How do I reduce vomiting caused by my fast flow?

[LennyW]

(Long, sorry!) My 2wo boy is turning into a bit of a vomiter, poor thing. He's exclusively breastfed and is latching on well, but about 2-3 feeds a day he is vomiting up varying amounts of milk, from a couple of teaspoons (we can deal with that) to what seems like 1/2 - 1 cup (surely his whole feed)! When he brings up a big amount like that, it's usually a projectile vomit - as though his stomach goes into a spasm and hurls all the milk straight out of his nose and mouth. I don't think it distresses him too much, but it throws any hope of a mild schedule into disarray, as he wants to feed again pretty soon afterwards, usually waking up from a nap because he's hungry when otherwise he'd be sound asleep.

I think the vomiting might be caused because I seem to have a very fast flow - he gulps and sucks fast for about 5-10 minutes and even though he has a good, air-tight seal on the breast, he has to quickly suck air in through his nose to keep up with the flow and I can hear little squeaking and gulping noises which I think is a bit of air going into his tummy with the milk.

I try really hard to burp (wind) him when he comes off the breast, but he often doesn't burp or does a big vomit instead.

Does anyone have any ideas about how I can reduce my flow speed or get him to suck more slowly or stop the wind going down or burp him more effectively? Thanks.

Okay I have a bit of a plan that might work....
Firstly, hand express for about 15 seconds a couple of times to get rid of a bit of milk before you latch him on.
Gulping sounds are good but squeaking sounds might mean he's not quite properly attached. Do his cheeks go in whilst feeding?
Could you try sitting him up to feed in more of an upright position? This is what you're supposed to do for babies with reflux (sounds like your DS could have a weak reflux valve and it's more common in boys). Try, after the feed to keep him as upright as possible (in a bouncy chair for e.g).
You could also detach him mid feed or after a inute or so to give him a little rest.
Try to 'lay' him on your chest (you're sitting upright) facing you with his legs hanging down as much as possible and see if that helps, rather than him lying down across your body.
If it doesn't get better though, you could take him to GP to get some meds for reflux.

my daughter has the same problem, especially first thing in the morning when she is really hungry and drinks too fast. the rest of the time she is relaxed enough to drink at a reasonable pace. My flow was also quite strong in the beginning as milk production was sorting itself out and she would often gulp and choke, but as she got older she was able to cope with it.

is he really really hungry when you feed him? that could be causing him to drink to fast. maybe feeding him a little earlier than his usual feed time would mean that he wouldnt gulp as much... if its your flow that is the problem, then he should be able to cope a lot better with it as he gets older. I find that stopping halfway and keeping my daughter sitting upright for 15 or 20 mins before carrying on really helps too. i have made the mistake a few times of getting up quickly and being rewarded with a decorated back and carpet!

You might like to try 'block feeding'. I'll go see if I can find some info on kellymom for you, but if the children distract me then that's what you need to search for!

Here you go.

Thanks guys, very helpful. Am looking at that Kellymom page on "forceful let-down", which I do think is the problem (his cheeks aren't sucking in when he feeds). Good to hear there are a few things I can try and at the least he will get better at holding things in as he gets a bit older.

I had a forceful let down when I had DS. I struggled for weeks until I found help on Kellymom. I latched him on for few seconds then took him off (lots of screaming!) and allowed the milk to squirt into a towel. When it stopped flowing I would pull the nipple a few times and only latch him on when the milk stopped squirting out. This could take a minute or so. I did this for a week and it completely solved the problem. I got told that it works better than expressing as it doesn't boost your supply any further (which can make the problem worse). He stayed a vomiter but it was nowhere near as bad and meant that I wasn't stuck in the boob/vomit/boob cycle.

I couldn't believe that it was so easy to fix, hope you find the same.