Overactive Milk Ejection Reflex

I have an overactive let down. It never "corrected" itself, it's just that as baby gets older, they can handle it. The little ones just can't swallow that much that fast. I always had to use a nipple shield until they were around 8 weeks old and could handle the fast flow better.

I had this exact same problem with my daughter at 6 weeks old. She was having a lot of digestion issues, hungry all the time, very gassy. The nurse told me to try nursing only on one side at each feeding. She explained that when you have that much pressure, the baby is mostly getting the "foremilk" which is 95% water. So she is filling up quickly but feeling hungry again soon. When the milk slows down after that initial spray, stop to burp her, then put her back on the same breast to eat as long as she wants. That way she is getting to the "hindmilk" that is much thicker & creamier, and will keep her full longer & gain weight better. It will also relieve some of the discomfort for you!

She is 3 months now and I still spray a few minutes into each feeding, but she is learning to handle it and not pull off or choke. I also started pumping once each morning before she wakes up, to let some of the pressure off. It really makes the whole day a lot easier on both of us. Good luck! (and keep a towel handy)

You should only use a nipple shield under the guidance of an LC, in my opinion, but that did help me regulate and feed my DD. My OALD did work itself out. I started feeding DD from one side only (I put a hair binder on my wrist so I knew where I left off) and that seemed to work. What you are doing with that is tricking your body into thinking it needs less. I nursed the first few weeks with a towel nearby so if she unlatched I could catch the milk that few everywhere.

Make sure her latch is good. You may have to express just a little at first to let her get a good latch (if you are super engorged, she won't latch on right and may be trying to use the nipple only). Break the latch and give her a break if she needs it. And don't forget to burp! Use those breaks to burp her. My DD was always a fast nurser. If you combine an active flow with a dedicated baby and a small stomach, 5-10 minutes may be all she needs right now.

It should even out. It just takes time. Oh and if she's not nursing as vigorously, it could be comfort nursing, which is different. Nothing wrong with it. Momma is the original pacifier. :)

I've had this happen to me. Your body is still adjusting to her needs and yes, it's hormone driven as well. I wouldn't pump for 5 minutes. Gosh, this will signal to your body to produce more...think "supply and demand." What you pump, on top of what your baby takes from you will cause your body to produce more. You are defeating your purpose here. What you can do is express just a little milk before latching her on. OR if you feel your milk letting down you can unlatch her for a moment, hold a cloth over your breast until it stops spraying. IF your baby is sucking air, she is not latched on properly so it's best to unlatch her when you hear her clicking and then re-latch her.

This block feeding you are referring to would be most beneficial if your baby is getting too much foremilk and not enough hindmilk. You would know this by the color of her poop. I found this out with my first born. Her poop was green and she was an infant so it had nothing to do with any solids she had been taking in. I researched it online and found that she was taking in too much foremilk which caused her poop to turn green. How I remedied this was to nurse her on the same side for 2 nursing sessions and then switch to the other side. This also helped my breasts regulate to the demands she required. And yes, this overactive reflex will work itself out. Just give it some time.

J., I had the same problem with my DD, born last summer. My lactation consultant advised to nurse laying down, so gravity isn't working against you. So I had to nurse her laying down from about week 3 to week 12, and then she became old enough to handle it, and I probably slowed down as well. The lactation consultant also advised nursing twice on one side, so "7am" was on the left, then "10am" on the left, then "1pm" on the right. The key there was that it ensured she got the hindmilk on the 2nd feeding as she may not have on the first feeding. Too much foremilk will cause tummy problems because it is higher in sugar, and this will upset your baby. Best of luck!

When mine would spew, I had a towel handy and let it go into a towel and the resume the position. sometimes you just have to let the pressure off.

I've never heard it called anything before, but with both of my boys I would let down fast and drown them and anytime they would pull off, I would continue to basically spray them all over. (Pretty gross, if you ask me!) :)

I found that some positions were more comfortable for them, like side-by-side rather than cradle (cradle would just force milk down sometimes and they would take in too much air). I would even recline a bit and let them be almost lying on me, but still on their sides, just to let gravity help keep from drowning them and letting them JUST take in milk. I think also pumping is a great way to help and it never hurts to have extra. I'm planning on donating milk after I have my third, so am actually hoping I have the same kind of milk supply I did with my first two and will be pumping anytime this happens to me. I also usually nursed just one side until it was completely empty, even if that was more than one feeding, and pumped the other, but still switched and nursed the other so both sides were nursed from about equally.

