almost all of the "oversupply" babies I have dealt with were NOT
>gaining well at all, despite the fact that mom had lots of milk.  This was
>a BIG clue that I was dealing with OALD.  I also want to point out that
>most of these mothers were following the standard "hosprital" advice
>around here to switch sides every __5__ minutes!!!

Heidi,
This sounds like the sort of situation described by Woolridge and Fisher in
their 'famous' Lancet article which resulted in the 'finish the first
breast first' guideline being adopted here. I must admit that the
oversupply colic babies I have seen are nearly all big weight gainers -
none so severe as to be like you describe, although the symptoms are the
same apart from the weight issue. For years now, we have not had the
'standard hospital advice' you quote, thank goodness. In fact, we tend to
get the opposite - let baby feed from only one breast per feed. This is
usually OK in the early days when lactation is turned on 'full bore'
(endocrine control), but may not always remain so later on when autocrine
control takes over.

These babies were
>getting waaaay too much of the high lactose milk, and were having green
>stools, gassy, spitting up, slow gainers, who seemed to want to nurse "all
>the time"  yet got plent of milk. It was not "balancing out" because no
>one was telling these moms to *finish* the first breast.  They aren't
>using the same breast at the next feeding at all. They just keep doing the
>"burp and switch" and the problem is exaccerbated.  I am very intrigued by
>this thread, since my own daughter and I dealt with this issue ourselves.

So have I with my son, which is why I got so interested. I always think it
is interesting (and often productive) to try to figure out why the
oversupply happened in the first place. Some of the possible reasons I have
come across include
- mum paranoid about low supply, so she feeds more frequently than baby
would normally demand (or maybe taught the frequent switching method)
- food intolerance making baby unsettled and wanting to suck for comfort
frequently, leading to overstimulation of supply, colicky symptoms from too
much milk, too fast, which in turn results in more unsettled behaviour
- difficult birth with forceps leading to neck misalignment, leading to
unsettled baby who doesn't handle wind in the gut well, sucks a lot of air
while feeding, and ditto as above.

>I have *always* had instant success with the institution of a one breast
>per feed/ and for comfort if baby still wants to suckle.

I agree, or even one breast per two feeds in a row, or for a set time
period, such as 3 or 4 hours. Actually, whatever our understanding of
exactly what is going on, these sort of management strategies *we know*
work in practice, and that is the most important point. If some something
else, like food intolerance is involved, of course this needs to be
addressed also.

 I am very tired
>of pediatricians in my area diagnosing "lactose intolerance" in breasfed
>babies who are quite obviously having a supply imbalance issue.

I think in the severe case, the baby certainly could get filled up to
capacity with a low fat milk, and end up showing signs of lactose
intolerance. This sort of feeding tends to hurry the system more than
normal, leading to less efficient digestion of that huge load of lactose.
We do sometimes have the same problem of doctors diagnosing lactose
intolerance, which is one of my soapboxes too. I try to explain that it is
not 'lactose intolerance', but 'lactose overload'.

 Any
>thoughts, comments??  Where can i find this research you are referring to?
>I have not seen it or heard of it previously.

Peter Hartmann and his PhD students at the University of Western Australia
have published in several journals, including JHL (Daly SEJ & Hartmann PE,
1995, Infant Demand and Milk Supply. Part 1: Infant Demand and Milk
Production in Lactating Women,  J Hum Lact 11(1): 21-26 and Daly SEJ &
Hartmann PE, 1995, Infant Demand and Milk Supply. Part 2: The Short-Term
Control of Milk Synthesis in Lactating Women,  J Hum Lact 11(1): 27-37) and
Experimental Physiology. Also Peter has a chapter in the book, 'Scientific
Foundations of Obstetrics and Gynaecology'. I am sorry I can't give you
more specifics on the actual points we are discussing, as most of my
understanding of his work has come from the many lectures I have heard him
give, and from talking personally to him, rather than having copies of his
papers. Perhaps others may be able to give you more specific references.

Joy Anderson IBCLC, NMAA Breastfeeding Counsellor
Perth, Western Australia
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