Kathy, you make some very good points.  I, also, see milk supplies
diminishing after ample output as months go by.  It is not uncommon to see
a supply drop just before baby is to come home. Facing the responsibility
of caring for baby at home creates anxiety along with the positive
excitement of finally getting home with her little one. And, of course,
once home everything changes, especially the number of hours in a day.

As you read in my post, I am talking about a daily milk production of 80-96
ounces, continuing to the time of attempts at feeding at the breast. I
don't see 25-30 ounces a day as excessive.  It is usually clear that a
given mother tends to over-production.  She could be advised about
gradually decreasing production to a reasonable amount.

Perhaps I am naive to expect so much of those who are in charge of babies
of all ages and stages and mothers of all levels of production
capabilities.  Sometimes those large freezer stores lessen the incentive to
keep current production up and to guide baby to the breast. After all baby
has grown very well on pumped milk and she loves the bottle so much.

Mother needs to make a shift from milk production (which felt like all that
she could do for her baby) to helping her baby come to the breast. The
transition from breastmilk production to breastfeeding is an important one.

As a private practice LC I usually see only 2-3 premies at a time and can
get to know mother and baby as individuals. So those of you in hospitals
can keep on doing what you do so well and I can work with *my* part of our
job--encouraging mother to continue "inviting" baby to the breast, where he
*really* wants to be.

Patricia Gima, IBCLC
Milwaukee, Wisconsin
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