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Subject:
From:
Janet Tolley <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 27 Feb 2001 09:24:27 -0600
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I have noted in our feeding clinic an increased population of patients with "a perceived colic".  When I bring them into the clinic and a nursing is observed I find it most likely is an overactive letdown with an abundant milk supply.  These babies are gulping and sputtering at the breast, then they pull off cry loudly, reattach and do the whole thing over and over again.  We go over techniques with the mother to reduce the distress for both of them.  Most of these mom's will report that the baby is hard to burp, gassy and extremely unhappy by the evening hours.  I also think a lot of the back to sleep mentality is not allowing mothers to place babies on their tummies to help with the gas.
Simple techniques that we try first
1) pump or hand express to obtain first letdown, to decrease milk duct tension prior to attachment.
2) modified Australian infant hold( where the baby is sitting in front of mother.
3) have mother lean back so baby is sucking uphill.
4) burp baby in a sitting position at the first slowing of the suck/swallow ratio.
5) burp after 5 min. and at the end of the feeding. 
6) allow the baby to finish the first breast first.
7) give the baby tummy time with the head elevated 45 o.
This will allow for increased comfort.  
I find that this works great with our patients.  Occasionally we do have to refer due to a diagnosis of reflux for medication.  But on the whole it can be lessened by the above.
Janet Tolley RNC, BSN,IBCLC
Lactation Program Facilitator
St. John's Hospital
Springfield, IL
"The only Certified Baby-Friendly Hospital in Illinois"

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