I have seen the many replies with suggestions for both OAMER and OAMS
(overabundant milk supply.) What I have not seen discussed yet is the baby's
distress and actual habit of rapid withdrawal from the nipple and
simultaneous anger. This is something I addressed first and foremost in my
private post to Rachel, because I get the impression it is already leading
to aversive behavior. I can't help but feel that this could well have
possible ramifications for anorexia nervosa, bulemia or other eating
disorders, or other forms of acting out anger and need for control in later
life.

< this strikes me first of all as the baby's fearful reaction to choking
from an overactive
> MER, and better at night because when mom and baby are lying side by side,
> there is neutral gravity involved, and theoretically, at least half the
> baby's nasopharynx is above the level of the bolus. IME , OAMER is almost
> always coupled withoversupply, and if the many daily stools have any hint
of
> a greenish tint, this would make me suspect relative lactose overload.
>
> If this were a mom I was helping, probably the first thing I would
suggest is
 >   1. always triggering the MER several minutes before feeds, and
>   2. consistent use of antigravity positions to take away the
>   respiratory threat which the baby now seems to have firmly associated
with
>   feeding.

In light of the obesity epidemic and general widespread presence of fear,
anxiety and anger in later psychological acting out, I think that we should
consider the possibility that the nature of the breastfeeding process
has its own importance beyond reception of the breastsfeeding product.
Although aphasic (unable to speak) the baby is certainly being compelled to
either eat rapidly or choke, and building up unpleasant and frightening body
memories in his swallowing and breathing muscles, and possible epsodes of
tachycardia (heartbeat too fast), or in some cases, bradychardia (heartbeat
too slow). I believe that this part of the overall problem seems to have
received little attention, with the emphasis of "fixing" OAMS mainly
concentrated on relieving the mother's physical discomfort and anxiety and
the baby's stool pattern.


When I teach parents and grandparents about the importance of and the skill
of pacing the feeding of any necessary bottles, I have taken to calling
attention to the infant's cardio-respiratory stress symptoms and the adult's
frequent misinterpretation of this as "extreme hunger" or "greediness" and
"proof that extra feeding was really, really needed". I would like to
suggest that this cardio-respiratory-psychological stress is just as
important to address in the breastfeeding relationship, or possibly moreso.
I hope that my calling attention to it stimulates more reflection on it from
the baby's point of view, perhaps equally as much as from the mother's. BTW,
we find Dianne Wiessinger's handout very helpful. We refer to it as "the 3
G's", the actual title being "Gaining, Gulping, Grimacing", I believe.


I have discovered that many of the patterns established in my own babyhood
such as being forced to remain fasting between 4 hourly scheduled feedings,
propped bottle, rapid draining of too large a quantity of too sweet a fluid
(probably both from extreme hunger and to avoid choking), and resultant
torpor, have set the stage for many of my own eating habits and emotional
comforting efforts, which remain very difficult to modify at 76 years old,
despite awareness and years of consistent effort. I don't think it is by
chance that a frequently used euphemism in my family of origin was "Don't
get your bowels in an uproar!"


I know Jennifer Tow has cited the existence of an organization focusing on
pre- and postnatal psychology. I would be particularly interested in hearing
comments on my reasoning from anyone with deeper knowledge in the
psychological area.

Jean
*************
K. Jean Cotterman RNC, IBCLC
Dayton, OH USA

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