Saturday, October 23, 2010

More breastfeeding-related issues

I'm jotting this down and putting this online, just in case someone with a similar experience is reading. I didn't really expect surprises with breastfeeding this time around, but as I'm learning, you can never know everything! So, here are two new (to me) lactation experiences...

Painful letdown - with Shira, I had mild tingling sensation during letdown which was even rather pleasant. Now, letdown is often so painful I have to gasp for air. It feels like pins and needles. There are no symptoms of breast infection and otherwise I'm feeling just fine. I suppose this is another feature of overactive letdown.

Feelings of depression and anxiety prior to letdown - I didn't really notice this during the first few weeks, because everything was such a blur emotionally - but now that things are becoming more or less steady, I can definitely tell I'm having strong, though fortunately brief, feelings of anxiety and depression at the beginning of each time I sit down to nurse the baby.

It is not postpartum depression as otherwise I'm feeling perfectly fine, and usually it passes after a minute but it is still unnerving because it's obviously a chemical/hormonal reaction which has nothing to do with my real-life emotions, and which I can do nothing about. This is something completely new to me - I never experienced anything remotely alike when breastfeeding my first child. I'm not sure whether something can, or even should be done about this (I can, after all, cope with feeling anxious for a minute at a time), or whether it might pass on its own. I searched the web and came across this link.

So much for breastfeeding babble for today! Hope all you ladies have had/are having a great weekend.

30 comments:

Serena said...

Regarding the first issue: is it possible you have a yeast infection? That might be something to look into, but, like you said, it might just be the overactive letdown. And as for the second issue, that is so strange. I've never heard of it, but it's good to know about.

mom-e-mae said...

Oh my, I had never heard of this pre-letdown feeling before, but have experienced it in varying degrees while breastfeeding each child. I am so glad to see that I was not alone. And reading those testimonies on the site you linked brought back the very real memories. I nearly quit breastfeeding my twins because of it, but thankfully my husband urged me to go one more week (several times). I never did quit, because when I would supplement a bottle of formula, which is what my doctors and friends said I should do, I felt a tremendous guilt that was worse than the D-MER, as they call it. I wish I could say it will get better, because it did with my first two children, but sadly, with the twins, I can remember that feeling all the way until they weaned at 15 months

Kate said...

Those let downs should let up in a month or two. With baby #3, my let downs were so painful, I couldn't move my arms and I'd sometimes even tear up. One time I got stuck in the middle of the road because as I was turning my car into my driveway, a letdown occurred that was so painful I couldn't turn the steering wheel!

Anonymous said...

Anna, the "pins and needles" might be thrush - my first baby and I had that, and it was EXCRUCIATING. Someone asked me "is it like nursing through ground glass?" and I told them that's exactly what it was like. Check the baby's mouth and your nipples for white patches. If it's thrush, catching it early is key.

His Talmidat said...

How about thrush for the first issue? I know you said there is no breast infection, but it is a bit different. I didn't know I had it with my 1st and it felt like being stabbed and made me gasp as you described... a thought.

Anonymous said...

Dear Anna,

I had the same expierence with both my children, probably due to a very painful beginning wiht my first childs breastfeeding. I never got over it but learned to cope with it by concentrating very hard on something else, and breastfed both my kids without problem för two years. God luck!

Maria

Dee said...

I had painful letdowns with both my babies. It did subside after about three months - hopefully yours will too!

Dianne said...

Anna,

I experienced overabundant milk supply and an extremely powerful letdown with one of my children as well. I had the same pain at letdown and my child had the same coughing/spluttering...when letdown began, she would have to pull off the breast and within a second or two we would both be drenched.

Some things that helped: as http://www.kellymom.com/bf/supply/fast-letdown.html recommends, and as my lactation consultant advised...

--Nursing on only one side per feeding did help. I had to put a folded cloth diaper into the nursing bra on the side where the baby was NOT feeding, to absorb the powerful let-down and excess milk...I found I let down enough that I was able to go to the next feeding without having to pump to relieve pressure. I looked pretty lopsided, but as I wasn't leaving the house much in those days it didn't matter to me.

--Block nursing (see same web page) was also helpful as the one-sided feeding did not quite help enough.

We only had to practice these measures for 2-3 weeks and then my milk supply, though still adequate, had adjusted, as did my letdown reflex. Looking back I found it interesting I had this problem at 3-6 weeks of age, when a growth spurt takes place. My theory is that her efficient nursing and the increased demand of the growth spurt contributed to the milk oversupply that didn't regulate itself within a few days.

After the problem was initially solved, it resurfaced at a later time when she was going through another growth spurt.

Another strategy I sometimes used was to pump just enough to get the letdown to start, absorb it with cloth diapers, and latch the baby on once the flow had slowed.

Also applying gentle pressure (toward the chest wall) with the heel of the hand on the top of the breast upon which baby was nursing helped to slow letdown somewhat and eased the pins and needles feeling.

