Angela, 

My $.02:

Regardless of what else is going on, it seems to me the stools and fussiness still shout possible oversupply, especially since you say she still has plenty even after constant use of a nipple shield. The nipple shield in fact may be protecting him from an OAMER.

You mentioned "block feeding", but I wonder if it was as strict (and done for a long time) as per Gonneke's article in the International BF Journal. I have worked with at least one mom who tried "block feeding" but continually interposed it with other ideas so that the goal of avoiding secondary lactose overload was never fully acomplished till she was finally persuaded of the way nature needed the right messages before she kept the appropriate block time regularly. I have an idea that many LC's themselves may not really understand how to manage the extreme cases of oversupply without re-reading her article.

This article is open access, and a personal contact with Gonneke may be helpful. I feel sure she would be willing.

Overabundant milk supply: an alternative way to intervene by full drainage and block feeding
Caroline GA van Veldhuizen-Staas
International Breastfeeding Journal 2007 2:11 

K. Jean Cotterman RNC-E, IBCLC
WIC Volunteer LC, Dayton OH

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