This baby may be clicking when the milk flow is too strong. Pumping off some beforehand might help, or cabbage leaves, anything to cut back on her supply. I would like to see a test weigh on this baby and know exactly how much baby is taking in at one feeding. I like to weigh these babies several times throughout the feeding each time they start clicking or squirming or choking/gulping. And at the end to assess total intake. I have seen many babies cope with a too fast MER by squirming with their bodies, making clicking or choking noises, or sliding down to the tip of the nipple with resulting sore nipples. 

Symptoms of Overactive MER can be found in the Breastfeeding Answer Book, also on Dr. Newman's handouts, and LLLI website under "articles for Leaders  (Finish the First Breast First and Overactive Letdown: Consequences and Treatment). 

Kathy Eng, BSW, IBCLC
Houston, TX

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