Arly asked how do I address the problem of "oversupply colic". I have both
had this experience personally, and counselled many mums as an NMAA
Counsellor over about 9 years.

If the mum has thought she did not have enough milk, she has most likely
been feeding baby very frequently (every time he cries) and switching
breasts frequently, sometimes in one continuous feed that lasts for many
hours. I confirm the oversupply situation by asking about output. More than
about 10 wet nappies per 24 hours and lots of dirty ones, including wind
from the bowel, usually is the case. I explain that the baby is likely to
be crying from tummy-ache rather than hunger, so mum is reassured her baby
is not starving. The output proves she has plenty of milk. ("What comes out
the bottom must have gone in the top, from you." etc.)

Next step is to try to slow down the rate at which milk is going through
baby. I usually first try to get mum to feed only one breast per feed, and
warn her about the unused side getting too full, watch for blocked ducts,
etc. I empathise with her the problem of what to do when baby cries, and
the only thing that seems to stop the noise is to give the breast. If she
cannot soothe baby by other means soon after baby has fed, then I suggest
she feed again on the same breast - not swap to other one. If necessary,
set aside a 2 to 3 hour period when she offers the same breast each time
baby wants to feed, and swap to the other breast for then next 2 to 3 hour
period, and so on. Each time baby goes back to the same breast, he gets a
smaller volume, higher fat feed which helps slow down his digestive system.
I explain how when the feeds are big, and taken quickly, or more is taken
before the last lot has had a chance to be fully digested, the baby's
ability to digest it all is overtaxed, so some of the lactose travels to
the bowel, where it is fermented by bacteria to form gas (wind) which
causes tummy-ache. This also explains the copious stools. Also higher fat
food tends to slow down transit through the gut (not just in babies, in
everyone). (BTW [By the way] this is one of those times when "foremilk" fat
content is probably higher from a recently-used breast than "hindmilk" fat
content of a "full" breast. - as Fiona mentioned, from Peter Hartmann's
research. Fat content depends on degree of breast emptying, not the stage
of the feed.) Usually it takes 2 or 3 days of these strategies to see a
change. Then hopefully baby is likely to be crying less frequently, and mum
can go back to a more "normal" feeding pattern (whatever that means!!)

The other thing that I like to get the mum thinking about is why this
situation arose in the first place. Sometimes it seems it was because mum
was encouraged to build her supply as much as possible from the start, eg
baby was premature, or small, and she overdid it. Others may have a history
of food (esp. dairy) intolerance which started baby crying, led to
overfeeding to comfort baby, etc. One case I saw had had a traumatic birth
and her neck was out of alignment - a chiropractor fixed her. The most
common cause a few years ago, but less so now, was timed feeds - you know,
10 minutes a side, both breasts at every feed, etc.

Whatever the causes, it still seems to be quite common here, but often poor
advice is given to mums by some health professionals. Some diagnose low
supply (from mum's perceptions), or lactose intolerance (which in a way it
is - more accurately "lactose overload" but doesn't require lactose-free
formula, etc) Others just say baby has "colic" and the parents just have to
wait until he grows out of it, at about 3 months. There is a good chance he
will, but it helps to understand the mother's feelings when you have "been
there" yourself, as I have, and know what a living nightmare it can be
day-to-day with a colicky baby. Mothers feel frustrated at being "fobbed
off" but often appreciate knowing that others have lived through this
experience as well and survived, and have healthy kids at the end of it.

Joy Anderson IBCLC, NMAA Breastfeeding Counsellor
Perth, Western Australia
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Happy New Year to everyone - it must be New Year by now in USA (3 pm here
in WA on 1.1.96)