I'm not sure what causes this, but I could usually go most of the day with only changing my nursing pads once eventually, so hopefully it will level off a bit for you.

It will definitely get better! Over the next few weeks, your supply will start becoming more regulated and your baby will learn how to handle it. In the meantime...

You've got a lot of good advice below, especially about making sure that gravity isn't making it worse. I nursed my baby with him almost verticle (as opposed to the horizonal cradle position). I would have him kind-of straddle my thigh, his head propped against my bicep, my hand behind his back with me reclining just a little. This was better for him than the cradle position.

What worked best though, was pumping a little before feeding him. I got an inexpensive hand pump and used that for a minute or so before feeding him. It took care of the initial forceful letdown, helped with the foremilk/hindmilk imbalance issue because I was pumping off some of the foremilk, and also softened me up so that it was easier for him to get a good latch (I also had an over supply issue, and often became engorged making latching more difficult for him). I would count, and if I did 50 'squeezes' with the pump, I could get as much as 2 ounces of milk! There was still plenty in there to feed the baby on just one side. And I froze down all that extra milk to use later (great if you are going back to work, and even if you aren't you can use it later when you start making baby cereal, etc).

Once my baby was older and better at latching and my supply regulated so that I wasn't engorged anymore (probably around 12 weeks), I stopped pumping before feeding. Like your baby, my baby has always eaten very fast - 10 minutes tops. That isn't necessarily a problem. Don't worry about making her eat for longer. She'll eat until she's full and that's all that matters, not the amount of time she's nursing.

If you have any more questions about this, feel free to message me.

Hi J.,

I had (still have at times) the same issue with my 9 week old daugther. She would the exact same thing as your little one. I spoke with my midwives about it and they suggested that I try to nurse her upright and myself leaning back a little bit. They said you could also try laying down, but to not do it too often because it could lead to blocked ducts. I was terrified of a blocked duct (had one with my son), so I never did it laying down. What I found to be helpful is to let her encourage let-down, then pull off of her and allow the milk to spray into the spit rag. And it would spray!! I've seen it shoot across the room! I couldn't image the force she must have felt in her mouth. Poor dear. Once the milk wasn't so forceful, I'd put her back on. We still have issues with it, especially at night when she goes longer without nursing. She also swallows a lot of air and is quite gassy/uncomfortable from it, so I really work to burp her well after a feeding. Stick with it! It'll get better. Good for you for nursing and seeking help when you need it.

I had this same exact problem with my first baby (daughter now 5). She would make a loud clicking sound. I had overactive letdown as well. i would let her nurse for a minute or so, then unlatch her and absorb the spray of milk with a burp cloth until it stopped by itself (just a minute or so) then continue nursing.
I did block feeding for all three of my kids. Only nurse on one side each session or only nurse on one side for two nursing sessions in a row before switching to the other side. I never could nurse on both sides during one session like they suggest. It's uncomfortable for about a day until your milk supply adjusts, but it worked for me.
It will work itself out. The baby will get used to it and actually want the milk to come out fast. If you ever switch to a bottle, she may need a faster flow nipple because that's what she's used to. Just keep trying, she'll probably be a pro in no time! : )

First of all: good for you for getting help early!!!!
Second: she's only 5 wks so your body is still in over-drive w/ milk production. It's trying to figure out if you've had 1 baby or a whole army of them. Likely, your supply will regulate in another 1-3 wks. Just keep nursing on demand.
Block nursing can be effective, but watch your supply as you continue to regulate b/c it MAY work a little too well & then you'll have to build it back up a little (which doesn't usually take long to do, so don't worry too much about that!).
You can nurse reclining back vs. sitting up. That way gravity is working against you some & that helps many women w/ overactive letdown.

Have you been to any LLL meetings yet? Your Leaders will likely have some fantastic suggestions!

Keep up the good work, mama! Congratulations