This is my opinion ONLY, but based on the idea of efficient baby breastfeeding and regulation of milk supply - block feeding is useless. Babies will reduce vacuum with high flow. When you only nurse one breast per feeding, with a higher storage capacity, it does not reduce milk supply fast enough, and the baby who may have had issues earlier (as in the t-t) may still not be using adequate vacuums to keep milk flowing forward. This causes what I like to call "milk reflux" - excess milk backing up into the ductal structures. Donna Geddes has shown this on ultrasound exams during MER. What I have found helpful in "oversupply" is nursing the baby on both breasts in the biological position. If mom starts with a very high supply, pump 2-3 minutes first on both breasts, then bring baby to breast, both breasts. Do not empty the breasts after feeding. Follow baby's schedule. Evaluate suck-strength and do suck-exercises if baby has a weak suck. I have found this will really help. Remember, supply takes 4 weeks to establish, 8 weeks to stabilize. This has really worked for my clients.
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Rachel Myr
Sent: Wednesday, January 08, 2014 1:36 AM
Subject: need help with difficult oversupply case
I'm trying to help a mother who since her second baby was born 3 weeks ago has been struggling with oversupply. Full drainage gave immediate relief but she was already very sore as baby was tongue-tied and holidays delayed getting that fixed. Baby gained well despite ineffective feeding because mother was producing buckets from day 3; after frenotomy baby feeds well and sores are healed. At one week she had ramoant mastitis, started antibiotic treatment as clinically she was very ill. Cultures from sores and from milk were positive for S.aureus and Group B strep, but antibiotic covered both. During mastitis she drained both breasts at least 8 times/24 hours. Drinking sage tea, one cup per day divided in three doses, have not seen any noticeable effect but we don't know how much she would be producing without it.
Throughout this time, she has had deep burning pain in both breasts, worsening immediately after feeds, and peaking an hour or two later, not totally subsiding in time for next feed or expression. Heat applied to breasts after feeding/expressing gives little relief. The only time she was pain-free was the first time she tried full drainage and block feeding, when baby was five days old. Normally I don't recommend this method so early but her history of extreme oversupply with first baby made us think there was little to lose. Now I am not sure.
The mastitis has been treated, but she still has the pain, and the oversupply. We are trying block feeding again, cautiously, but after less than 24 hours her breasts are tense, overfilled - and PAINFUL. She is exhausted besides. Wants very much to continue breastfeeding but also wants this long drawn-out painful stuff to stop.
I am not sure what to try next. We are open to all suggestions.
Rachel Myr
Norway
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