Billie, usually oversupply seems to subside by 12 weeks pp.  Over Active
Letdown I am not sure if there has been any literature that just addresses that
especially regarding how long it occurs in a postpartum period.
It sounds like this baby has compensated for the OAL by biting down on the
nipple and reducing the flow. (OUCH)  This may still be all protection to his
airway or now some by just habit.  You did not say what positions she did use
just that this baby did not like the more upright or Australian hold.  Does she
use the side lying position at all?  I find that with OAL babies like this
position because they can allow some of the milk to dribble out of there mouths
and the milk goes more to the cheek, allowing the baby to collect it and then
swallow.  When a more upright position is used such as the football, I find
these babies are dealing with even more of a direct spray to back of the throat
without any time to compensate.
I like your suggestion to have mom pump first to eliminate the first letdown.
 At this point I don't know if the shield would benefit if the baby just
doesn't like it.
I will be curious to see what others suggest.
Ann Perry, RN, IBCLC
Boston, MA

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