Hello Everyone,

I Would appreciate any input - I've checked the archives on this - I've
been working with a mom for the last 10 days who has an overactive let-down
and over supply among other things.  Baby is 4 weeks old,  tongue was
clipped last week, for what appeared to be a type 3 tongue-tie according to
the article Catherine Watson Genna co-authored (congential tongue-tie and
its impact on breastfeding).  Baby has 'found' tongue and recovered well.

Mom has tried pumping to empty as per Gonneke's reference in the archives -
pumped off 9 ounces and then baby breastfed blissfully for about 24 hours,
then at 48 hours needs to pump off again - but is finding she is dripping
milk everywhere again 48 hours later.  Mom has tried oil of pepperment
according to directions given in Sheila Humphrey's book for the last three
days.  She is going 8 hour intervels between feedings per breast.  She has
a nasty crack on her left breast - initially I think because of the tongue-
tie - but now I think the baby is re-traumatizing it with the overactive
let-down.  (had shown some improvement) She is using an all purpose cream
on it - and cleansing with Normal Saline as per Barbara Wilson-Clay's
advice in the Breastfeeding Atlas.  I also suggested saline compresses
TID.  (my background is wound care)

Any thoughts or ideas would be appreciated.

Sincerely,

Kerri Zandberg, RN, BScN, IBCLC, LLLL
Chatham, Ontario

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