Kathy wrote and I agree "Some of the behaviors we see in infants of mothers
with oversupply may be due to a relative lactose overload and I also think
they may be due, also, to
these babies getting too much volume too fast. They grow well but they have
a
tummy ache. Fixing the supply issues often fixes it. "
I recently did a phone counseling for a mother who, it appears, has this
oversupply type problem. She had a 6 wk old with 'colicky' symtpoms,
vomiting, and who was beginning to nurse less and less. He had a robust wt
gain. Of note was that her pediatrician was at a loss as to what was going
on, but suggested she call me.
I asked her Do you feel you have less than the right amt of milk for the
baby, just about the right amt or much more than enough? She answered much
more. This is a typical answer. We explored the baby's behavior at breast
and he was pulling off, acting very fussy, etc. I gave her the standard
oversupply, OAMER management guidelines which involved one breast per 4 hrs,
express to comfort the other (minimally), positioning ideas, and not letting
the big gush of the first MER overwhelm the baby, and to keep an eye on his
wet/dirty diapers. We agreed I'd call her back in one week. At 1 wk, she
reported the baby's symptoms were 80% improved and that w/i 1 day she saw
improvement.
The mother reported back to the pediatrician who, according to mom, was
surprised to learn about this problem and some ideas on managing it. I don't
think we've heard the last word yet about foremilk/hindmilk/storage etc and
appreciate the outstanding work our lactation researchers have done/are
doing in this and other areas.
Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA
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