Engorgement again, ideas?

Now that I'm back to work, I'm having engorgement issues again and I'm frustrated. I was only nursing before returning to work, and now I am still nursing at least twice throughout the night (Brody gets up still a few times!), pumping once in the morning at about 8:30 am, nursing him on my lunch break at about 11:30 and then pumping again at about 2:30 at work, nursing again around 5 or so at home, etc...you get the idea. But I'm finding I'm having a problem of too much foremilk...he gets filled up before one side is even empty. On the weekends I'm forced to pump because I'm getting so engorged. I had to get up in the middle of the night to pump just last night because I was hard and engorged and couldn't sleep. Do I suffer and just not pump so that I produce less? I'm confused how to regulate! Maybe I should just pump one side when I pump, being that I only nurse from one side at home? I think that is the main problem. I only nurse from one side but pump from both with a double pump so it's causing me to become engorged when I'm only nursing. I contacted a lactation consultant though and they told me not to just pump on one side. Maybe I'll just take my own advice and try that. Somehow this has to be regulated...I thought I was done with the engorgement issues early on. Brody will be 4 months old soon. I shouldn't complain...I do have ample milk supply! It's just not comfortable getting so engorged all the time.

[peekawho]

Usually, your breasts take a few days to "catch up" to a change in nursing schedules.  You might try only pumping enough to take the pressure off if you are finding yourself engorged frequently.  In a few days, I'd think your supply would lessen a bit to match your situation.  

Hopefully Andi will see this and have some good ideas, or you can send her a message and ask.  

[jenstam]

Maybe I'm pumping too much. What I'm noticing is a bluish/watery milk for the first (believe it or not) 2-3 ounces! Then, the fattier, creamier milk with a slightly light yellow tint comes in after that first 2 ounces or so. I get a good 5 ounces out of each side when I pump that first time in the morning and then only about 3 ounces from each side when I pump in the afternoon. I make more than enough for him to drink the next day and I'm freezing some, too. But the lactation consultant said do not pump less than 15 minutes each side. I would think I would be regulated by now, this is going on week four back at work! Not only that, but I know he isn't getting as much fat as he needs because of the consistency when I pump. When I'm engorged like that and I feed him, I know it's mostly the low fat foremilk that he's getting. I thought they would "catch up" but maybe I'm doing something wrong with how often I'm pumping, or how long or something! Maybe somebody else has ideas too?

[peekawho]

Hopefully Andi will see this, then.  I work tonight, and I'll ask the LC there what she feels about it.  

[jenstam]

Thanks peek ;)

[tiredbuthappy]

if he's still nursing in the night, i would not get up to pump and try to tough it out when you feel engorged. or maybe just use a hand pump and draw out an ounce or 2 to feel less engorged. my situation is a bit different, as i only pump, but i have learned about supply in the process! you should be able to make it through the night without having to get up to pump in addition to nursing him. (how on earth do you function after being up so much?!?!) i go 8-9 hours at night without pumping. in fact, i only pump a total of 3 times/day (about every 8 hours) and i still make much more than dd needs (40-45 oz/day).

i was terrified of being engorged and getting clogged ducts when my LC suggested dropping pumping sessions. i admit there was some discomfort for a day or 2, but my boobs adjusted very quickly. again, i know the situation is different since your schedule is different on weekends, weekdays, etc... but your body will adapt quickly. honestly, i think your best bet is to try to completely emmulate your weekday schedule on weekends too. peek is right that it does take your boy about a week to see the full effects of any changes you make to your schedule.  if brody is gaining weight properly, especially if he is only nursing from one side at a time, i wouldn't worry about the amount of foremilk he's getting. i'm no expert on doing both, but it does seem to me that you should be able to drop a pump at some point and you are emptying your breasts very frequently. my LC said it is possible to successfully have different lengths of times between pumps and you body will adjust to it. do you have to pump at 2:30, or could you slowly try to push it back until you ultimately eliminate that pump? your body will eventually learn that you will nurse at lunch and at 5. my lc also said it's ok to just use a hand pump in between to relieve some engorgement while trying to adjust my schedule.

i'm having trouble writing a coherent response because i keep going back and reading different components of your questions. i keep realizing i'm not totally answering your question, but maybe a little of the info can help you make a decision? it bothers me that you are still so engorged after so much time- you shouldn't have to suffer discomfort at this point in time. i used to feel that way after 3 hours... now i only feel that way if i wait 9.

[jenstam]

Thank you for your response, it does help. I also appreciate the website offered in the message you sent me. It is frustrating dealing with this again. I was fine before I came back to work. So obviously the pumping has sent my body messages to produce more. I need to figure out which session to cut out, or maybe shorten sessions...something has got to give. I was finding myself over the weekend wanting to nurse Brody more than he even wanted to nurse just to ease the discomfort. I was thinking I would not have to pump on weekends, but now I'm thinking I might just have to adhere to the same schedule at home, too. I love to nurse him much more than I do pump and give a bottle though! I feel I don't get to do it enough and he absolutely loves nursing. Even my girlfriend who has nursed all of her children noticed how much he loves it (: He closes his eyes, rubs his hands on me and is just in heaven. Not only that, but he really doesn't like taking a bottle from me. I know I'm probably imagining things but it seems as if he is looking at me, asking me why I am feeding him with a stupid bottle when I have the real deal. It breaks my heart. Probably all just my imagination though :) I'll check out that website you gave and see if I can get any other similar experiences and suggestions.

[tiredbuthappy]

(sighing...) your description is beautiful... making me think about what i am missing out on :(

[anxiousmomtobe?]

Cabbage Leaves, I kid you not, they are the best thing in the world for engorgement.  Put them on the swollen breast for no longer than 30 minutes or it can decrease your milk supply.  There is an enzyme in cabbage that helps.

If looks bizarre (DS, aged 4 asked me "Mummy, why do you have salad in your bra?") but it works better than anything else I have ever tried.  God bless the midwives who have been using this for hundreds of years.

[jenstam]

Oh, anxious...thanks for the good laugh! "Why do you have salad in your bra?" That is classic! Kids...gotta love 'em. I should try the cabbage trick. So, I just stick a cabbage leaf in my bra??

[rubyolivia]

I know the heartbreaking look you are referring to! :( I do 1 formula bottle a day while Max and I are at work and I make my mom give it to Max because I feel too guilty!

[tmv]

Your little Brody probably just finished a growth spurt and your body will take a few days to adjust back. I think that your schedule for pumping away from him is good, but you could drop one pumping if he isn't eating at that time. Does he take 2 bottles while away from you? If only 1, then pump only once and space it out. You'll adjust.  Do you pump for the same amount of time for the first morning session as the last? If not, try pumping the same amount of time. Encourage him to take from both breasts. You may have to stop him and change his diaper, wipe his face with a cool washcloth, etc.  Hope this helps some.

[amberd5191]

Ok so its not actually to cabbage but that was what I was responding to, I used this with my son I wish I had tried it sooner it was like a miracle cure for engorgement!

[jenstam]

Ugh...I forgot to get some cabbage last night and I was miserable. I just wonder if there isn't something else going on. I am going to try to pump only one side today at my pumping sessions and then feed him from the other side every other when I nurse to see if that helps. Severe engorgement last night...not fun. I had to pump due to how hard my breast was! I can't switch sides because he can't even empty one side. He doesn't drink 5-6 oz yet...only about 4. When I pumped last night, the milk was so watery like skim milk. I have to do something different. I guess it's just going to take some adjustments. Thanks ladies for all of your helpful hints. I will definitely try the cabbage tonight.