Joy states, "I certainly agree that latch is important, but I maintain that  
you 
can have oversupply, with too much milk too fast, with a perfect  
latch."
 
I have to agree with you Joy. I believe that most oversupply is  biologically 
determined.  I've worked with many mothers pumping for  premature or sick 
infants. Those with oversupply can get away with a lot. They  sometimes pump 3 or 
4 times per day and get 10 oz. each time.  A mother  with biologically 
determined "normal" supply will quickly decrease milk supply  if she decreases her 
pumping or feeding frequency. A mom with oversupply  can have a very difficult 
time ramping down.  I just saw a mother  today who is 2 days post partum. Baby 
is gulping at the breast,  clicking to slow the flow and spitting up 
frequently after breastfeeding. She  had oversupply with her first baby. That little 
girl gained almost 2 pounds in  the first two weeks. This had nothing to do 
with latch, just too much  milk.  Although I seldom try to bring down supply in 
the early days post  partum I've recommended that this mother feed on one 
breast per session and burp  the baby in the middle of the feeding and I'm sure 
we're going to have to get  more aggressive than this to manage her supply.  
 
I also agree that too much milk too fast can cause babies to have GI  
distress. We might not feel well if we slugged our whole meal down in 4 minutes  
(although nurses are pretty good at that).  I also see many more babies of  moms 
with oversupply exhibiting reflux issues. It makes sense to me that over  
filling the stomach too fast with too much milk stresses the sphincter and these  
babies may develop significant reflux.  
 
Kathy Boggs, RN, IBCLC
Mountain View, CA

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