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From:
Diane Wiessinger <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 9 Nov 2006 22:06:34 -0500
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I've learned a few cool things in the past year about oversupply.  Maybe none of them are pertinent to the baby (babies?) being discussed, but they're cool anyway:

1.  From Catherine Watson Genna - Sometimes a tongue-tie results in the baby being unable to control the flow.  Catherine has an almost painful video of a baby swallowing something like 70 times without pause, finally coming off to cry and cry.  Once his tongue-tie was snipped, he was able to pace his feeds.  I don't know why he didn't just come off the breast periodically to catch his breath, but he didn't; he just soldiered on, swallow after swallow after swallow after...  Seemed like oversupply, but it really wasn't.

2.  I weighed gulps.  It was a baby who'd had trouble for some weeks because of a small mandible.  She was now able to nurse pretty well, but tended to gulp when the flow was fast.  "Ooh," I said to the mother, "Let's weigh the gulps."  I assumed there'd be a substantial weight gain following that surge of glugs... but there wasn't.  She had taken in only .2 oz (6 grams).  Then it occurred to me: Gulping involves swallowing air.  The gulping phase is probably the *least* productive part of a feed.  The baby may be dealing with almost an aerosol of milk - a mist that's not really all that productive.  I'd love for some others to weigh gulps and see if they find the same.

3.  A mother came to me with her 2 week old, after having had oversupply issues with her first baby.  The new baby would settle in, nurse, start to gulp with the let-down, and pull back.  The mother would accommodate him by taking him off, then restarting.  It was frustrating for both and painful for her.  On a hunch, when he started to pull back and she started to take him off, I said, "See what happens if you snug his back and shoulders in even closer instead of taking him off."  She brought his back and shoulders closer, which of course put his chest more firmly in contact with her.  He was now slightly arched, which tilted his head farther back.  Instantly, he switched, as I thought of it, "from turbulent flow to laminar flow" - from gulps to smooth swallows.  She e-mailed me just a couple days later to say everything was fine, and I wondered how much of our "oversupply" is really just babies who aren't being held close enough to their mothers - who aren't "looking up the mountain" when they eat.  I've since come to think of sword swallowers as having the same issue.  If you want a sword (or a liquid) to go down your throat smoothly, you don't want it to have to go around any corners.  Put your head back, and the corners go away.   

Diane Wiessinger, MS, IBCLC  Ithaca, NY  USA
www.wiessinger.baka.com

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