Hi Anne, If fast flow is a problem, suggest that mother reclines at the beginning of feeding at least. This way the milk has to flow uphill, and thus more slowly. The degree of reclining is established by trial and error. As baby handles the flow, mother can sit more upright. Some mothers may have to lie flat on their back (called posture feeding in Australia - see NMAA publication Too Much). Hope this helps. Beverley Rae, MSW CSW IBCLC Manhasset, NY