( The rhythm of my subject title just reminded me of Teddy Roosevelt's
"Speak softly and carry a big stick.")

<When I have a mom-baby pair that suffers from oversupply, often combined
with over-enthousiastic let-down, I suggest mom to pump both breast as
empty as she gets them, without "dry-pumping" for minutes. Then the baby
will nurse on one of the seemingly empty breasts and will, perhaps for
the first time, experience a really pleasant nursing session, without
choking and drowning-fear. His stomach is not overfed and his GItract
does not have to cope with an overlaod of sugar that is not balanced with
a good amount of fat. He can easily digest the smaller amount of milk.
Then mother starts "block-feeding", deviding the days in blocks of 3,4 or
more hours. In hard cases mother may need to do the pumping again in a
couple of days. These pumpings will get more and more spaced, untill
milkproduction is levelled to the need.>

Gonneke,

Have you ever written this up anywhere? It sounds to me as if, for those
mothers with access to an efficient double pump, this "thorough pumping,
then block-feeding on one breast per x-# of hours block" might bring
quicker results than the slower, tamping down of supply I usually
describe to moms. In regard to reduction of choking and gastric symptoms
for the baby and comfort for the mother, it would also fit in quite
nicely with our particular culture's love of technology.

It would also probably be useful to pediatricians whose baby patients are
having such problems, and even obstetricians who are called about breast
problems, to clear it up in "one fell swoop", perhaps even over the
phone, and start "fresh" as regards level and rate of milk production.

Physicians have no real control over what kind of breastfeeding info the
individual hospital nurses hand out. I hear from our clients that some of
them have still been told in our Level III hospital, the old "switch
breasts [religiously] halfway through the feeding" info. If they don't
get it there, they often get it from their relatives who heard it across
the board a generation or two ago. For some mothers, especially those
with lots of production and/or storage capability, it seems to be this
pattern that often results in the relative lactose overload symptoms and
oversupply.

An added advantage might be that the mother has an ample supply to gently
mix thoroughly so as not to damage the cells, and package in 2-3 ounce
lots for freezing, for use in whatever kind of situation she might wish.

Please consider it if you haven't already published it somewhere. If so,
please give us the reference so I can quote you!.

Jean
*******
K. Jean Cotterman RNC, IBCLC
Dayton,OH USA

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