Milk sprays across the room at let-down and she comes off screaming every feed

She is 5 weeks. About a minute into every feed she goes rigid, unlatches, and milk fires out of me in about six directions, genuinely across the sofa, and then she screams at the breast with her fists clenched. Then she'll go back on, gulp like she's drowning, cough, come off again, repeat. Feeds take forty minutes of this and she finishes windy and miserable and I finish soaked.

Health visitor weighed her Tuesday and she is gaining beautifully so nobody seems worried, but every feed is a fight and I am starting to dread them. Her nappies are frankly explosive and green a lot of the time which I'm told is fine but doesn't feel fine.

Two people have now told me I have "too much milk" which sounds like a nice problem to have and does not feel like one. Is this an actual thing or is my latch just wrong?

That's a forceful let-down, and yes it's an actual thing, and yes it is a miserable problem despite everyone congratulating you on it. My second was exactly this. Rigid, off, spray, scream, back on, cough. I used to feed with a muslin permanently over my shoulder like a waiter.

Two things fixed 80 percent of it for us. One, I stopped fighting gravity and started feeding leaning back with her on top of me rather than sitting upright, so the milk had to go uphill. Two, when I felt the let-down coming I took her off, let the first mad spray go into a flannel for maybe twenty seconds, then put her back on for the calmer bit. Sounds faffy, took about four days to become automatic.

The green explosive nappies were part of the same picture for us and settled as the feeds calmed down.

laurenp91 said:

Two people have now told me I have "too much milk" which sounds like a nice problem to have and does not feel like one.

It really isn't a nice problem. Mine was the opposite end, I spent week 3 convinced I had none, and the thing nobody says is that both ends feel like failing. You're not doing it wrong.

Lauren, what you are describing is the classic picture of a fast or forceful milk ejection reflex, and Gemma's two adjustments are exactly the ones I would start with. Direct answer first: a baby gaining well, with plenty of output, who fights the breast in the first minute and then gulps and splutters, is usually reacting to flow rather than to a poor latch or to anything wrong with your milk.

The reason positioning helps is mechanical. In an upright cradle hold the milk arrives with gravity behind it. Leaning back so your baby is lying on top of you means she meets the flow going uphill and can control it, and it also lets her come off and breathe without losing the latch entirely. Catching the first strong spray in a cloth before latching takes the peak off. Both are covered in oversupply and fast letdown along with why the green frothy nappies often travel with this and usually settle as feeds calm down.

Two things I would gently push back on. Do not start pumping to "get the extra out", because removing more milk tells your body to make more and you will be doing this in a fortnight at a higher volume. And do not assume the latch is irrelevant either: flow problems and a shallow latch can sit together, and a shallow latch makes coping with a fast flow much harder, so the guide to how to get a good latch is still worth a read.

The professional line, as always: I cannot see your baby. If she starts refusing feeds outright, if the weight gain changes, or if the pain or the dread does not lift, have a midwife or a board-certified lactation consultant watch a full feed in person. Forty minutes of a fight every time is worth someone's eyes.

Two weeks on. Laid back feeding was the big one, I feel ridiculous that a change of angle did that much. Still catch the first spray in a flannel at the morning feed when I'm fullest, don't bother the rest of the day now. Feeds are down to about fifteen minutes and she comes off looking smug instead of furious.

Nappies still occasionally alarming but less often. Sofa has been saved. Thank you all.