I believe in decreasing abm supplements slowly, less stress on everyone.
I usually suggest decrease abm by 2-3 oz for 2-3 days.  Mother can tell
how well it is working by her and infant's reaction.  Weighing at end of
third day can give an indicator, if all is well.  If all is well, then
decrease again by 2-3 ozs for 2-3 days.  Again, look at all indicators
and if all is well continue decreasing.  With an infant taking 9oz of
abm per 24 hours, this could take about 9days before exclusive
breastfeeding occurs.  I try to prepare moms for the possibility that it
will not always go as planned and that it may take longer to decrease
the abm.  Usually the hardest 2-3 ozs to eliminate are the last 2-3
ozs.

I don't think its a good idea to stop all abm supplement(to use a "cold
turkey" method), if the mother is giving more than 3 oz/24 hours.  I
think it stresses the infant and mother too much.   I read somewhere
that it takes a woman 24-48hours of increased nursing to increase a
supply by 1-2ozs.  I used this method to relactate myself and have
suggested it too many other mothers.  Most of them felt that it was
helpful.

I believe that stooling patterns reflect the use of abm.  As the infant
gets more and more breast milk, the stool should become more like a
breastfed stool.  The lack of stools may indicate an intolerance to the
abm being given and/or the fact that this infant is an older infant.  I
have seen some totally breastfed infants that right from the beginning
never stooled very often but gained well and did not seem in any
discomfort. Hope this is helpful.  Valerie W. McClain, IBCLC

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