A side note on SSRIs (antidepressants) during pregnancy and lactation...although in recent years some studies have supported them as safe, other studies have highlighed a causal link between SSRI use during pregnancy and fetal heart defects and pulmonary arterial hypertension. In any case SSRIs cross into breast milk. Although these medications are necessary for some mothers, it is important to make informed decisions and discuss possible alternatives with your healthcare provider.

Michelle Bell said...

I'm a birth and postpartum doula, and I just recently had a client with similar issues with the tingly feeling before/during letdown. Eventually through elimination, she managed to have a culture done and discovered that it was a yeast issue. There were some other symptoms as well (babe had an odd round rash in the folds of her bottom, but this showed up almost a week after her tingly episodes started), but none of the "normal" indicators for thrush. While that tingly pins and needles feeling isn't atypical, especially with an overactive let down, it might be something to keep in mind if this lasts for any length of time.

I hope you and your family are happy and healthy and enjoying your time together. They always grow so quickly!

Matushka Anna said...

I hadn't heard of this before but I followed the link and read it. That seems to fit perfectly! I'm glad that it doesn't last but a minute or so with let down. I didn't notice, but did that link have information on how long it lasts?

Anonymous said...

Hi Anna

Given that this was my first time breast feeding I didn’t really think that these things were strange, but I certainly know what you mean! Mostly I don’t experience the feeling of ‘letdown’ but when I did it was quite sharp and painful. Six months down the track however that seems to have stopped thankfully!

Often still though, when I begin feeding I experience a feeling that I can only describe as desperateness that leaves me feeling quite vulnerable, but as you say, it doesn’t last long and I just distract myself playing with her gorgeous chubby little fingers :)

Milly

Diane said...

That's very interesting to hear about the anxiety associated with letdown you're experiencing. I had just the opposite. With all three of my boys I had what I described as a "sure of happiness" that more often than not would make me smile or grin and frequently even giggle. I hope that the intensity fades and that it isn't too big of a hinderance in nourishing your baby in the best way possible!

Leah Brand-Burks said...

My goodness, Anna! I'm so sorry! All I can say at least there is a name for what is going on, even though it's newly recognized, and there are others with whom you can (hopefully) share experiences and solutions with! Certainly praying, dear friend!

The Whites said...

I had a very painful letdown also - toe curling, grimacing painful. I'd say it stopped around 2-3 weeks though, but definitely by 6 weeks when my supply was leveling off. At 17 months it's still a pretty strong feeling though and quite uncomfortable if she pulls off before/during letdown. And, I never had over supply issues.

What you're describing sounds very much like D-MER. A friend also has it, and from what she says they're still researching a solution. It sounds very difficult, I'm sorry :(

Mrs. Parunak said...

That is fascinating! I had a really strong feeling of being upset when I first began to nurse my oldest child. It felt almost like being guilty. At first I thought it was guilt for sitting down to read blogs rather than doing something more "productive" with my nursing time, but eventually, I figured it must be hormonal. I had forgotten all about it until I saw your post. The feeling was very strong with my first baby, but hardly there at all with the next three. I'm glad to know what it was.

Liz said...

I had the painful letdown with my second child. For me it got better over time and I didn't have the pain at all with my third.

Anonymous said...

Oh my, I thought I was the only one. My children are mostly young adults now but I remember giving up breastfeeding much much earlier than I wanted because of these feeling. I would feel utter dread, dissappointment, anxiety and worst of all guilt. Really guilt for absolutely no reason at all.

Then I would be back to normal in a few minutes but the negative feeling would be so horrific that I would DREAD the next nursing session. I was not depressed otherwise and just couldn't understand what was going on.

So happy that research is now being conducted.

Megan said...

I was also surprised by quite a few things with my second baby, including some differences in breastfeeding (both positive and negative). Definitely a lesson to reinforce the fact that everyone's mothering experience is unique and I may not understand exactly what another mom is going through!

One hormonal side effect I never expected from breastfeeding (but experienced with both babies) is having absolutely zero "libido". Not a topic I typically discuss, but I think it is important for women to know that this physiological response is normal and actually quite common -- and (normally), the effect ends shortly after you stop breastfeeding.

Rosemary said...

Mrs. Anna,
When I nursed my children, I did not have a depressing feeling before letdown; however, my nipples hurt so much I wanted to scream (just before or during the letdown). Once the milk letdown, the pain disappeared. I only had this pain with one of my four children, and the experience stopped after a few weeks.

Di said...

Hi Anna,

Sorry to hear that you are experiencing some issues with breastfeeding this time around. I know exactly what you are going through as I had the same issue feeding both of my children. I had an over-abundant supply with an over-active let-down. I had no help at all from the professionals, just a 'you're lucky to have so much milk'.

