Kris -
I am going to chime in with an opinion here rather than something with
references.  I hope it helps.  If this mom were to come to me, I would first
want to know how much milk the baby was drinking at a time and how fast baby
was drinking it.

I have a lot of moms come in for tips on how to increase the amount of milk
they pump.  Typical scenario is for what ever reason baby does not feed well
at the breast.  Parents decide that breast milk is more important than
breastfeeding and decide to pump & bottle.  Baby is now a couple of weeks
old and continuing to root after most feedings.  Baby is usually somewhat
colicky, spitty, or both.  I find out baby is drinking 5 or 6 oz every 2 - 3
hours.  On further questioning I find baby drinks the 5 - 6 oz in less than
10 minutes.  I suspect baby is getting so much so fast that baby has a tummy
ache.  Baby learned early that "If my tummy hurts and I eat, I feel better."
Now baby wants to eat to feel better except that his tummy is already
overfull and it does not help.

I usually try to remind the parents how they feel if they eat too fast.
("When you eat at a buffet dinner, ten minutes after you stop eating, you
wish you would have stopped 25 minutes ago.")  We talk about the size of
baby's tummy and how much comparably mom would eat to consume the equivalent
of what baby did.  My understanding is 1-oz for baby is about 1 pint for mom
(30 ml ~ 0.5 litre.)

They often understand quickly why baby is colicky and that MORE milk is not
needed but slower feedings are needed.  Mom is often using one of the angled
bottles that "prevents gas" according to the advertisements.  I will give
mom a water bottle without a spout and have her drink from it with the level
of the milk higher than her nose and she understands how it feels.  Then I
have her tip it down so that the fluid only comes to her top lip and she
drinks more comfortably and does not swallow as much air.  We then turn the
angled bottle upside down and tilt it until the milk only hits the top lip
and does not fill the entire bulb of the nipple.  Baby slows feeding down,
takes half of a usual feeding in twice the time and drifts off peacefully.

(Boy this is easier to explain in person than in writing.)  Hope this helps
somewhere along the line.  BTW, formula is thicker and does not drip as fast
through nipples.

Linda Pohl, IBCLC
Phoenix AZ

I'd like to know what any of you would have advised (references would be
good). This mom is not interested in starting back pumping, but I would
like to have the info to share with her pediatrician as she refers
mothers to me.

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