Thank you all for your help on this, and thanks for the additional
questions.  You are such a generous crowd, offering your time, wisdom and
empathy.  I should have included more background information with the
original email, but I’m trying to keep it simple for a number of reasons.



This started as an LLL helping call, so I’m afraid my involvement with this
mom has been far more limited than if she were my client. Mom contacted me
on Day 3 after baby #2 was born within a few days of his due date.  I gave
suggestions on calming the engorgement, and improving baby’s comfort at
breast while she worked on reducing her supply.  I asked her to call me back
a few days later with an update so we could further reduce her supply, but
she didn’t call.  I assumed that she was doing well and didn’t need any
further assistance.



Mom called again a few weeks later describing all classic symptoms of
oversupply and she’s easily pumping enough milk for two extra babies, so I
reviewed block feedings and discouraged pumping for a while, at least until
her supply was under control.  Later I learned from a friend of hers that
she threw out all my suggestions after a day and a half because her supply
wasn’t fixed in that period of time.  The infant's supposed aspiration was
detected by the nurse practitioner in her ped's office and confirmed by a GI
specialist and some test that costs $1K; he's the one who ordered all feeds
at the breast to discontinue until baby "outgrows" the condition.



So this situation started out as severe oversupply that basically went
unchecked, and you can all fill in the blanks from there.  I’m willing to
bet that the aspiration was something that developed as a result of mom’s
enormous supply.  If mom were more cooperative and welcomed my help, I would
definitely become more involved in the case, but she’s flighty about who she
consults and who she listens to on any given day.  I'm forcing myself to
suppress the "Why" questions that nag at me, because she may get overwhelmed
again and block me out.  She clings to every word uttered by her baby’s
doctors because she was so spooked by the test results they reported and how
they said the baby could have died.  She was vulnerable in the first place;
I suspect she’s dealing with some degree of PPD.  She looks like a bird
whose cage has been rattled a few hundred too many times...and did I mention
her 2yo dd was just diagnosed with learning disabilities around the same
time?  I’m trying to remain very low-key and answer the questions she
chooses to present to me, without adding any more pressure.  It’s almost a
tease when I learn new ways that could help him, and I'm sure many of you
feel the same way about these juicy cases that offer so many opportunities
to improve the situation.


Thank you for pointing out the risks of oil with the feeding; I believe she
had organic flaxseed in mind but I’m sure oil of any kind would probably be
detrimental.  Given this mom's huge supply, I'll definitely urge her to do
some "lactoengineering" of her own and see if he starts putting more meat on
his bones; that might also improve his feeding comfort not to have so much
milk sugar.  He appears lean but not really scrawny, and he's full of energy
and very alert.  It’s my understanding that even glycerin suppositories are
irritating to the bowel and can dull the nerves in the bowel, but IMO it’s
far less invasive than the prescription oral laxative they’re pushing
(pardon the pun, LOL).  It’s fascinating that your triplet could aspirate so
clearly, but never develop pneumonia; this little guy didn’t either, so I
suspect it’s a similar situation and that breastfeeding was unnecessarily
interrupted.  If any of you have other suggestions on improving constipation
while using Simply Thick, I'd love to hear it.

Thank you all again for your support!!

Debbie Gillespie, IBCLC, RLC

Registered with the International Board of

Lactation Consultant Examiners

East Valley Lactation Support

(480) 786-0431



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