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Subject:
From:
"Kermaline J. Cotterman" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 22 Jan 2003 10:14:57 -0500
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<Just wondering if you have any insight that might help....AND any polite
=
effective way to educate peds about the oversupply symptoms.>

Jennifer,

Out of curiosity, have you checked with the moms whether the hospital (or
childbirth educator, or mother-in-law or other prenatal teacher) told
them they *must* use both sides at a feeding, from the beginning? This
was deeply ingrained starting 40+ years ago when <50 years ago, many U.S.
hospitals were rigidly instructing "one breast at a feeding". Lots of
well-meaning relatives "came up under that 'hafta use both breasts
[equally each feeding]'system"

"First breast first" pattern gives moms more leeway to let baby self
regulate if mom is one of those whose anatomy sets her up to be a "milk
goddess".
Melissa Vickers article on this in a past Leaven is one very good
reference.

As an extension of that, we have had great success with advising moms to
slowly extend the interval during which they use just the same breast. If
it's done gradually, (to avoid plugged ducts, etc. ) many mothers reach a
stage where they use one breast during all feeds for 12 hours and the
other during the next 12 hours. Dr. Newman's book tell of one mother who
gradually put herself on alternating breasts every 24 hours!

Gonneke has another way, whereby she has them pump both breasts
thoroughly, then start "fresh" (on creamy leftovers), if I remember
correctly, using just one side at a feeding. Maybe that would be quicker
and easier for peds to have these moms try.

It's a good point that peds, as well as others in the instructional
pipeline understands the phenomenon of "temporary lactose overload".
Cluster feeding too, could be associated with "eventually getting down to
the creamier milk".

Dewey KG, Lonnerdal B.Infant Self-Regulation of Breast Milk Intake Acta
Paediatr Scand  75:893-898, 1986
        Focus on infant, no mention of maternal discomfort, etc. Due to my
underdeveloped filing system I'm not certain whether this is the article
I want to recommend or whether there is a newer one in the same
publication that discusses research on having some mothers use one breast
at a feeding in the hospital, versus others instructed to use both.

Good to be back on LN.

Jean
*******************
K. Jean Cotterman RNC, RLC, IBCLC
Dayton OH USA

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