My experience of overactive let down
At the age of 25 I went into labour with my first son, 4 weeks early. I was told by the midwives that as his birth weight was good (6lb 3oz) there was no cause for concern and that, provided they could tick off all the necessary checks, we would be sent home later that day. I had wanted to breastfeed but wasn’t given much guidance on how to do this.
After a few hours of unsuccessful attempts, I called a midwife to help me. My son had been sleeping a lot and didn’t seem fussed about feeding which the midwife told me was normal for premature babies. She helped me to get him latched on, waited for a few minutes and ticked my chart to state that I was successfully breastfeeding, and left. My son was latched on for less than 5 minutes and I really wasn’t sure that this was normal so I called the midwife back who again told me not to worry as he was premature, so it was all normal. They discharged me despite my concerns.
I failed to feed him at all at home and the next day the midwife who visited sat with me and again got him latched on, saw that he stayed on my breast for a very short time and told me not to worry. I had no experience of breastfeeding and didn’t know what was normal so when my milk came in later that day I was alarmed to find that as soon as my son’s lips brushed my nipple, milk started pouring out. He couldn’t latch on and was obviously distressed.
The next morning when the midwife visited again she noticed that he was jaundiced and weighed him to find that he had lost far more weight than was normal so sent us immediately to hospital. Once there, the breastfeeding expert came to see me. She explained that I was experiencing overactive let down. I now know that this is a fairly common issue in the first 4-6 weeks as the woman’s body gets used to how much milk to produce and will usually settle down, however at the time I wasn’t given any additional information. I was told that as my milk was flowing too quickly, and my son was premature, that he couldn’t keep up with the flow so he was essentially struggling to breathe or swallow. They recommended that I express and give him milk from a bottle, they also inserted a feeding tube into his stomach, via his nose, so that they could ensure he got the amount of milk they felt he needed in order to gain weight sufficiently.
I was expressing 8 times a day, sometimes I wouldn’t produce enough milk for the amount they wanted him to have. On the first occasion, I was asked very seriously by the midwife if it was OK for them to give him formula. I remember thinking “you’ve decided on the amount he needs and I have no more milk so of course you need to give him the formula” she went on to say “because breast really is best so if you think you can give it another try that would be really good”.
I was an inexperienced, young mother, who had been through labour earlier than I was mentally prepared for, had no experience to draw on in this situation, was sore from an episiotomy, hadn’t slept in 5 days and thought there was a good chance that my baby might die. I needed her to recognise what I was going through, and do what was best for my son, which was to give him the formula. I politely said “please give him the formula” and when she left the room burst into tears (for the umpteenth time that day).
On day 7 we were sent home, he had regained the lost weight and they felt that I had a feeding plan in place – express every 3.5 hours so that I could feed him a bottle every 4 hours. This turned out to be extremely difficult. I found that my breasts were full, hard and sore, about 45 minutes after each expression so I was regularly in pain. This would cause my breasts to leak, saturating a breast pad immediately and leaking through to my clothing. I couldn’t shower without milk streaming from my breasts either, which I found upsetting.
During the first 6 weeks of his life, I had 3 blocked milk ducts causing me to need antibiotics for mastitis. The 3rd time I experienced this I told the doctor that I couldn’t carry on, surely it wasn’t good for my body if it was making me ill so regularly, to which she replied that if I was capable of expressing and feeding breast milk then that was what was best for my baby, and I should continue. I knew at that point that I couldn’t go on like this. I decided that I was going to get him to breastfeed, or stop trying and turn to formula full time.
Through a lot of trial and error, I learnt to hand express a few ounces of milk before trying to feed him. It took a few weeks but in the end I was successful. By releasing the first gush of milk, my flow would settle down and he could then latch on and manage himself.
After just a few days, I found that my breasts stopped hurting so often, I wasn’t needing to express as much before feeding him in order to release the pressure, and my body was adjusting. By the time he was 10 weeks old, I was no longer expressing at all.
I managed this transition entirely by myself, without any advice from my midwife or health visitor, a fact which I was immensely proud of at the time, but which makes me want to cry today. I feel that if I had been advised differently, I could have had him breastfeeding much sooner, and avoided all of the pain and stress that both me and my son went through. I also wish that I had been encouraged to give him formula when I was struggling to produce enough milk, I wouldn’t have put my body under such pressure and my son would still have been nourished.