I find one of the most common scenarios is a mother who *perceives* low
supply because the baby is always wanting to feed, is unsettled after a
feed, etc despite good weight gains. I ask about the number of wet and
dirty nappies (diapers) before I go on with anything else. Almost
invariably, they are producing heaps (like more than 10 wet ones, and lots
of dirty) out the bottom end. I say to the mum, 'If that much is coming out
the bottom, then it must have gone in the top! So there is no lack of
supply - more likely *too* much.'

Once she gets the idea that the supply is too much, not too little, we work
on strategies to reduce it. I explain the reason baby is acting like he is
- he gets a large volume, low-fat feed which doesn't get totally digested
in the stomach, as it is too much for his system to handle. Therefore, some
of the lactose ends up in the lower bowel where it gets fermented by the
bacteria, and produces gas. This gives baby a tummy-ache (colic pains) and
these tend to be worst straight after a feed. The only comfort baby knows
is to suck, preferably on a breast, so mum feeds him again. (It's the only
way to shut him up!!) So he gets another large feed which feeds this
vicious cycle (excuse the pun!).

The formula tends to slow the system down, so he gets less colic pains, so
it seems to work. Much better in the long run is to slow down the rate the
breastmilk is going through, and increase the fat content (which helps slow
the system down).

The strategies usually involve feeding one side per feed, and if the baby
still wants to feeds very frequently, set aside a time period, say 3 hours,
and feed only on one side, and then the other side for the next 3 hours,
etc. The time period may need to be adjusted according to the severity of
the oversupply. Mum needs to watch full breast for blocked ducts.

If, on the other hand, there are the normal number of wet and dirty
nappies, I would then suspect some form of food intolerance. Again, it is
*much* preferable to clean up mum's diet than switch to artificial feeding,
as baby will almost definitely end up with intolerance problems, and may
have to be fed one of those super-expensive hypo-allergenic formulas that
taste gastly. Chances are there would be long-term allergy/intolerance
problems as well, perhaps throughout the whole child's life.

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Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia.   mailto:[log in to unmask]
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