(Gee, Sar, I don't know why I can't get your message posted from here to Lactnet, but...) Oops, oh hello folks! Just having some technical difficulties here. Please excuse the round about way I had to go to get the following earnestly written message from Sarah posted. Whew! Harry -------- Original Message -------- From: [log in to unmask] (Harry Chaikin) Date: Sat, 4 Mar 95 18:42:28 EST To: [log in to unmask] Cc: [log in to unmask] Message-Id: <[log in to unmask]> Subject: oversupply Hello, Some of you may know me from the days of LLL of Prodigy. My name is Sarah Chaikin. I am a League Leader and an AAPL with La Leche League of New Jersey and an IBCLC. I have recently come across a perplexing breastfeeding situation and I would welcome any bright ideas anyone might have as to how to help this mother. Mother is in her late 20s. This is her first baby. The mother has an oversupply of milk like I have never before seen. With the exception of one day since the baby's birth she has nursed the baby on one side only per breastfeeding session. The infant is satisfied and does not take the other side when offered. The infant (a girl) nurses approximately every three hours for *no more than 10 minutes*. She has frequent wet diapers and bowel movements. She is described as a "good baby" but is quite gassy. The bowel movements tend to be copious and rather explosive. The baby is gaining rapidly. The mother has had large breasts since puberty and they developed significantly during pregnancy. Her periods have always been very regular. During pregnancy the mother had bouts of tachycardia which were initially thought to be "panic attacks". Eventually she was referred to a cardiologist who did a 24 hr. Holter monitor and found that these occurred periodically throughout the day and night. The mother reported to me that an adrenal scan was eventually done in an attempt to explain the tachycardia, but this did not yield any useful information. The mother experienced premature contractions during her last trimester and was eventually put on a small dose of Brethine (the cardiologist restricted her dose due to her prior experience with tachycardia). The pregnancy went to term. Labor and delviery were quite rapid and no medications were used. At eight weeks postpartum the mother continues to experience painful engorgement. Her breasts are very enlarged, hard and very painful. She does not use a breastpump except on rare occasion. She experiences frequent let-down reflexes throughout the day. When breastfeeding a let-down will be stimulated within 10-15 seconds. The baby struggles at the breast and will let go when the let-down occurs. Breastmilk spurts forcefully for 12-18 inches from the nipple and the mother reports that she frquently soaks a hand towel before the milk flow slows down. When the infant returns to the breast she gulps and struggles to coordinate sucking and breathing. The infant terminates the breastfeeding after about 10 minutes. After burping she does not usually wish to return to nursing. On those occasions when she does she usually spits up a large amount of milk. The infant frequently sucks her hands. In addition to breastfeeding on only one side per nursing session, for the last 3 days the mother has been applying ice packs to the breasts after nursing. This has improved her comfort level somewhat but has not appeared to reduce the milk production. We used cool cabbage compresses for part of one day. Fresh, chilled cabbage leaves were applied for approximately 20 minutes (until wilted) after nursing. She repeated the procedure 4 times during the late morning through afternoon. Paradoxically, that night she experienced engorgement and pain more extreme than ever before which was not relieved by nursing the baby. The infant vomited a large amount of breastmilk after nursing and wanted to be fed again. The mother fed her a second time then used her pump to relieve the pressure. She was able to pump an additional 4 ounces. After this pumping she reported feeling "normal" for the first time in many days, with soft non-painful breasts. The next nursing was easier and the mother reported that this was her first time in memory that the baby seemed to be able to nurse for comfort longer than 10 minutes. The next day brought the same level of engorgement and leaking that she has been experiencing. She is reluctant to try the cabbabe again due to the middle-of-the night engorgement she experienced and described as "rebound". The mother is feeling frustrated and I am about out of ideas. Any new ones would be appreciated. Sarah Chaikin