Rachel, from the description it appears to be over active let down and
possibly over production.
Did you do a suck assessment of this baby?  I have observed a few  cases
lately where the babies will not allow anything deep into their  mouths.  They
will gag just beyond the alveolar ridge so they tend to only  latch onto the
nipple.
If this is also part of the problem I would have the mother do some suck
training to help the baby get comfortable with a deeper latch.
If there is an over active let down, I find the side lying position the  best
for the babies.  This allows the milk to pool in their cheek while  they
collect the bolus to swallow.  If a mother uses an upright position  the milk
"shoots" faster to the back of their throats and exacerbates the  problem.
I think your suggestion to express off some milk before she starts is  good.
I would also only do one side a feeding.
Short frequent feeds sound like what this baby would like too.
Ann Perry, RN IBCLC
Boston, MA

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html