Please forgive cross posting. The archives have some good info, but I wanted to get current thoughts:
PTP: Baby is 9 days old. Mom has significant oversupply issue and an overactive MER. With her first child she dealt with frequent mastitis and plugged ducts and the baby had lactose overload from the copious amounts of high lactose milk. A nipple shield helped with the OAMER and block feeding calmed things down eventually. 
With the new baby, she initiated block feeding on day 2 of life. Baby had a lingual frenotomy on day 5 of life. This baby is a sleepy baby, which aggravates mom's engorgement. Mom is well aware of arousing strategies but they just don’t work well for her. Baby refuses to eat occasionally, and has taken a bottle once after extended refusal without problem (disheartening for mom, for sure). She expresses milk prior to feeding so that baby can latch and says that since the frenotomy there have been no problems with latch, although it’s painful at first (protection against the OAMER. She uses laid-back nursing, lets down into a cloth, and applies a nipple shield to help with flow. Mom has tried Full Drainage Block Feeding but hasn’t seen much benefit.
Weight gain is good – baby is already 3 ounces over birth weight. Elimination is good. So far no mastitis or plugged ducts with this baby. Mom is considering full time pumping at this point.
ANY tips would be appreciated!
Nancy Gray, MS, RD, LDN, CLC

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome