Significantly different milk production L/R

[katiegolightly]

Hi all, wonder if anyone has tips here.

From day 1, DD1 (18 days) prefers L to R boob. We have persevered and she now happily suckles both, but I suspect not satisfied after R. I try to stick to one side per feed so she gets her fill of the full fat hind milk, feeds are usually 20 mins every 3 hours then she unlatches and falls asleep.

L has always been marginally bigger than R and I'm aware this is quite usual too. But the size difference is now significant.

Also, I'm expressing twice daily (usually straight after morning feed and after early afternoon feed) for DP to do night feeds (heaven). I'm only getting maybe 10-20 ml from my R and easily 100ml from my L.

How can I re-dress the balance - attempting to actively use both in bfeeding and expressing but the difference in production is startling, (And I'm starting to look lopsided!!)

Help!

katie, almost every mother ends up, sooner or later, with one breast that's 'better' than the other :) Perfectly normal.

Who has advised you to stick to one side per feed?

This is not standard, although some HCPs and some books wrongly say it is.

In the newborn period, the best way to get bf going well is to not deliberately stick to one side per session - probably most women would be fine doing this, but others would not, because it significantly reduces milk production. Milk production depends on frequent effective removal of milk from both breasts, esp in the early days (later on, one side per session is just what emerges from the baby's preference and that's ok). So feeding your baby on side 1 until he signals to you he has had enough for the moment is the first step; then after a break/wind/cuddle/doze, you offer the second, which he usually will take (but may not every time). You can offer side 1 again and side 2 again if your baby indicates a need - 'cluster feeding' babies often do :)

The idea that one sided feeding per session is essential to get the hindmilk is quite erroneous and you can be pretty suspicious of any sort of info that tells you differently :)

Also, night feeds are essential at this stage, at least for the majority of babies. Skipping all night feeds is not helpful and could reduce your supply as well as making you feed uncomfortable....even when the feed is ebm. Your body is not getting the right 'message' if you do this, with hours between feeds.

Hope this helps - at least you can be sure that a difference in production in breasts is ok :)

Thanks tiktok, great advice, thank you. I'll make sure I get both sides in from now, frustrating that I'd been listening to not so great info! I'd heard one side only from a few of the midwives but I guess so long as it's a good length feed and she's gaining wait then no real problem. Everything you're saying makes sense. Even the bit I didn't want to hear about enjoying my 'long' stretch of sleep whilst DP took over

I have been a bit reluctant to break off for a wind/change etc - I know this is not ideal but I've not been able to do it successfully without her refusing to go back on. Tight lipped and no amount of persuading gets her back on within an hour at least. Perhaps I need to try just 5 minutes before interrupting her to make sure she is still hungry when we swap sides.

Thanks for your tips!

You don't need to break off to wind her or change her, katie - who told you that? :) :)

Just leave it to her to show you when she wants a break. Deliberately taking a baby off often does result in the baby not going back on again - really, just let her come off herself or indicate in some other way (stopping sucking and swallowing; falling asleep) that she is done (for the moment.....)

I was in a similar situation, one breast is "normal" while the other produces very little milk. I tried feeding DS from both breasts equally but he had a definite preference for the "good" (left) breast from the beginning. Unfortunately I didn't know there was difference, DS wasn't gaining weight at 10 days old, and I gave in to a midwife's suggestion to supplement with formula in desperation (probably wouldn't have if I'd come to this board for support). It wasn't until he was 8-10 weeks old that I figured it out. V similar with pumping too, 100ml from the left breast and 10ml from the right. I also had 1 D cup and 1 B cup so a very obvious size difference! (They've gone back to the same size now that I've stopped BFing.)

In the end, I stopped feeding DS from the right side and fed exclusively from the left. I had a double pump on loan so pumped both sides until I returned it at 6 months then stopped cold turkey on the right breast with no problems. I'm interested in tiktok's opinion on this, as I'll probably feed my next baby on the left side only. I never had problems with engorgement on the right side, even when the left side felt like a rock at the beginning.

You'll prob be fine one-sided, expat. That 'good' breast will just do double duty :) Mothers of twins only ever have one breast per baby. The difference between what you plan and deliberately only offering one side per feed is that 'one side per feed' reduces the frequency of stimulation of each breast - in fact it halves it. You'll be doubling the stimulation of 'good' breast and will be using it frequently.

Check with a bfc before you do this, though, as initially you will produce on both sides and you will need some management strategies :)

Thanks tiktok. Yes, I did think the same about nursing twins - now hopefully I don't have twins!

Sorry to hijack your thread OP!

No probs americanexpat - sounds like similar situation in many ways. Also what used to be 1 cup sized difference is now at least 2!

Feeding is going well apart from the obvious lower production on that side. Tiktok you ask who told me re breaking her off to wind/change - I'm very much following her cues at the mo - I've let her feed for as long as she likes and there is a clear squeal and harder suck if I try to gently ease her away after a long pause of maybe a minute or two of eyes closed, stopped sucking and head lolled back a bit. I'm trying all the usual tickling, blowing in her face, gentle stimulation to keep her focused as she begins to drift. Problem is, once she's off, she's off - whether she's gone for a short of long feed. Even with a short break for a change she is just not interested in coming back on. (And I've been persevering daily on this so far)

I think as I say I'll try and give it to go with a very short burst on one side to make sure she really is still hungry and up for more! I don't want to constantly swap her but try and break the habit of being on one side for the duration.

But I suspect even doing 'all the right things' (whatever they are ) looks like I will predominantly be a lefty! They've been treated much the same so far. Thanks!

It's good to follow her cues, katie - not sure why you are doing the face blowing, tickling??? Why do you feel you need to keep her focussed? Just let her stop feeding when she wants to....she will drop off when she is properly asleep. Not sure why you need to change her nappy mid-feed.....?

You dont have to deliberately have her feeding on one side only or deiberately have her feeding on both sides. No one is suggesting you constantly swap her. Just follow her cues....if she is zonked out after one side, that's ok. She may wake in a few minutes, even so (18 day olds are unpredictable!) then you can offer the 2nd side. If she stays asleep for an hour or more that's ok, too :)

The stimulation (ear, feet & hand tickling) was advice from 3 different BF councillors at the hospital, it's been working really well as a gentle reminder as to why she's there - as she has been quite 'lazy' on the feeds from the start (not just when she's had enough). The nappy change has just been another tool to wake her up for more if she's not responding to other things when it's clear she's not been on for long enough. All bfc tips so quite happy that those have worked for us!

OK - keeping a baby 'on task' is not a bad idea if they are sleepy in the very early days.

It's not usually needed later on :)

I had to keep my babies awake in the early says as they were both premmies. Funnily enough now dd is nearly a year that isn't needed.....