Overactive letdown or bad positioning?

by Brandi
(Fort Worth, TX, USA)

My 2 week old sometimes has trouble nursing, most often at night. She will cry and seem to want to nurse but may not latch but just plays w/ the nipple and cries instead. Sometimes she latches on and pulls off quickly. There have been many times that when she touches the nipple even lightly the milk lets down and sprays out over her. Sometimes this happens when she latches on and she pulls off crying while milk sprays out. The only positions I use are the "standard" cradling position and laying on my side at night (unless she gets really frantic). She has more trouble when I am laying on my side to feed her. I've noticed lately she seems to be gulping much more. She is gaining weight at a good rate, but there's just a lot of frustration when it takes a while to get her calm and latched on and keep her nursing. She will want the breast very frequently during these times and nurse for a very short amount of time, but isn't always fussy once she stops. Is there something I need to fix? Should she be nursing for 10/15 minutes or more and only every 2-4 hrs like some resources suggest?

Answer from the lactation consultant
Your situation is very common. Around the second week you get your mature milk in and baby goes through a growth spurt. We get an an increase in milk supply during this time. Due to that increase it is common to have overactive letdown simply because the breasts are so full. It will likely resolve on its own in a few days. If not, you may need to sit up to feed, lying on your side puts a little more pressure on the breast. Two answer your second question, you should be feeding the baby on one breast until it is empty, a good average is 15-20 minutes, then offering the other breast. Most 2 weeks old have a 20-30 minute feed total and feed every 2-3 hours.

Hope this helps,

Liz Pevytoe, RN,IBCLC