Re: << OK, I have a new one -- at least for me. I have a mom who was (not so) blessed with oversupply with her first baby. We worked through it. Now she has twins. She was told by the hospital lactation consultants that in order to make enough milk, she would need to pump after each feeding, which she did diligently until she called me, reminding me of her history. So she stopped that several weeks ago. >>
1. I really like the way you put the positive spin (and posthypnotic suggestion) on overproduction re: "blessed" with it! Very nice!
2. Please tell me the mother misinterpreted what the nurses allegedly said! If not, WHERE DO THEY COME UP WITH THIS STUFF?!?!!? The need not to or or the need to pump should be based on each individual infant's/multiple's outcomes re: BF observation for sustained, nutritive suckling, good diapers, etc. -- just as for single-born infants. (Duh!) Mothers of healthy, normal twins did manage to produce quite enough milk prior to the invention of affordable, user-friendly pumps. Sure, lots of MOT really need to pump but that is due to the increased incidence of less-than-healthy, distressed and/or borderline mature multiples with immature mouth parts! Sheesh! (Sorry, a particular soapbox for me! Seeing way too many mothers these days who think they are "supposed" to pump and therefore believe they are supposed to feel constantly somewhat engorged and therefore have all the related problems! OK, getting off soapbox.)
<< Well, today she called, and the babies are drowning! They choke, sputter, get mad, pull off, and vomit. In the normal course of events, I'd have her nurse only one side each feeding, pumping the second side only to comfort. She likes to nurse simultaneously -- but I wonder if for a few days, she should nurse both babies on just one side, and then the second side for the next feed, alternating which baby gets to go first. >>
As long as each baby is an effective breastfeeder, I'd suggest she assign each a particular breast for the time being. Generally, I'm for alternating every 24 hours, but I've seen it really help re: overproduction when each baby regulate s a specified breast. She can go back to alternating breasts (p.r.n.) when the problem resolves -- usually several weeks to a couple of months.
Re: pumping to comfort -- I'm assuming she's to "down regulate" to pumping just to MER as soon as "to comfort" leads to less, gradually not pumping at all? Does this include during the night?
<< I've suggested sudafed, compressing the areola slightly to compress the
ducts so that it decreases the overwhelming let down, for a couple of feeds pump off the first couple of ounces (though don't do often as she can increase supply -- but at least it would make the babies more comfotable), and take a lot of peppermint altoids. >>
Rather than pump a couple of ounces, she could pump just to MER, stop the pump and wait to BF until flow slows, or your idea of BF one at a time may help so she can take a baby off more easily until let-down settles. Has she tried between BF cabbage compresses at all? See what happens if each baby is assigned a particular breast -- but it may take a few days for the difference to be noticed...
Karen
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