Dear Lactnet

It's my experience too that some babies are restless and distressed the day
before the mother's milk comes in, but I have always explained it to
mothers and to myself that just sometimes, mother and baby are out of sync
with each other for 12 hours or so....which is something more likely to
happen if the mother and baby have had a delayed start to bf, if there's
been little skin-to-skin contact or general holding and cuddling, if the
baby has not learnt yet to latch on well, if the mother has been told/has
decided to place the baby in the cot for as long as possible and only
respond to cues for feeds when the baby is yelling. Interference of all
sorts with the physiology of bf delays the milk coming in - we have known
that for years.

The opposite situation happens when babies are sleepy and reluctant to feed
(often because of meds during labour) and the mother's milk has come in,
and she's either dripping all over the place or hard as a rock with milk
she can't wait for the baby to take.

Both situations seem to me to be best dealt with by explanation and a
little patience and a lot of support . I'm afraid I can't agree with Jude
when she suggests teaching the parents to give water, and sending them home
with a bottle of formula. Of course it's the mother's choice to give
formula if she feels she needs to, but we know (and the stats are there to
prove it - eg the UK's Infant Feeding 1990 survey) that this is likely (and
I mean *likely* ) to seriously  undermine her breastfeeding. I would be
concerned that this one bottle is given to stop the baby's temporary
distress and fussiness is recalled in two weeks, or three weeks, and next
time the baby is hard to settle, or doesn't sleep as often as the mother(or
her family) thinks he should, the experience is repeated...again and
again...slippery slope?

Heather

Heather Welford Neil
NCT bfc UK