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Fri, 5 Oct 2007 13:37:12 -0400 |
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Phone call from a lovely mother nursing a 24-month-old (feeding fairly
frequently -- short feeds) and a one-month old. The one-month-old is
gaining very fast -- two pounds above discharge weight by the two week
appt., and the mother suspects the one-month check-up next week will
show even more rapid weight gain. The younger baby has become
increasingly fussy, sputtering sometimes during feedings, with very
forceful spitting up after most feeds. Bowel movements are normal and
yellow. When the mother was away from the toddler during the day
yesterday, and just feeding the baby, she got quite engorged.
I encouraged her to discuss the projectile spitting-up with the
pediatrician, and discussed that food sensitivities are sometimes
linked with excessive spitting up. We talked about some positioning to
help with the fast flow. But this sounds like classic oversupply (which
can happen even without tandem nursing). And I'd love to hear some
ideas on ramping down the supply with two very different nurslings. A
lot of the tandem breastfeeding literature stresses giving the
vulnerable younger baby first dibs -- and this is quite the opposite
problem!
Perhaps she should breastfeed the toddler first when possible, so the
younger baby is generally coming to a fairly soft breast. But then this
fast-gaining baby might then be getting a disproportionate amount of
hindmilk. (Though in most oversupply cases, babies are gaining very
fast on too much foremilk, so maybe lower volumes of hind-milk would be
better.)
Since either breast would be sufficient for either child, I suggested
that assigning a breast to each would be the most logical way, at least
for the next few months, to let each child balance out the production
for their different, and changing needs.
I also discussed with her the various herbal and medicinal routes for
racheting down the supply, but it seemed better to work first with the
body's own feedback mechanisms.
Any thoughts or experiences?
Margaret Sabo Wills, LLLL, IBCLC
Maryland, USA
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