PTP. I have a mother, 2nd child, who had oversupply with 1st and is dealing with it again. With her 1st child she did not seek help. With this child, he will nurse well, per her story, but spit up al day long.  Peds had diagnosed reflux and suggested mother pump and offer EBM. Infant was taking 4.5 to 5.5 oz a bottle at 6 weeks. Birth weight was 8# 2oz and was 14# at last visit. Spit up was less with bottles. Mother was obtaining 40oz /day, pumping till milk flow stopped, 10-15 minutes. I recommended she discuss zantac or some such with peds to help break the reflux cycle. We discussed diet, dairy elimination, probiotics. I suggested she try posture feeding along with full drainage at her fullest time (which was 2am) and then blocking to one breast per feed. I suggested an outpatient visit as we have seen her with any feedings since delivery.


Last week, we talked again. She had tried to directly breastfeed several times, doing the full emptying and block feeding but infant had significantly increased spits again. She found herself getting fuller in 12 hours and did not care for the fullness of the side not used at a feeding. She did not apply ice for comfort. She had tried dairy elimination but saw no changes. She will be returning to work soon and wishes to enjoy breastfeeding. At 2am she was pumping 12-14oz to empty. Infant was feeding every 2-3 hours, except for 2 longer sleep sessions. She will be having a Mirena IUD placed in 2 weeks. 


Again, I discussed dietary changes. She does not eat red meat. I talked about dairy needing longer than a week to show a difference and mentioned corn, soy, eggs, gluten, wheat, nuts/peanuts as common allergens. We had discussed herbs at 1st discussion but she did not seem keen on the idea. 


I am not a good one to help reduce supply. Do you find that when helping a mother reduce oversupply, they are very worried about not having enough in the freezer for later?


Allyson Michaels, RN, IBCLC
Charlottesville, VA

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