Dear Susan,

You might want to review with the mother any medications that she is currently
taking, or any herbal teas that she may be drinking quantities of - either could
contribute to her overproduction concern. There is a section in R. Lawrence,
BREASTFEEDING: A GUIDE FOR THE MEDICAL PROFESSION, pages 496 - 498, and a
section in J. Riordan and K. Auerbach, BREASTFEEDING AND HUMAN LACTATION, page
91, both consider galactorrhea, you may want to review these (see if anything
rings a bell). Additionally, the later resource, under the subject *too much
milk*, offers a 6-step plan to reduce an abundant milk supply, page 238 ,
including: (1) offer one side per feeding, expressing the other side a little to
ease any discomfort; (2) positioning the baby in an upright posture - baby
straddling mother's leg, facing the breast, head level with point above the
nipple, mother leans back slightly, supports baby's head and is prepared with
cloth diaper for any leaking - that helps releive choking from the fast
delivery; (3) stay with the same side for the following hour if baby asks for
additional nursings; (4) relax  through the initial let-down or catch this
let-down in a towel before latching on baby; (5) burp frequently; (6) avoid
expressing unless there is no other choice - for comfort.

Susan, what are the mother's thoughts on nursing once in the night? Just before
she turns in or one waking in the night, where she nurses briefly on each side
to relieve that brick feeling in the morning? Possibly you are seeing an
abundant milk supply because of the length of infant sleep time  - I know that
women employed outside the home often deal with over and under supply variances
because of their schedules (time spent away during the week, and the weekend
spent nursing). Though our bodies are wonderful things when it comes to
producing just the right amount of human milk that our infants need, maybe 12
hours of *down-time* every 24 hours is asking for too much fine-tuning from this
mother's system.

And one final thought, though many babies begin to need less human milk at 5 and
1/2 months because they are eating solids, many others still depend heavily on
mom throughout the whole first year and don't make this transition to 50%
nutrition met at breast and 50% met at table until after a birthday. Is the
mother possibly expecting weaning to be happening and is concerned because her
supply seems so abundant?, just a stray thought.

My last breastfeeding relationship had some rocky points and I could get no
where with my OB/GYN group. I ended up with a family practice physician who
promptly ordered the tests to assess prolactin levels, estrogen levels, etc.,
giving us the information we needed. I wonder if this woman's experience
breastfeeding her five children had anything to do with the immediate support I
got??!!

Good Luck with this one, Susan!
Jeanine Klaus, MS, IBCLC
Oakville, Ontario