Well, I'll do my best.  We don't have much literature on this other than case 
studies.  What I'm sharing is from clinical experience but I am investigating, 
mostly because these women are so miserable.  

I don't think many women call about "too much milk" if they are asking for 
help. I also don't think they get seen by consultants much.  I think the kids 
are seen as "thriving" and colicky or diagnosed with reflux.  And without an 
explanation for or some improvement in all the irritability, moms wean.

I also think that the babies get blamed for lots of the problems (poor latch, 
discoordinated suck/swallow,  colic...) when they are actually adapting to the 
circumstances given to them.  I often wonder if the tongue movements, 
shallow latch, clicking...aren't an adaptation rather than a primary problem.

My red flags... I hear moms ask about gas drops, what foods to avoid while 
nursing.  I hear compaints about recurrent plugged ducts and hear stories of 
recurrent mastitis.  I hear them ask if the baby can be allergic to breastmilk.  I 
get asked about formula recommendations because the baby can't go for very 
long in between feedings or the baby never seems satisfied (often in the face 
of tremendous weight gain!) and the mom thinks she doesn't have enough 
milk.  

Any cranky kid I get worried about too.  As they get older, they are able to 
respond better to noxious stimuli and adapt.  Some kids just let the milk flow 
right out of their mouth, never seeming to be bothered.  Others bite, pull 
back, push away the breast, or learn a very shallow latch to control the flow.  
Others pull of and just yell.  Or, the kids get fussy just approaching the breast 
since they know the flow is coming-- the moms obviously don't like that.  
Instead of seeing it as means of communicating that something is wrong, they 
take it that the baby "doesn't like them."

I get asked about thrush all the time. The mothers sometimes have been on 
diflucan or something several times because their nipple pain is "yeast"  (I 
think it's often repeated trauma from adaptive behaviors).  I get asked about 
about colic, or the child being on reflux meds.  I also listen to find out if they 
were feeding the baby at the breast and now are feeding expressed milk in a 
bottle.  

I guess what I'm trying to say is that the diagnosis of ovesupply is probably 
hidden in the misdiagnosis of lots of other problems.  And I don't think many of 
these mom are seeking help for "oversupply" if they are seeking help at all.  
Their main worry is probably hidden in a mess of other concerns about their 
ability to feed and mother their baby.

Jenny Thomas
www.drjen4kids.com

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