My name is Denice Goodheart and I am an NICU RN for the past 18 years. I will be sitting for the IBCLC exam this July. I had chronic overproduction with my 2 children and am successfully nursing my 14 month old now. I tried everything in the literature with my first child and nothing seemed to help (ie. positioning upside down, nursing one side, small frequent feeds...). The thing that finally worked for me was nursing one side for 12-24 hours. My milk supply didn't normalise for several months. My situation was also comprimised by an over active let down. Does she have that as well? Of course you have to be very careful to watch for mastitis, especially since she has had it before. I believe I avoided mastitis by not wearing underwire bras, having the ability to leak very well, and some gentle expression of the engorged breast at the twelve hour mark. I would nurse the breast that seemed to have the overall bigger supply at night, say from 8 pm to 8 am. Then I would nurse my left side from 8am to 8pm. My baby slept with me and I would nurse sidelying very frequently at night because when she was more wakeful during the day she would have difficulty with the let down and supply. These nursing couples need lots of support and since weight gain or lack of, can be an issue, you must get the calories where you can (ie. at night). Another tendency in these cases is milk blisters. Often they can be your first sign of a problem. They masquerade as a plugged duct and you pump and massage and warm pack all to no avail. If you get a sudden onset of nipple pain and a hard painful streak without redness(usually), get a magnifying glass and check for a small whitehead and pop it with a sterile needle. The milk will flow, nurse right away on that side and pump if necessary. And speaking of pumping, it is definitely something to avoid with an abundant supply as it only exacerbates the problem. A couple of additional things to be aware of is an overactive let down is due to an abundance of oxytocin. This extra supply of oxytocin can wreak havoc with brain seratonin levels and so it is a good idea to check with these moms regarding their emotional health. A huge milk supply is related to too much prolactin and in some cases it can be a sign of a pituitary adenoma. This is a benign tumor pressing on the pituitary and apparantly is somewhat common but underdiagnosed. Often you will see moms who continue to leak long after weaning and a host of other symptoms. Of course, an MRI is needed. I realise I have been somewhat verbose but I hope this can be helpful. I am also available to this mom by e-mail or by phone. Feel free to let me know if you have any further questions. Denice---------- > From: Susan Keith-Hergert[SMTP:[log in to unmask]] > Sent: Thursday, April 01, 1999 7:17 PM > Subject: chronic overproducer > > I need some advice about a mom I am now working with. She has a history > of overproduction. It was so bad that she only survived a couple of > months with her second child and then weaned after a bout of mastitis. > > She now tells me, at four days postpartum, that she is feeding baby > every two-three hours, is severly engorged, pumps off about two ounces > after each feed with a manual pump, and twenty minutes later she is > "full again." > > She seems to know what she is talking about...I mean this is not just > your normal overfullnes related to milk coming in. > > Any suggestions? I'm going out to do a home visit on her tomorrow. > > Susan Keith-Hergert > > *********************************************** 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