problem with fast letdown?

[Maenad]

My 8-week-old seems to be really struggling with feeding (though she is gaining weight ok). She comes off during a feed screaming, and keeps going on and off screaming miserably.

She often refuses to feed for more than about 6 minutes at a time, and screams hysterically if I try to offer her the breast after she's come off. She does swallow air - I can hear it - and then sometimes burps quite dramatically, but that doesn't seem to make her more inclined to go back on the breast.

I've noticed her pulling off and screaming when the milk lets down, and today I could see the milk spurting into her open screaming mouth, so I wonder whether my letdown is uncomfortably fast for her. I've tried pressing down above the nipple in the hope of slowing the flow, and I've tried letting the milk go into a muslin before giving her the breast again, but since there are several letdowns during a feed, this doesn't help.

Ever since birth her feeds have been between 6 - 10 mins long, so I do think my letdown must be pretty fast. Could this be the problem? And could it be causing her to swallow air? And if so is there anything I can do to help her? It is miserable spending feeding sessions with a frantic baby, and she never seems to come off looking 'milk-drunk', so I wonder whether she is not getting as full as she would like to be.

Sorry this is a bit long... any advice or information would be great.

I had this when until dd was about 10 weeks old when she seemed to work out how to cope with fast let-down (or it slowed, not sure). I found it helped no end if I fed her laying down. Much calmer and easier for her to cope. She also has only ever needed under 10 mins for a full feed and now at 7 months only feeds for up to 5 mins. Fast feeding is such an advantage if you can get past the screaming stage and she learns to cope.

Oh, that's very encouraging, thanks! I have noticed that when I feed her at bedtime, propped up against my pillows with her swaddled, she has no trouble. I thought perhaps it was the swaddling, but maybe it is the angle I'm sitting at then.

DS is 5.5 months and although he never screamed would pull off and spray everyone in the room, and still does sometimes now.

He has never fed for more than 15 minutes unless he has fallen asleep (which he does frequently)

I was told that sometimes you need to lean back to make them work for the milk rather than keeping poker straight like the books/websites say

I used to lay on my side with her snuggled in next to me. I think getting as flat as you can (while maintaining good latch - that's the tricky bit, I had to be aware of it or I got sore when feeding lying down) helps a lot. Was always entertaining/pain in the bum as ds used to bounce on the bed while we were trying to feed.
Luckily it was only one fast side with me so I could feed her in other places on one side and come home to feed laying down if it was the other side's turn.

Lie down, she can then turn her head to one side to avoid the milk shooting down the gullet, which must tickle. As strange as it sounds, I have found that actually pressing them to you with your arms, as they writhe around, helps. Both mine went througha phase when a combination of gripeing tummy pains caused by tired/hungry combination met with shooting jets of milk and their instict is to wriggle away - that would lead to more probs, so press the back gently so that any wriggling simply produces a cuddle feeling, and after 2 mins or so you will feel that the wriggling has stopped and feeding is going more smoothely and calmly.

Are you sure your baby doesn't have silent reflux? My baby had all the same issues: would only feed for 5 mins at a time, would cough and splutter, would come off the breast crying - feeding was a nightmare.

It was OK for the first 2 weeks, but it really got bad after that. I searched all the websites and decided it must be because of my fast let down (both myself and the baby were soaked each time he fed).
I kept searching for solutions on the web, because I knew something was wrong.

The first thing that helped was Colief, so he must have been slightly lactose intolerance too. But the reflux must have got worse because he went back to the crying and pulling off after 2 oz.
The infant Gaviscon helped a bit, but there is a limited amount you can give. Then I read about Silent Reflux and his syptoms sounded identical - feed for a little while, pull away crying, making him cough and splutter. He wanted to feed but it hurt him when the stomach acid came back up from his tummy. He would be sick a tiny bit (posset) after each feed. I read about Carobel, and asked the health visitor if we could try it. She said it was only for sick babies with reflux (full on vomiting) but I insisted I wanted to try it. As my baby was still putting on a bit of weight each week, she had not taken my issues seriously. The difference was unbelievable. He was able to feed and take 4, 5 or 6 oz at a time (about 3 mths old and had never taken a full feed). I was able to get him onto a 4 hour schedule.

He is still on the carobel at 9 mths old. I tried to take him off the caroble last week, but his milk intake went down and he started to be sick a little after each feed. It can take up to a year and a half for the valve at the top of his tummy to develop properly and stop the reflux.
Hopefully your baby doesn't have silent reflux, but it may be worth a try with the Carobel.

Try leaning back - just leaning back in a chair can slow the flow.

If iy's reflux, feeding lying down should be worse as being horizontal makes it easier for the acid to come back up.

Maenad, I don't have any advice but just wanted to say that I had a ridiculously forceful and fast letdown for the first 2-3 months and poor DS used to choke and scream! I also had to be careful not to spray people across the other side of the room if he suddenly unlatched!

I never found a cure to it and it happened worse on one side, it just subsided at around 3 months. So, no helpful advice but just to say it is usually one of those things that settles down, plus I think the baby gets used to it.

I answered an old thread! The new one I meant to answer is at www.mumsnet.com/Talk/breast_and_bottle_feeding/1215350-breastfeeding-help-needed-please?msgid=25526731#25526731

Japhrime, just a point about the reflux. You are right about lying down making it worse, it normally does. But when a baby is half asleep and is relaxed, for some reason, their reflux can reduce. I, and friends, have found it's easier to lift a sleeping silent reflux baby and feed it - they take more milk and it doesn't seem to hurt as much.