The attached photo is to demonstrate that when a mother produces a lot of milk, almost any position of the baby (babies in this case), on the breast may work. The above babies are obviously older and were exclusively breastfed to 6 months. I don't remember how long the mother breastfed them, but it was a long time.

The point of this article, however, is to discuss the question of so called "oversupply'" of breastmilk. If a mother can feed twins exclusively for six months, then the "notion" of oversupply surely makes sense and is possible. I disagree.

I expect a lot of disagreement about what I am about to write here.

I think that the idea of "oversupply" comes originally from mothers pumping for premature babies in the special care units, the babies being considered too premature to go to the breast. However, the notion of "too premature" is often considered as young at 32 weeks' gestation when it is in fact clear that a baby of 32 weeks can indeed latch on and drink from the breast and receive enough milk.

So, what explains a full-term baby, of a month of age who is fussy at the breast even though the mother produces a lot of milk (as demonstrated by her pumping more than the baby requires)?

Basically, the baby's latch is not as good as it should/could be. And why is the latch not as good as it should be?

1. The mother has not been shown, from day 1 of the baby's life how to get a good latch. Indeed, in our Toronto hospitals, babies, unless born with a midwife in attendance, are very frequently immediately given bottles of formula "because there is no milk yet", which is clearly not true.
2. If the mother has birthed with an epidural, she is likely to have received large amounts of intravenous fluids during the labour, birth and even after the birth. The mother is overhydrated, her breasts are engorged with fluid.
3. The baby has a tongue tie. Tongue ties interfere with how the baby latches on. Those of us who work with breastfeeding mothers, have seen mother after mother with sore nipples whose baby then latches on without pain after tongue tie release. I admit that I release a lot of tongue tie, including that of my granddaughter on day 2 of her life. The baby (my granddaughter) who could not latch on, immediately latched on after the tongue tie release.
4. Breastfeeding should not be painful. Okay, perhaps some tenderness in the first 2 or 3 days, but should not be so painful that the mother refuses to put the baby to the breast, which we see among our patients. If a mother has sore nipples, she should get good "hands on" help as soon as possible, within the first week or two after birth.
5. We see babies with tongue tie frequently, some of whom were referred when the baby is already 2 months old, sometimes even older. When is the time to refer? a. if the baby is not latching on. b. if the mother has sore nipples after the first 2 or 3 days, especially if the mother cannot bear the pain and feeds the baby away from the breast.
6. If the mother has late onset decreasing milk supply, often noted around the baby's age of 2 or 3 months. Noted how? Baby is fussy at the breast and after feeding, the baby sucks his/her fingers, the baby's weight gain slows, in rare cases, the baby has small amounts of blood in his/her bowel movements.

Please consider buying and recommending my new book: What Doctors Don’t Know About Breastfeeding

Print version and ebook version on Amazon: https://www.amazon.com/dp/B09WC2HCC6

Print version on Praeclarus site: https://stores.praeclaruspress.com/what-doctors-dont-know-about-breastfeeding-by-jack-newman-and-andrea-polokova/?showHidden=true

#BFpain #BFnotnough #BFnotlatching #BFlateonsetdecrease

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