Nipple shields? Mastitis? Low supply? Breastfeeding is a relationship, for sure, but it's also a bit like yoga class with all those different props and holds. So what do pigeon pose and milk ejection reflex have in common? They're both difficult enough to require some special modifications. So what breastfeeding position is best if your letdown is too fast? Romper spoke with lactation consultants to figure out so you can help your baby keep up with the flow.
According to Kelly Mom, a forceful letdown, also known as milk ejection reflex, is often the result of oversupply. You know your milk is coming too fast when your baby chokes, gags, coughs, or clamps down to slow the rushing tide of milk (ouch). Your baby might also pull away to take a breather, make a clicking sound while breastfeeding, or spit up more often than normal. The problem can range from annoying, to call-the-lactation-consultant severe. (Anyone else think Call The Lactation Consultant has the makings of a hit PBS television show?) Luckily, most positions can be modified to manage the issue, as Andie B. Schwartz, M.Ed., RD, LD, CLC, of Happy Family's Happy Mama Milk Mentor program, tells Romper. The key is to get baby nursing upright, with her head above the nipple, to enlist the help of gravity.
Fast letdown can cause a host of problems. "For mom, it can lead to engorgement ... with the risk of frequent clogged ducts and/or mastitis," notes Schwartz, adding that babies may act fussy during feeding, and even occasionally refuse to nurse in addition to the symptoms discussed above. Here are the modifications Schwartz suggests making:
"The 'laid back' position is a good one at home, where baby is on top of you and you are reclined in a comfortable position; you can use a chair, recliner, or pillow to support the baby. When nursing in public, you can position the baby sitting up and facing the breast."
Kristin Gourley, IBCLC, of Lactation Link, also recommends a laid-back position. "But even a cradle position where mom scoots her bum forward and leans back can help," she tells Romper. "This is because it puts baby above the breast rather than right under it or to the side in a traditional upright position ... Baby can generally also get a deeper latch in these laid-back positions which helps them to manage the flow."
Because fast letdown can't always be attributed to oversupply, and because your supply is precious (as you well know), Kelly Mom didn't recommend trying to reduce your supply, especially if you're in the early months. At that time, your body is still gauging how much milk it needs to produce to effectively feed your baby. This means the problem may be only temporary, as your baby learns to keep up on her own.
KellyMom also recommended burping your baby often, and nursing when she's relaxed or drowsy, and likely to drink more slowly. You can also try pumping or hand expression until the milk comes at gentler pace — but she suggested considering this method last. Stimulating your breasts more is basically like sending a message by express mail, calling for more milk.
You can learn a lot about nursing techniques online, but if a problem persists, it's always best to find a certified lactation consultant in your area (the International Lactation Consultant Association has built an awesome directory). Good consultants will observe a full feed to offer the best advice, and will become more helpful over time as they get to know you and your family. These days, many pediatricians' offices employ lactation specialists or can refer you to one, so don't hesitate to give them a call either.
In the meantime, if you have a fast letdown, remember that gravity is your friend. Getting your baby's head above the nipple can help a lot, as can having the baby sit and face you. If you've only been nursing for a month or two, remember that you might not have a long-term problem (though dealing with the resulting baby gassiness is never fun) — your body, and your baby, will find the right gear in time.
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