Clinical practiceHyperlactation: How Left-brained ‘Rules’ for Breastfeeding Can Wreak Havoc With a Natural Process
Section snippets
Infant Symptoms
Babies can exhibit a variety of symptoms and often arrive with a variety of diagnoses (Table 1, Table 2). These infants often “act hungry all the time,” breastfeeding very frequently, as if “starving.” Yet, clinically, they gain weight very well, frequently much faster than normal, crossing to higher weight percentiles rapidly in the first months of life. Rarely, an infant may fall below the expected growth curve for breastfed babies, and may be termed “failure to thrive.”2 Spitting up is
Overview—The Physiological Basis for the Regulation of Human Milk Production
Human milk production is regulated by a supply and demand process that occurs through the interaction of infant and mother. Key to this process are a variety of factors: infant behaviors of appetite and satiety, maternal response to infant behavior, infant suckling, maternal pituitary hormonal response to infant suckling, and local alveolar conditions affecting response.
Summary/Conclusions
Hyperlactation is an underrecognized problem that often goes misdiagnosed. Even when secondary codiagnoses are correctly identified, their treatment is complicated by failure to recognize and treat the underlying hyperlactation. Hyperlactation itself is not something inherent in the mother's anatomy or physiology, or caused by the infant's feeding style, but is rather a vicious cycle of behaviors initiated and reinforced by cultural expectations and rules for feeding, which overrule basic
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ABM Clinical Protocol #32: Management of Hyperlactation
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2013, Medical HypothesesCitation Excerpt :First, unidentified feeding difficulties commonly result in breastmilk substitution, which delays maturation of the intestinal epithelial barrier and increases permeability, alters intestinal motility, alters intestinal microbiota composition and diversity, and predisposes to allergy [9,62]. Second, unidentified feeding difficulties may result in functional lactose overload, which results in increased intestinal contractility, large volumes of gas, explosive, frothy, acidic stools, crying, and altered intestinal microbiota composition [49]. A randomised controlled trial of 302 breastfeeding mother–baby pairs demonstrates that functional lactose overload is a treatable cause of infant crying [48], but signs of functional lactose overload are still commonly misdiagnosed as allergy or GORD [16,49].
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