Rachel: Sounds like a case of really OALD (overactive let-down) to me. If 
the baby is gaining weight well and has plenty of diapers, he is getting 
enough.  The other, more important piece of this picture, is whether eating 
is a pleasant, enjoyable experience for both mom and baby.  In this case, 
no, so what can mom do to make feedings more enjoyable for herself and her 
baby?  I've had good luck with having the mom pump or hand express thru the 
1st big spray (let-down) and then offer the breast.  I'm also betting that 
baby would prefer only one breast a feeding - better to drown once rather 
than twice! I would recommend to her one breast/feed.  The appearance of 
the BMs are pretty indicative of OALD, also.
If mom or baby do not perceive breastfeeding as an enjoyable experience, 
mom will quit, no matter how well breastfeeding is going mechanically.  And 
I think the way breastfeeding tends to be "managed" especially in the USA 
(micromanaging position/latch is a big one; overuse and overrecommendation 
of pumps and other gadgets, another)plays a bigger role in shortening 
duration of breastfeeding than LCs may want to admit.  To increase 
duration, a happy mom and a happy baby are key!  It is my job as the LC to 
help her achieve that goal!

Pam Hirsch, BSN,RN,IBCLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL    USA

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