Too Much Milk: managing oversupply and overactive letdown
While having too much milk seems like a bonus, it’s often as difficult as dealing with low milk supply.
With oversupply or overactive letdown, you see that your baby is gaining weight well and having plenty of wet and dirty diapers, but he seems to hate feeding. He only stays at the breast for a short amount of time, and he is fussy when he’s feeding (and maybe when he’s not). He comes on and off the breast multiple times, and sometimes arches away seeming like he doesn’t want to feed. Nursing just isn’t fun for either of you.
What is Overactive Letdown?
Overactive let down can best be described as “trying to drink from a garden hose that is turned on full-blast, while lying down on your back” (West 2008).
You may find that your baby gags, chokes and sputters, especially at the beginning of a feeding, or that he pulls off the breast and milk spays everywhere. You may hear clicking when baby is nursing. He may spit up often, and may seem fussy or gassy. His bowel movements may be green and frothy. You may experience nipple pain and your nipples may look misshapen when baby unlatches.
For moms who simply have forceful letdown, making minor changes in how they’re feeding can often resolve this issue. For moms whose overactive letdown is coupled with oversupply, the problem can be more challenging.
What is Oversupply?
Normally, milk supply adjusts to match your baby’s needs. But for some moms, the body continues to make too much milk regardless of baby’s hunger. You may hear it called oversupply, overabundant milk supply or hyperlactation syndrome. Whatever you call it, it simply means the body makes more milk than the baby needs.
The symptoms are often the same as those listed above for overactive letdown. These babies have a love-hate relationship with feeding at the breast. They may resist latching, and even scream at the breast. They may seem fussy, gassy, spitty, and colicky. The may have very short feedings, but be hungry again shortly afterward.
Moms with oversupply may experience prolonged engorgement, constantly leaking breasts, recurrent plugged ducts or mastitis, and nipple soreness.
Oversupply occasionally happens when mom has a hormonal imbalance, but can also happen due overzealous pumping and switching sides too soon or after a certain number of minutes.
What Can I Do?
If you notice that you have an especially forceful letdown, start with these simple breastfeeding management strategies:
- Express a little milk before offering baby the breast – just until your initial letdown. You can use a pump or hand expression.
- Take your baby off the breast as soon as you notice your milk letting down. Allow this milk to flow into a towel, then put your baby back to the breast once the flow has slowed.
- Put pressure on the breast at letdown to physically restrict the milk flow. Be cautious with overusing this method to avoid plugged ducts.
- Lean back while feeding and keep your baby fairly upright so your milk flow has to work against gravity.
- Pay close attention to getting a deep, asymmetric latch, especially if you’re experiencing nipple soreness.
If you’re trying to manage oversupply, too, consider these additional strategies:
- Get the best latch possible, and pay close attention to positioning. Holding baby in an upright position may be very helpful.
- Nurse often – even though it seems counterintuitive, nursing often will keep the milk flow slower and keep the milk fattier (which will keep baby more satisfied).
- Let your baby come off on his own when he’s done on the first side and don’t feel obligated to offer the second breast. Don’t switch breasts just because a certain number of minutes have passed.
- Use block-feeding with caution. If no other methods seem to help, nursing on the same breast for several feedings in a row may be useful.
- Consider ‘Full Drainage and Block Feeding’ where you begin by pumping both breasts until you no longer see any milk being expressed first thing in the day. Then proceed with block feeding.
- Cabbage leaves, herbs and medications might be helpful in severe cases of oversupply where management techniques don’t seem to help. Herbs to decrease supply include sage, jasmine and peppermint. Pseudoephedrine, found in cold medicines, can inhibit milk production for some women, as can combined oral contraceptives. These methods should only be used under the guidance of a doctor, herbalist, naturopath or lactation consultant.
Before trying any method to decrease you milk supply, you may want to have your baby evaluated to make sure a health problem isn’t causing feeding difficulties. Tongue tie, cleft palate, reflux, respiratory problems, and sensory integration issues could be at the root of your baby’s behavior at the breast.
Keep in mind, as the weeks pass, your baby will be growing. He will be getting stronger and more coordinated, and his digestive tract will be maturing. At the same time, your milk supply may naturally start to settle into a pattern to meet your baby’s needs. So, over time, your issue may resolve on its own.
Keep track of baby’s wet and dirty diapers so that you know he’s getting enough while you’re trying to decrease how much milk you’re making. If you decide to try some of the suggestions above, you might want to work with a lactation consultant and your baby’s doctor to be sure your milk supply and your baby’s growth both stay on track.
Mohrbacher, N. 2010. Breastfeeding answers made simple. Amarillo, TX: Hale Publishing.
Riordan J & Wambach K. 2010. Breastfeeding and human lactation. Boston: Jones & Bartlett.
van Veldhuizen-Staas, CGA. 2007. Overabundant milk supply: an alternative way to intervene by full drainage and block feeding. Int Breastfeed J. 2, 11.
West, D. 2008. Am I making too much milk? http://www.llli.org/faq/oversupply.html