>Melissa:  How about weaning her down to one breast per feeding?  She might
>have to pump or hand express temporarily (emphasis on temporarily).  Also
>let her know the baby will need and handle more milk as it grows, and that
>his need will start to catch up to her supply if she lets it.

Arly, I agree with your suggestions for this mum, like one breast per feed
for oversupply. Even one breast for about a 3 hour period (may have several
feeds during that time) before swapping to the other. Melissa asked about
cabbage leaves - these can be used to reduce an oversupply at any stage, as
far as I know, but she needs to take care that she doesn't overdo it and
reduce the supply too much. However, I'd try the one breast per feed regime
first. A reference for this mother's situation is "The Effects of an
Overactive Let-Down Reflex" in the Lactation Consultant Series. Some
mothers and babies with long-term oversupply problems need ongoing support
as some encounter problems at 3 to 6 months of poorly feeding babies,
nursing strikes, etc, as described in this paper. Something else that was
discussed on Lactnet a while ago was the use of herbs, in particular sage
tea, to reduce oversupply. Again, she needs to be careful not to overdo it.

Another reason I wanted to write something here was a snippet I learnt a
couple of weeks ago while at a talk by Prof Peter Hartmann. It was that a
baby's daily milk intake does *not* actually increase with time. I used to
give the same sort of explanation as Arly said above - that baby will need
an increasing amount of milk and "grow into" the oversupply. Also the
concept of "appetite increases" (or what used to be called "growth spurts")
also follows this increasing need assumption. In actual fact, when amounts
of milk being synthesised in mothers feeding happily growing babies at
different ages (same mothers and babies, longitudinal studies) were
measured in Peter's research work, the amounts did *not* increase, but
remained constant. When I queried how this fits in with our (NMAA's)
explanation of supposed appetite increases, and fussy babies at well
recognised ages, etc, he could not explain it, but was certain it was not
to do with the baby indicating that he/she wanted a greater amount of milk.
(His data he was showing was actually being used to show that the daily
volume of milk synthesised stayed the same over time, while the prolactin
level dropped significantly, lending support to the autocrine control of
milk synthesis - ie not dependent on prolactin.)

I asked some friends whether they knew what the labels on ABM cans state
with regard to amounts needed by babies at different ages, and one told me
that the amount per feed does in fact increase with baby's age, BUT the
number of feeds per day decreases, so balanced out, ABM fed babies don't
increase their daily intake much either. I don't have a can here to check
this. Anyone else care to comment?

Joy Anderson IBCLC, NMAA Breastfeeding Counsellor,
Perth, Western Australia
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