Archives searched (no answers beyond what I've already tried).
Permission from mother to post.

Hi, all,

I need your help!

I have been working with a primipara mother for the past four weeks; her
baby is now six weeks old.  She contacted me for help in coping with severe
oversupply issues.  It's been a tremendous challenge, but we have mostly
down-regulated her supply by keeping the baby on one side for 6 hours,
expressing foremilk prior to feeding, using Sudafed and sage.  Gripe water
and lactase drops have also greatly helped the baby cope with the severe
discomforts of foremilk/hindmilk imbalance.  The father is a cranial/sacral
practitioner and has been adjusting the baby since birth.

Although her supply is mostly adjusted now, she continues to have
tremendous difficulty with an extremely forceful MER (OALD).  She has tried
all the traditional management techniques:  taking baby off for first
letdown; spraying into a cloth; pumping before feed; lying down for feed
(baby positioned on top); nursing when baby is sleepy, and using the
scissors hold.  None of these techniques help and the MER continues to be
strong throughout the feeding.  The baby is choking, belching, and crying
throughout the feedings.  To manage the flow, the baby has begun sliding
down onto the nipple and clamping, which has caused large bleeding
fissures.  We are treating the fissures with Jack's APNO.  As a last
resort, we tried a nipple shield, but the baby absolutely refuses to latch
with it.  The mother has had a cranial/sacral adjustment  and several
acupuncture treatments.  The acupuncturist prescribed several herbs to
reduce the MER (one was a mushroom of some sort), but the mother did not
know what they were and they did not make a difference.  She has tried
visualization (and is highly adept at meditation), but without success.

This dear, dedicated mother is thoroughly committed to breastfeeding, but
isn't sure how much longer she can continue.  Every feeding is agonizing
for both her and the baby.  She feels that if she didn't have the
tremendous pain of the sore nipples, it would all be much easier to
handle.  But she feels the stress of the feedings vis a vis the MER has now
been significantly worsened by having to stay on top of the latch and
keeping the baby latched deeply (which angers the baby).  She has
considered exclusive pumping and bottle feeding, but the baby absolutely
refuses the bottle and screams piteously.  At the end of feedings, the baby
relaxes and clearly expresses her pleasure at being at the breast, which
gives this mother a glimpse of how it can be when all goes well.

If we could reduce the MER, all else would fall into place.  But what will
reduce it???  I know goat's rue can increase MER -- is there an herb that
decreases it?  Any other tips or techniques I haven't mentioned?

(One interesting side note:  the mother is convinced that she was
originally carrying twins because her HCG levels were so high in the first
few weeks of the pregnancy.  She feels certain that she lost the twin in
the early part of the first trimester.)

Thank you so much for lending your wisdom to this dedicated mother.

Diana West, IBCLC

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html