Joy, There's a tablet lactaid and Liquid . The liquid does need to be added to milk for 24 hours ahead. however you can take the tablet, chew or swallow whole, and it will work somehow when ingested with the food. You observations regarding the "overactive letdown" and how to manage and the same as mine with patients. I have had the experiecne of seeing results within 24 hours of going to one-sided, and less frequent feedings ( in the case of the mother always putting the baby to breast, which to me is like always skimming off the top of the breastmilk) Cindy from Lansing MI-Didn't you speak at Sparrow once? THat was great .