With my first it was worse than my second, but even now, 7.5 months in feeding my son, I am still leaking when I feed. I can relate to the pain of let-down (I often said that it must have been a man who described let-down as a 'pleasant, tingling, champagne like sensation'. More like needles being scraped through your breast...) And I think the anxiety is normal too, you are anticipating pain which you know you have to go through, I don't think anyone would look forward to it!

It does get better. Have you thought of trying nipple shields? This slows the flow of milk down so your baby is better able to take the milk. I used them with my first, but didn't need them so much with my second. Its worth a try to reduce some discomfort perhaps?

Hope you feel better soon

xxx

blessed@home said...

Dear Mrs.Anna,
I'm not even sure if this is even related, but it's something I'd like to share with you. I am the mother of ten precious blessings, all of which have been breast fed. Mine was a story of succes, up until the eight one came along. I never could understand why other women had any problems nursing their infants. Then I gave birth to my eight. It was nothing like anything I had ever experienced. I was in tears most of the time, and felt like such a failure. I had no choice, but to supplement with formula. Encouraged by my midwife I went ahead and supplemented while continuing with the nursing. Eventually, my baby began to put on weight and I dicontinued the supplementing. I learned from this that every birth and nursing experience is unique, and that I needed to just persevere. I hope this helps even if only in a small way. Be blessed, and continue the wonderful work.

Rachal said...

Yes, I have experienced that feeling of depression and anxiety when I sit down to breastfeed my babies! It happened with both, and at times was so overwhelming I could hardly bear it. Mine would start when I sat down to nurse and continue until the baby unlatched and was finished. It's such an awful feeling! With my second, I quit breastfeeding at 6 months because it was getting so bad I could not handle it.
I am so sorry you are feeling this way...I hope you can find relief!

Melanie said...

I experienced painful letdown with my first.

I have also had an emotional precursor to let down. It usually happens for me, not when I'm actually sitting down to nurse, but when I'm away from the baby. I'd just be going about my business, and for no particular reason, I'd suddenly feel emotional. For me it was not as unpleasant as you describe--I'd feel choked up, but not exactly sad, more like I was going to cry with joy or love. Then in about 10 seconds my milk would let down. Sounds like the same thing though. I've never heard anyone else mention it before.

Mrs. Anna T said...

Di, the feeling of anxiety has nothing to do with anticipating pain; it's not something I think about, it's purely hormonal and comes even when I'm thinking about something else.

Cheryl said...

I don't have a lot of time to comment, but I have nursed 7 babies (still nursing number 7) and I nursed the others for approx. 18 months each. I found that number 6 and 7 were the most difficult. Number 6 was tongue tied and we went through a very difficult time until his frenulum was cut and then it was instantly better.

Number 7 also had trouble gaining weight and nursing was extremely painful. She nursed all of the time and didn't seem to get much. She didn't seem to be tongue tied when I looked at her frenulum, but because I experienced almost exactly the same problems as number 6, I asked the doctor to clip her frenulum and voila! The nursing was no longer painful and she began to gain weight a lot easier!

I was never in tears so much as I was with number 7 before her frenulum was clipped...every labor/nursing experience is so different and although I never had to supplement I could begin to understand before number 7's frenulum was clipped why people do supplement.

Someone told me that in Canada they automatically check for tongue tiedness in the nursery at the hospital and remedy it immediately so it doesn't become a problem.

Hope I didn't say anything that was redundant. I know that you did a previous post on being tongue tied, but because of time constraints, I cannot say that I read it all.

With Hope,
Cheryl

SarahF said...

Hi Anna, I read about 'feelings of depression and anxiety prior to letdown' a few weeks ago on a thread on a UK parenting site (mumsnet). I'd never heard of it before but a number of women described exactly what you describe. I think most of them, like you, didn't want to get medication for it as it thankfully lasts for a short while then lifts during the feed. Fascinating how intricately hormones affect us.

Ghost said...

Ran across this post on CArol Gray's blog right after reading this post, and immediately thought of you. DMER sounds almost exactly like what you describe:

http://www.carolgray.com/carolgray/Carol_Grays_Blog/Entries/2008/8/17_Dysphoric_Milk_Ejection_Reflex:We_All_Need_to_Know_About_This.html

take care.

City Sister said...

My midwife said that the afterpain and letdown pain gets worse with each child at the beginning but should get better after about a month.

CappuccinoLife said...

Anna, I had the painful let down with my third child. Painful enough that I would have to put him down or hand him to someone else for a moment so I could breathe through the let down. Crazy. He was one that ate a lot and I always had a ton of milk for him, so maybe it was overactive let down. It didn't last forever.

I did, however, have several bouts of mastitis. People kept telling me that it was yeast infections, but apparently the pain can be a symptom of either. I have never had a yeast infection while nursing, only mastitis.

Lillian the Ponderer said...

I also had very uncomfortable let-down in the beginning, which I think was linked to over-active let-down - Kellymom has some helpful advice. you mentioned before that the baby comes away spluttering - that may also be linked.