have gone through this. Around 1.5 to 2.5 months the beautiful well-fed breastfed baby that you held in your arms, stops smiling and starts screaming, pooping, and looking weird. They get baby acne, or the cradle cap starts to dry up. They look like they're in pain part of the time. You wonder what you've done wrong.
So at exactly the same time that all the "regular" ugly-baby things happen to your child - baby acne is hormonal at this age, and goes away by itself when the hormones rebalance in a week or two - your child hits a developmental step, and instead of just drinking the milk like before, they learn new coping strategies and start telling you had hard this is, and has been. And the gut starts to show more and more signs of lactose imbalance if the milk is still in oversupply. And let's not even get started on the latch. The wonderful strong sucking child, has been replaced with clicking, and popping on off, and the sore nipples are back!
Imagine if you didn't know this was overabundant milk (indeed, maybe you don't have to imagine because you're learning it as you read this)... how scary is that?
K is my beautiful baby even with the rashes, and the goo, and the farts. The acne will heal, the green poo will get better, and I will use these signs to tell me that my baby is asking me for help, from the one that they love most, from the one that they can scream to the most, and the one that can help them the most, their mommy. She screams because I'm her world, and she's asking for help. And I will help her.
I don't get nearly enough time to nurse her. Good news, she gets tons of milk in a short time. Bad news, she's certainly showing signs of disliking the milk, coming on and off and giving a little yell every time she does. Nights are better mostly, the milk supply might be starting to lower slowly. I've had a cold the last couple of days and the medication can reduce milk supply slightly so lying in bed sick has been slightly better than it might have been.
They say that 6 weeks is when "breastfeeding is established"... but they don't say that that's in best case scenerios. With overabundant milk that's just the beginning of the baby's coping, and their lack of it. I'm just waiting for things to get harder, at around the 2.5 month mark. Wait for it.
My back and my hand have been very sore and that's lead to not as much babywearing as I'd hoped. She's also 12lbs now! Babies coping with OAM often gain fast and lots! But it means that they sometimes don't get what they need -- lots of time on mommy's chest so they can nurse often on the one side. Unilateral nursing sets you up for mastitis because you're purposefully not draining the breast, I've had it almost every time I've been really stressed, so nursing has to be often and comfortable for baby. And as K gets more irritated by the flow she needs to be comforted more, and it's so easy to just hand her off rather than keeping her on my chest. I did this more with my first, because it was frustrating that he was so sad all the time. But what he needed was to stay at the breast and nurse more often. This is especially important later when they get "colic" at a few months old and spend time with a hurting gut. They need to know that mommy is with them and stay comforted at the breast.
This week has been all about figuring out the "flow" of my day switching back and forth. If we nurse all evening on one side so she gets a good long cluster nurse, then I have to think about whether I should switch the "last" nurse of the day, and potential get her annoyed and not fall asleep, or do it earlier and not nurse as long in the evening on one side and have more milk supply over night. It's work, and when she sleeps extra long in the car, sometimes both breast get "too full" and then I have to figure out where and when to nurse next.
Luckily my left is lower supply, so it seems to drain faster even from "full". So I keep that in mind when switching at night, if I switch on to it, it's likely to be easier for her to handle. The right is still the real issue, but we're going longer on each side to see if it will settle and it hasn't become truly engorged for a few nights. When it gets bad, the breast is so heavy and full that I actually get a sore chest wall -- but I am a 38G! So there's a lot of breast tissue to get engorged. Though don't think that you need large breasts to have oversupply or overactive flow, I've seen it in women of every size!
I think of it this way... a young baby (under about 2-3 months) will just "cope" with the milk, click their tongue, come off and on etc because their brain goes...
"hungry, hungry, hungry, nursey. nursey nursey, suck suck, gag gag choke choke, pop off, screech, still hungy hungy, nursey, suck suck, gag gag...."
their little brains can't quite come up with any other solution but to keep eating...
but at about 2-3 months if nothing is done, or if the flow is still too much even with trying to modulate it down, then the baby tries some secondary techniques that are available to them at that developmental stage. Coming off and refusing to go back on, screaming, arching etc. Their brains have "gotten tired" of fighting and they're stronger and older and don't keep going back on. That's what I'm trying to head off.
It's very frustrating for women who are told that nursing gets "easier at 6 weeks", which IS generally true, but for nursing pairs with OAM it's the beginning of things getting harder sometimes.
The bad news is that 2-3 months is the worst time, the good news is that 2-3 months is the worst time. If we can get through the next couple of months babies nurse for as long as mom and babe want to... we just have to get there.
I prefer the more, no pun intended, fluid term for what is needed to cope with switching sides - unilateral ad hoc. It sounds like a technical term, but it really just means "one sided, as needed". It puts the control back in the mothers hands. Yes, it means that I have to figure it out. But it also gives me permission to say I'm the best person to figure out what's right. But where do I start?
