So, you have determined that you have an oversupply problem. Let’s figure out how to make this a little bit better.
TMM Problem #1: The Drowning Baby
TMM Tip #1: Before getting baby on the boob, tuck a burp cloth into your bra to catch the drips.
The moment your baby’s lips hit the boob, it is game on. He is chugging like a freshman at a frat party. So, can he handle it? Will his buddies boo him or cheer him on? If he can handle it, there is no problem here. He is efficient. Enjoy the extra time you’ve gained by having a quick nurser.
If he can’t handle it, let’s help him out. First of all, keep your eyes locked on his. If he starts to get overwhelmed, he may start to widen his eyes and slowly pull away from the breast. If you see this, unlatch him, but keep him in the nursing position (he may get really mad if he thinks you are taking the boob away). Let him catch his breath while your milk sprays or drips. Once he and your boob settle, try again.
Take frequent breaks when he seems he needs one. Burp often. If he screams every time you take the breast away, trying burping him while he sucks a pacifier.
TMM Tip #2: Become good friends with the pacifier.
Babies who have mamas who have TMM don’t get to non-nutritively suck. In fact, you may notice your baby acting conflicted at the breast. He may latch and suck a few times, then pull away to only latch again and pull away. It is as if he is trying to say “I want to suck, but I don’t want milk, but I want to suck!” Use the pacifier to help gauge if your baby really is still hungry or just wants to suck, which may also help with the spit up problem you may be having.
TMM Tip #3: Get baby in an easier position to drink.
The classic nursing position for a baby drinking from a fire hose is kind of like you trying to drink while lying in bed. Get baby a little more upright, then lean back so that baby has an extra second to cope with the flow before it hits the back of his throat.
TMM Tip #4: Be careful not to squeeze.
You may be supporting your breast with a little too much pressure. Make sure you aren’t squeezing your boob. That will take a heavy flow and make it a force to be reckoned with.
TMM Problem #2: Bossy Boobs
You probably feel like there are three bosses in your house now: your baby, your left boob, and your right boob. When your baby wants to eat, you feed your baby. When your baby doesn’t want to eat and your boobs do want him to eat… you have a problem. To pump or not to pump?
TMM Tip #5: Pumping is demand on top of baby’s demand, which means it will create supply for the pump on top of baby’s supply. I’m not saying not to do it, I am just saying be sure you know the consequences of your actions… and make room in your freezer.
If you nurse your baby and still feel the need to pump your breasts, then decide to pump and drain them, you will get sweet relief. But, it will happen again. And again. And again. At first it seems awesome to have so much extra milk! Then, you may start to get sick of having to feed your baby and your pump. If it comes to that and you are ready to make a change, remember the mantra:
TMM Tip #6: Full, but not uncomfortably full.
If your breasts feel uncomfortably full and baby is too full or asleep to help out, pump enough to “take the edge off.” This is a great time to use a hand pump or hand expression rather than an electric pump; you probably only need to take out about an ounce. When you leave your breasts full, but not uncomfortably full, it asks your body to please only replace the one little ounce next time rather than four to six ounces. Eventually, this will slow down your milk supply to the point where you don’t feel the need to pump after breastfeeding. Applying cool compresses and a well fitting bra between feeds can help you to cope with the uncomfortable feeling of fullness.
This is also the case if your baby only nurses on one breast at a feeding, but your opposite breast can’t handle waiting three hours for the next feeding. Don’t pump the unused breast fully; just take the edge off.
Please note that when you start asking your body to down regulate like this, you are at a higher risk for plugged ducts and mastitis because your milk is sitting stagnant in your breasts. Be ready to do a complete pump to drain your affected breast if this happens. It will set you back a little, but you can get back on track soon enough.
Another effective technique to manage TMM is block feeding.