I believe that over-supply is a common problem with all it's accompanying
sx. very fat baby, unsettled, irritable, gassy, green stools, mom full or
over full most of the time.  I think it stems from 1. our belief in rules
(nurse each side each time, nurse x minutes, nurse q. 2 hours).  We don't
pay enough attention to what the baby wants !  2. Well nourished state of
most moms in US today.

My clinical observations are that most babies are very content to nurse one
side at a time in early days, beginning to look for 2nd side as 1st week
ends, they wake up more, appetite and milk increase etc. And we (the hosp
staff) are standing there saying "baby  needs to nurse each breast each
time or you won't have enough milk".  Or "his sugar will drop" or "he
doesn't have enough wet diapers" - setting mom up to doubt.  Very few moms
are secure at this point.

But the opposite observation is that I truly believe that unrelieved
engorgement early on leads to poor supply later. (and I agree with Heather
that we are seeing less of horrible engorgement as BF management gets
better)  My solution, keep mother and baby together, nurse ad lib at baby's
direction.  Use comfort measures if mom gets a little over full.  Reassure
and encourage.  Don't mutter "rules." One of the biggest problems in the
hospital is  inflexibility.  All moms and babies must do this or that.  We
don't appreciate them for the individuals they are.  They have to fit our
expectations of normal or fit into hospital rules and policies.  And people
aren't made this way!!!!  And I find this applies to many areas of life.
well off the soapbox -  I'd better go get ready for work where I can
appreciate differences  :-)  Sincerely, Pat

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