Kay Hoover spoke at the 2004 ILCA Conference, tape F-502, Overabundant Milk
Supply and Rapid Milk Ejection.  The behavior of your client's baby sounds
typical of one his age who has been dealing with feeding off a fire hose,
i.e. overactive milk ejection.  He compensates by allowing milk to spill out
of his mouth and by insisting on a shallow latch so he can clamp off the
flow, or use less stimulation.  If they find feeding to be too miserable an
experience they may simply refuse to feed after a few months.  I would
recommend that she put the baby to one particular breast for any nursings
over a 5 hr. period. Then use the other breast for all feeds over the next 5
hours, etc.  Do this for a day or so. If not improved, keep increasing the
time, i.e. 6 hrs., 7 hrs., etc.. Initially, mom may need to hand express a
little milk from the second, unused breast, just to relieve pressure. A pump
may be too stimulating. Only she will know when and how much milk to remove.
Sometimes a tablespoon is enough for comfort.  If the pressure is bearable
and she doesn't have hard spots she'd be best leaving it alone. If at any
time the baby needs more milk, he certainly may be given the other breast. I
had a mother who needed to go out to 11 hrs. before she got her supply and
milk ejections under control.  Hope this is helpful.

Anne Grider, IBCLC,
Private Practice, Marietta, Georgia, USA

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