In response to Sanna-Mari's posting:
"After the symptoms disappeared, did you have a chance to do another
test weight with this baby? Was the amount of milk consumed less than
previously, and how much less? I am hoping not to sound blunt (English
is not my first language), just wondering, is a baby considered being
'overeating' if he consumes 4 oz (120 ml), esp. if he after that no
longer shows interest in bfing?"
I did not do another test weight on this particular baby. However, there
have been many situations in which the mother has requested that I leave a
Baby Scale at her home so that she could validate the theory that she is
simply feeding the baby too much. In almost every one of these situations,
when the mother reduced the per feeding intake as well as the 24 hour intake
to approximately 2.5 oz/lb/day (90-120 kcal/kg/24 hours), the baby's comfort
level and condition improved dramatically within 1-2 days.
"Overeating" means different things for different babies. Babies will eat
different appropriate amounts depending on many factors, including his
weight and his eating frequency. For the 7 1/2 lb baby I discussed earlier,
I would expect his 24 hour intake to total approximately 20 ozs. If he is
eating 10 times per day, he should be eating only 2 oz per feeding. If he
is eating 8 times per day, he should be eating 2 1/2 oz per feeding. For
him to eat 4 oz at a time consistently, he only needs to eat 5 times in a 24
hour day. This would be quite unlikely and not recommended for a 3 week
old. So if mom's expectation is that this baby is supposed to eat for 15-20
minutes per breast every 2-3 hours, she would clearly be overfeeding him and
causing him to experience all of the digestive disturbances we've been
discussing. Of course it is conceivable that this 7 1/2 lb baby would
occasionally consume 4 oz at one feeding. But it unlikely that he would do
this consistently.
Then Sanna-Mari writes:
"After fighting the oversupply issue for three weeks (and getting
nowhere really, one step forward but next day the same step backward),
I started donating the excess to the local milk kithchen."
If a mother's body is trying to produce say 40 oz of milk for her baby who
needs 20 oz, it would be unwise for her to decrease to the baby's demand
without expressing the rest. She would be at a higher risk for plugged
ducts and mastitis. So I recommend that the mom pump regularly to reduce
discomfort, but not so much as to boost her milk supply. Then I instruct
her to proceed in one of the following ways (mom's choice):
1. Gradually decrease the amount she pumps so that her production
falls more in line with the baby's needs. Usually these moms can eventually
stop pumping or continue just pumping once a day - usually after the first
morning feed.
2. Continue to maintain regular pumping so that she can stockpile
her milk for when she goes back to work.
3. Continue to maintain regular pumping for comfort, realizing that
as her baby grows, his intake needs will begin to catch up with her supply.
4. Donate her extra milk to a milk bank.
============================================
Ellen A. Steinberg, RN, LCCE, IBCLC
E-mail: [log in to unmask]
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