Hi mamas, I’m Stephanie Weight Hadfield, an International Board Certified Lactation Consultant (IBCLC) and mom of 4. I’m here to talk about how to breastfeed with oversupply and share my top 3 tips for managing oversupply.
What is oversupply of breastmilk?
It’s pretty obvious that dealing with low breast milk supply would be a problem to breastfeeding mothers and babies, but too much milk can also be a problem. When a mother makes much more milk than her baby needs, we call this oversupply of breastmilk, overabundant milk production, or hyperlactation. So, what are the symptoms of oversupply? Mothers who breastfeed with oversupply often have full breasts, breast engorgement and deep breast pain with letdown and/or between feeds, excessive leaking, and even recurring blocked ducts and mastitis. What causes overprpduction? There are multiple things that could be affecting your milk supply and let-down reflex. You could have a congenial predisposition, be taking a certain medication that affects production, or you could happen to have more prolactin in your blood (this hormone can lead to overactive letdown).
How does overabundant milk supply and forceful letdown affect baby?
Oversupply can also be hard on baby, partly because it often goes hand in hand with forceful letdown. When the letdown or flow of milk is too fast to manage as baby feeds, it can make nursing a stressful and sometimes scary experience for baby, sort of like trying to drink from a fire hose.
A baby struggling with milk flow may be fussy at the breast and choke, splutter, or pull away often during letdown. This is important to avoid as foremilk (the first milk produced during each breastfeeding session) contains mostly water, which means the baby may miss out on the higher calorie hindmilk. Not experiencing full-drainage affects both baby and mom! Some resourceful babies will try to slow strong milk flow by using a biting or chewing motion, rather than sucking. As you can imagine, this hurts mom, and can cause injury and infection to the nipples. In some cases, babies get so frustrated with the fast flow that they refuse the breast and go on a nursing strike. Other signs of oversupply in a baby can be frequent spitting up, reflux and colic, being gassy and fussy, and green, explosive poos. When baby gets an oversupply of lactose, these symptoms can be more apparent.
The key to oversupply
The big key to the oversupply puzzle is weight gain. In the first three months, we expect babies to gain about 2 pounds a month, on average. If your baby is gaining much more than that, oversupply is likely to be the cause of those symptoms mentioned above. Your breastmilk contains a lot of fat content and calories that baby needs, but there is such a thing as too much. If your baby is gaining at about expected rates, or slower than expected rates, oversupply is probably NOT the cause of your breastfeeding concerns, and any efforts to reduce milk supply could do more harm than good. And remember, the first 4-6 weeks are an important time for regulating supply, so don’t try to reduce the amount of milk you’re making before that.
How to manage breastmilk oversupply
Now for the good news: with good breastfeeding management and patience, and maybe a little help from an IBCLC, your body will most likely regulate to make just the right amount of milk for your baby.
Here are my top 3 tips for how to breastfeed with oversupply:
- Change positions. Use positions that help baby have more control over milk flow, such as laid-back nursing, or side-lying. Give baby frequent breaks to catch his or her breath and burp.
- Switch up feeding pattern. Try feeding your baby more frequently, or using your breast pump between feedings, before your breasts feel overfull, and feed on only one side, alternating breasts at each feeding. If your baby wants to eat again within 30 minutes or so, put baby right back to that same side he or she just came off of. You can also use breast compressions to help baby drain the breast well.
- Consider block feeding to reduce your supply just enough that it is more manageable for your baby. Here’s how: continue to feed baby just as often as he or she wants, but offer the same breast for a certain block of time (for example, 4 hours), and then alternate to offer only the other breast for the same amount of time. If the unused breast begins to feel uncomfortably full, you can hand express or pump only enough milk to reduce the pressure and discomfort. Give it about a week. If baby seems more comfortable, and you are feeling more comfortable, you can go back to alternating breasts for the next feeding.
If you have questions about your specific situation, schedule an e-consult or in-person consultation with one of Lactation Link’s IBCLCs for the right breastfeeding support, or reach out to your healthcare provider. We would love to give you the support you need to meet your personal breastfeeding goals.
We have a free e-mail course to help you get breastfeeding started right! Click the image below for more info.
Thanks for reading,
Stephanie Weight Hadfield, BS, IBCLC
Mohrbacher, N. (2010) Making Milk. Breastfeeding Answers Made Simple (pp 425-430). Amarillo, TX: Hale