I have a client with an unusual problem that has been going on for some time
and would appreciate input/insight from the group on how to direct her.  She
has a 5 month old born with some congenital problems and had a Nissen
procedure done.  The baby was hospitalized for 2 months and the mother was
instructed by her OB nurses to pump 6-7 times a day even though the baby
wasn't being fed.  She ended up overproducing (i.e. over a gallon a day) and
has continued to have a problem with overproduction.  I gave her a very
detailed schedule on how to gradually curtail on the pumping, and she is
now comfortable during the day.  She states that the baby has slept through
the night (12) hours for 2 months, and she  still wakes up with two bricks
on her chest each morning.  Why wouldn't her body NOT be getting the signal
to stop producing since she's not giving it any stimulation?  She describes
a copious letdown  and a tendency to "clog" , not leak.  Her milk just flows
into the baby.  He is currently not nursing well due to teething and a bout
of asthma and croup, as well as decreasing naturally, due to starting on
solids.  She has discussed her problem with her OB and he refers her to go
to an LC.  I am questioning if there isn't a medical reason for her over-
production.  I feel there should be some testing done, but I'm not sure if
this comes into the realm of the OB or someone else.  She just sent 30 gallons
of human milk to the milkbank in Denver.  She is embarrassed to go back to
her OB, because she has mentioned it alot and he doesn't seem to want to
deal with it.  Do you all think I should give him a call and let him know
this is NOT NORMAL??!!

Susan Purdy, BSN IBCLC