Hi Terri -
I have a couple of things for you - one is an excellent handout from
kellymom.com (no financial interest, but I LOVE this website!)
on "bottlefeeding the breastfed baby" - it's designed to be printed out and
given to the care provider (there's a pdf link), and has great suggestions
to avoid overfeeding. Here's the link:
<http://www.kellymom.com/bf/pumping/bottle-feeding.html>

Also - a suggestion I give to a lot of moms who are just a little short
each day is to add in an extra pumping session as soon as they get to
work.  I encourage them to nurse right when they leave the baby, then pump
as soon as they get to work - even if it's just 20-30 minutes later.  Most
women get a higher pumping output early in the day, and pumping right when
they get to work doesn't disrupt the flow of the day like other sessions,
so moms also tend to be more relaxed then (=better output).  If they have a
hands-free setup (discussed here before), it's also a good opportunity to
check email and voice mail and such while settling into the work day.  If
they're not in an office, it may mean getting to work that 15-20 minutes
earlier, but for a lot of moms its worth it not to have to supplement.
Note- this is in addition to other pumping sessions, not replacing one of
the existing ones. It may take a week or so to start producing for this
extra session, but usually not any longer than that.

I agree the overfeeding is a big problem (I find especially when family
members are the caregiver!).  If a mom sends the same amount of milk in
smaller bottles, they can sometimes get rid of the "finish the bottle"
overfeeding - and I believe current guidelines are that it's OK to put a
half-finished bottle of EBM back in the fridge to reheat for later - though
I would appreciate any references on this.

Kirsten Berggren, PhD
aspiring breastfeeding researcher
working and breastfeeding advocate and educator

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