I would treat this as an oversupply/ hyperactive letdown case. For some
reason...this baby is really stimulating (overstimulating?) this mom!
Some ideas are...feed only one side at a time to decrease the
oversupply. Try a shield to decrease the amount of nipple stim. Avoid
any other kind of nipple stim. (ie. pumps).

The literature seems to indicate that painful letdown resolves within
six weeks...so she may just need to hang in there. My personal
experience tells me this is not always the case and, sometimes this kind
of oversupply has to be dealt with more aggressively. Another idea is to
get her started on some sage...to depress supply. This painful letdown
is often associated with contraction of the alveoli when the ducts are
already full. Decreasing the oversupply resolves the painful letdown.

Good luck,

Susan Keith-Hergert

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