Dear Holly,

I don't think that you will find a protocol for using BCPs to reduce supply.  My suggestion would be that she go on a week or two of a BCP which contains a low dose of estrogen and see what happens.  Some moms have also tried using various antihistamines for the same purpose, with varying success.

You say that the mom is doing one-sided feedings for up to two feeds in a row.  We usually suggest that moms feed on one side only for 6-12 hours(some have gone for up to 24 hours)  - which can be many more than just one or two feeds.  The side that is not being used should be emptied only as much as necessary to prevent true engorgement, or as much as the mom can stand.

How much sage is she consuming?  If she is drinking a cup or two a day of tea, that may just not be enough.  The usual dose of the tea can be made by infusing 1 TBSP of dried herb in 1 cup of hot water - steep for 10-15 minutes.  Drink 1 cup, 3 - 6 times per day.  You could use a tincture instead:  30-60 drops of tincture, 3-6 times a day in water or juice.  Powdered sage that is in most cupboards can also work:  1/4 tsp 3X a day for as many days as is needed;  It doesn't dissolve well in most drinks, with vegetable juice being the exception.  Mom can make a sandwich of peanut butter or other sticky substance and in one corner she puts her 1/4 tsp of sage, tears off that corner and swallows it without chewing, drinks some flavorful juice, then eats her sandwich.  There is no taste of sage.

Why does this mom have scabbed nipples?  Babies of moms with oversupply and/or OALD do often not latch properly in an effort to cope with the onrush of milk.  Is she using postural feeding to help the baby?  If the baby is not having a lot of problems dealing with the MER, then there is no reason not to work hard on latch in order to prevent future damage to the nipples.  I was leading a discussion on this a few days ago and one Leader shared that she would press down very hard on her nipples for a few minutes to temporarily staunch the flow.  This allowed the baby to get a good latch before the milk started coming again - she also used postural feeding with great success.  This mom may want to be using an anti-infective ointment such as Jack's APNO to ward off infection.

Hope this helps.  This is a very uncomfortable and annoying situation for the moms so afflicted.  Let us know what happens if she does end up using the BCP for supply control.


Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
mailto:[log in to unmask]

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html