In a breast with "average" milk flow, over the course of one feed the baby gets a small amount of early milk that immediately available , and then the milk speeds up with the letdown in a few 10's of seconds and quenches the baby's thirst, then that subsides and slower, higher fat milk is drawn down from the breast to fill the baby up and "fatten" them up. In a breast with higher flow there is so much early milk, and so much milk is ejected at that letdown that the baby never gets to that later higher fat milk.
Nursing on the same side again allows the baby to "finish" that later milk (though sometimes with a bit of another letdown of milk as well, though that often decreases as the days go on and things improve, and the second letdown on the same side is usually calmer anyway).
But milk flow slows down in the evening, so it might take less time to use the first breast. And my milk is often hugely full in the morning so I would like to stay on that first side for a long time, but then the side that didn't get used much overnight AND all morning feels like exploding. So I have to play with it. Right now I nurse one side in the morning to get it a bit more comfortable and then I switch sides and nurse on that side for a few times, maybe for the rest of the morning-ish (I never look at a clock, just listen to the fullness of the other side and what it's telling me). And then I switch to the "afternoon" breast and try to stay on it til the non-nursing breast is starting to feel just on the edge of uncomfortably full again (yes you want it to be a bit uncomfortable, that fullness is what tells the non-nursing breast to slow the flow, cause the milk is just not needed as fast as it's making it).
Then in the evening I stay maybe a second nurse on the same side, but often she wants to nurse enough that sometimes I even switch back to get her to cluster nurse more in the evening. Sometimes I don't because it just didn't feel like it was going well and she needs some slower milk still, and sometimes it really seems like she needs a bit more milk to get to sleep, and if I get too full on the one side, I'll wake up in the morning ready to explode again, and when we have bad morning nurses that's the day she grumpiest in the evening cause of all the gas from that bad morning nurse.
So it's a constant play by play. And teasing out the right thing to do. And she's still so young and we'll see what we have to do with her, but I know that if I start to think about it now that I'll be better at finding her pattern sooner.
The better it gets, the better it gets. I'm amazed how much the day before affects the next day. I always think of this journey as what affect the morning or day before has on the nightly colic-y behaviour etc but I'm always learning new things that factor into just what makes it better or worse.
At 7 or 8 I'd done this up down routine so much that I couldn't even latch her, my arm was too numb to support the breast, there was too much milk (even overnight) and I was too tired to focus on getting her on.
I think I went back and forth too much last night cause the letdowns were strong all night. They're still coming on after about only 10-20 seconds I think. Certainly not a long time. And she's already gulping before the letdown so she gets mad at the letdown, and then after that there's tons. The left side has a slightly lower supply so it's not as bad. But I need to slow the right so that it doesn't get so full overnight.
Right now she's sleeping in the evening, which is not the best as it seems that if she's awake in the evening she sleeps longer into the night. I'd rather have the nurse, nap, wake, annoyed in the evening and cluster nurse, than overnight. I have to move the cluster feed somehow, I don't love it at 3 am.
We already have way too much milk, not as bad on the left side, but overwhelming on the right side. Even three or four "times" on each side I still choke her on that side. We've fallen into a routine of mostly a "quarter" day on each side.
I had chest pain last night I think the left side was so full that the weight and the fluid brought up my costochondriatis. I still choked her lying down on the left side, and I sometimes am able to hold her up on my arm, but if I have to support the breast with the right hand it hurts from the hand being so numb (even typing this is really hard and I want my hand to get back!)
She weighs over 10lbs, mom and I weighed her on the shipping scale and it said 10lb6oz. She's gaining 4oz a day! But there's no green poo or anything, and she's burping well. She's also gaining length and fitting into new outfits already so I don't think it's too much. She's very good at coming on and off and dealing with the milk, like a much older babe.
I'm thinking about using soy lechithin this time (and trying to be better about my efa intake as well). See what that does to the milk. Two weeks and we're already trying to slow things this much. I could nurse triplets I'm sure. I just with the headaches, arm pain and chest pain weren't all happening at the same time.
She nursed like a champ right after birth (about 15 min in), and nursed well the first night. She's got a good "latch" already, we had a bit of trauma the first night from letting her suck without trying to get her on to deep, but we'll correct that pretty quick I'm sure, got to get some new Newman's cream. She's got a strong head, and can lunge in, and get herself on already. Not really a wobbly head at all.
And now I'm ready to have my third, and have it be better *and* worse. Perhaps I know more, will do more, faster. But I will also have three kids under 5, and it will be busy, crazy, and I have no idea what babe will be like.
But I know that I will cope, and I will write and I will get through it, because I have support and I have friends that will help me, and I know that even while in the midst of all of this, the fact is that if it *does* happen again it's because it's the same thing, and that the same strategies and coping techniques will work again!
This blog is now set up to record my experiences with my third child, and will then stay here as a record for other mothers who are currently in the midst of their own OAM journeys. Happy and Successful Breastfeeding to All!