Would like any input on this phone call:
Healthy thriving baby, 8 wks old. Mom has been pumping x last 4 wks to
stockpile milk. Mom returned to work this week and after the first 3 days
baby began to refuse at times to nurse, unless coaxed to do so quite a bit.
Mother describes baby pulling off the breast after first few sucks and
crying, and also going several hours refusing to nurse.
Baby is cared for by grandmother when mom at work, and is fed by bottle,
Avent newborn slow-flow nipple, according to mom. Mom is a physical
therapist and works 8 hr days, M-F. Mom feeds baby in a.m. before work and
then pumps at 9a (6 oz), 12N (4 oz) and 3p (4 oz) with a pump in style
(medela) pump, and resumes bf when she returns home shortly after 3p. Has
not started birth control pills or any other meds, does not believe she is
pregnant. When questioned about letdown (which I was expecting to be slow),
mom reports it is very rapid and milk is seen leaking from baby's mouth. Mom
is considering "just pumping" and feeding the ebm in a bottle. (NO NO NO I
really tried to steer her away from that! I just hate to see that happen so
often).

I believe this could be Overactive letdown/oversupply sort of presentation,
brought on by the extra pumping. But could it also be a nursing strike type
reaction to mom going to work? I counseled her re these things and sent her
to LLLL for another opinion. What do you all think?

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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