Many women speak about challenges balancing and maintaining their milk supply. Today, we chatted with Renee Prymus–who has so much milk she once pumped 10 ounces in between her newborn’s feedings–about her nursing journey with baby Siena (3 months).
Mother’s Boutique: When did you first notice that you had an oversupply?
Renee Prymus: I’m not exactly sure if this was a problem from the very beginning or not. Engorgement is pretty normal when milk first comes in. After a few weeks in, I definitely started noticing that I was leaking through all of my clothes. For weeks! When I nursed, the other side let down and everything got wet. In the very beginning, my supply affected her latch and it was very painful for me.
I went and got a nipple shield, which actually helped her latch get better because it both regulates the flow of milk and forces her mouth to open wider. I’d use it for the first three minutes or so of the feeding. Then, when she relatched, she was able to open her mouth wide enough to get around the nipple and the areola.
MB: Did you still find you were letting down from the non-nursing breast?
RP: Oh yeah. When Siena was about 3 weeks old, I noticed that one side, particularly my left, was just leaking, leaking, leaking while I nursed on the other side. I went to A Mother’s Boutique and bought a Milkies Milksaver. That was the very first thing I did! I was getting 2 ounces in my Milkie each feeding! It was a lifesaver. I don’t need to pump to build my freezer supply, I can save the milk, AND it means my pajamas are no longer getting wet.
MB: Less laundry for you, right?
RP: Yes! And more comfortable sleep. I still use it to protect my clothes. I really love it.
MB: What happened with your milk supply as Siena kept getting older?
RP: I had been feeding on demand, so the longest our baby slept was about 3 to 4 hours. When Siena was about 7 weeks old, we tried an experiment where, instead of me nursing and then cuddling my baby to sleep in my arms, my husband, Kylie, would take her and put her in her bed. This was a few hours earlier than she’d normally been going to bed. She began to fuss a bit, but my husband soothed her, standing right by her and patting and shushing her, talking to her. He did this maybe 3 times and then she fell asleep and stayed asleep until 4am!
MB: That’s amazing.
RP: It is. But it’s a lot of hours that I was accustomed to…being milked. I woke up with numb arms and fingers. Not just tingly, but numb. A week into this experiment, Siena kept sleeping longer and longer and I woke up at 1:30 in the morning with piercing pain in my arms. I got my pump and expressed 5 ounces from each breast, and then the pain went away. I realized it was related to my oversupply, to my engorgement.
MB: That sounds very serious–numb arms?
RP: The next day, I went to the doctor. She told me that even if I feel like I pumped myself dry, most women still have about 2 ounces left in the breast. She estimated I was carrying 15 ounces of milk in the middle of the night. She explained that the mammary glands extend back into our armpits, so severe engorgement can restrict the nerves.
MB: I know many women experience carpal tunnel syndrome when they are breastfeeding. Did she suggest your pain might be related to this condition?
RP: It certainly felt like carpal tunnel syndrome at first. My fingers were tingling each morning. It was similar. My doctor felt it was related to my engorgement, though, and recommended I take an anti-inflammatory after we put Siena to sleep. She suggested Aleve because it would metabolize out of my milk and blood stream before my next feeding. When I feel the need to pump to relieve pain, she has me tapering how much I pump, so maybe an ounce per breast less each time.
I also use cabbage leaves to help with my ongoing engorgement. Another strategy that I use to manage my supply is block feeding. Most of the time, mothers nurse on both breasts each feeding, but I only offer one side for two feedings and then switch.
MB: Did you consider donating all your expressed milk?
RP: I really wish the Three Rivers Mother’s Milk Bank were up and running. If it were, I would keep going with the night pumpings instead of tapering off. I haven’t looked into [the Mother's Milk Bank of Ohio] because at one point I was on medication for thrush and I do occasionally enjoy a drink after dinner. I feel like if I were going to donate I’d want to monitor my diet more carefully.
MB: I feel like many women assume over-supply would be a “better” problem to have than not enough milk, but it really sounds like this is affecting your health.
RP: I wake up in the middle of the night every night, even though my baby sleeps 8 or 9 hours at a clip now. I’m at a point now where I only have to pump whichever arm is in pain, and I only pump an ounce or 2 to relieve the pain. I live with numb fingers–I’ve stopped shuffling decks of cards and I can’t feel the ends of my fingers when I type.
Sometimes it’s even hard to lift my baby or snap her onesies.
I think the most frustrating thing is there is no quick fix. It’s weeks of trying different sorts of things…sage tea, even.
I think it’s pretty rare to have this much milk. I haven’t found anything on the Internet that seems similar to what I’m experiencing.
UPDATE: Ellen Rubin, a local IBCLC, read this post with interest and wrote to let us know some important information about Aleve and anti-inflammatory medication. She writes, “Aleve is generally not recommended during lactation due to its long half life (12-15 hours, which means it takes 60 – 75 hours to be completely out of a mother’s system). The 2012 Medication and Mother’s Milk reference lists it as L3/L4 (L3 = Probably Safe, L4 = Possibly Hazardous).
LactMed says, “Limited information indicates that levels of naproxen in breastmilk are low and adverse effects in breastfed infants are apparently uncommon. However, because of naproxen‘s long half-life and reported serious adverse reaction in a breastfed neonate, other agents may be preferred while nursing a newborn or preterm infant.”
So – while adverse effects are uncommon, there are other anti-inflammatories (such as Advil) which are L1 (Safest) so that is what breastfeeding Moms are usually directed towards.”
Thanks, Ellen, for this important information!
Did you experience an oversupply? Leave us a comment to share some of your supply management ideas.