To all of you who have sent responses to my appeal for input on the case of
the unhappy breastfeeding baby, thanks so very much.  I've decided to
compile all the replies and present them to the mother in writing when I see
her, which will be tomorrow.  If any of you have been considering writing
but haven't so far, I'd still be interested in hearing from you,
particularly if you suspect something other than oversupply and overactive
MER.
For the record, my first and strongest suspicion was oversupply and strong
milk ejection reflex.  I will want to see the stools, and we will have a
pediatrician available.  This is also a case in which I'd consider a pre-
and post feed weight to be useful.
The best thing about all the responses was that they all go in the same
direction, and the suggestions were basically the same.  All that really
says, I guess, is that they are in keeping with the Lactnet community
standards of care, but it's good enough for me.

I've just read through the dozen unread Lactnet digests in my inbox and
can't recall the names of everyone whose posts I've just perused, so please
forgive my not mentioning everyone by name.

The thread about Penny's case of oversupply and overactive MER contained
several useful posts as well.  But the one that really gave me a moment of
revelation was the post about the mother who had started expressing her milk
and feeding it by bottle because she was unsure about whether he was getting
enough otherwise.  Thanks to the poster who reminded us that unless the
mother believes she can produce (and I would add 'deliver') enough milk, the
breastfeeding won't work.  The mother I am working with is extremely
committed to doing her best for her baby.  She is also influenced by
generally accepted lay knowledge that five minute feeds at the breast aren't
long enough to be sufficient, and she is seeing that her son shows signs of
hunger even after coming off her breast.  I think we'll need to talk about
the safety of taking active steps to reduce her supply in the context of her
concern that baby isn't getting enough.

Thanks again.  I wish I had a Lactnet to ask for help from in all my major
life decisions, not just BF consults.  What a pleasant dream.

Rachel Myr
Kristiansand, Norway

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