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Subject:
From:
Linda Hill <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 18 Oct 2011 13:15:44 -0500
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Pat says:  "I agree about taking him off a moment so he doesn't gulp air
with strong let down.  But I don't agree that she should express away the
first milk and then let him nurse.  That is still telling the biofeedback
system that she needs to make too much milk.  Her whole system needs to tamp
down so she doesn't make too much milk, have super strong letdowns and have
a fussy baby .  Or she can contact a milk bank or borrow another baby" :-)
Pat in SNJ

 

I should have also stated the other measures I suggest to down-regulate the
supply.  I am usually dealing with a mom who is at her wits end with an
extremely fussy/gassy baby.  The docs are wanting to treat the baby with
medicine for reflux . when it is probably just an oversupply/OMER problem.
So, I don't want the baby to continue to drink fast and I don't want the
baby to continue to fill up on a disproportionate amount of foremilk.  So,
tho at first the manual expression isn't going to help the overproduction,
it WILL help the baby have more comfortable feeds.  Then the mom will also
implement:

1)  Block feedings

2)  Softening of the unused breast only as needed in the beginning to
prevent plugs and mastitis.  

    (they are struggling enough with a distressed baby and don't need to
then get a breast 

     infection and add to their struggles)

3)  Consume peppermint candy,tea,gum thru out the day.

4)  Depending on how much oversupply she may have, or if not noticing any
down regulation within a

    couple of days of block feeding and peppermint,  two cups of sage tea
(mixed with peppermint 

    tea for improved flavoring) a day is implemented. Judicial use of sage
is covered

    so that we don't cause her to decrease too much.  Most of my moms have
only needed two cups

    for 1-2 days and then do one cup for a few more days.

5)  Pumping to empty once a day, usually helps them to be more comfortable
for the remainder of

    the day.  (starting the block feedings after the good emptying)  We all
know that the highest

    time of milk production is between midnight and 5 am (or thereabouts)
and so they are more 

    likely going to make too much in those first feeds of the day. 

6)  Comfort measures:  ice/cabbage leaves/ibuprofen

 

I've had pretty good results with all of the above.  

 

Warmly,

 

Linda Hill RN, IBCLC

 


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