For mothers trying to build a milk supply, or those struggling with a low supply, having an overabundance of milk probably seems like a blessing. But oversupply ” and it's related complications, like lactose overload and overactive milk ejection reflex ” can pose many problems for a mother and baby trying to get breastfeeding off to a good start.
Typically, milk supply is determined by the baby's removal of milk. The more often he nurses, the more milk you make, the stronger your supply. It usually evens out to exactly meet baby's needs by 4 to 6 weeks of age. When dealing with oversupply, the mother makes too much milk, no matter what baby takes or needs.
How Can I Tell If I Have Oversupply?
If you have an oversupply of breastmilk, your baby may experience:
- choking and sputtering when feeding, especially when your milk lets down (may leak milk from his mouth or nose as he nurses)
- pulling away from the breast, arching his back, fussing and crying when he tries to feed, ‘fighting' the breast
- quick feedings, but hungry very soon after
- colic, fussiness, gas, uncomfortable belly most of the time, spits up often
- rare comfort feeds and doesn't fall asleep at the breast
- green, frothy, explosive bowel movements, some maybe even with blood
Some of your symptoms might include:
- breasts that always feel full or uncomfortably engorged
- milk leaking, often copiously
- milk spraying out of the breasts at let-down
- recurrent blocked/plugged ducts or mastitis
- feeling like your baby is biting or chomping at the breast (he actually may be doing this, using his gums to staunch the flow!)
- misshapen nipple after baby is done nursing, nipple pain
If you experience any one of these symptoms alone, then it may not seem like it's an issue of too much milk. But when you and your baby are experiencing a number of these symptoms together, it's likely that you're both suffering from oversupply.
What Can I Do To Even Out My Supply And Make Breastfeeding More Enjoyable?
There are 8 things you can do:
#1: Nurse your baby often
While this may seem counterintuitive, it may solve the problem of the green, frothy bowel movements. Closely spaced feedings are higher in fat. So even if it's only been an hour, feed baby again. Frequent feeds also keep milk flowing so that you can avoid blocked or plugged ducts.
#2: Pay close attention to positioning and latch
With oversupply, babies to better with upright positions. So you may need to experiment to see what works. Consider the ‘koala hold' ” sit baby facing you with his legs straddling your thigh. Younger babies may do well with a more sitting football or clutch hold. ‘Laid back' breastfeeding or a reclined position can help gravity work in your favour. When latching, be sure to get a deep, asymmetric latch to alleviate nipple pain.
#3: Let baby determine the duration of a feeding
Allow baby to completely finish one breast rather than switching breasts after a set amount of time. Offer the other breast. If he's hungry, he will nurse more. But with oversupply, babies tend to take only one side per feeding. You may need to express a little milk for comfort, but don't express so much that you're adding to the oversupply problem.
#4: Rule out any health issues
Make sure baby doesn't have a healthy issue that's causing his inability to handle your milk flow. A baby with reflux, tongue-tie, a cleft palate, respiratory problems, sensory integration issues, etc. may have problems feeding no matter how much of a supply you've got. So before you do anything to decrease the amount of milk you're making, have your baby fully evaluated by your healthcare provider.
#5: Consider block feeding
With this method, you will feed on only one side for a set amount of time. Start with a 3-hour block of time. Any time baby is hungry during that block, nurse him on the same side. Then switch to the other breast for the next 3-hour period. Express just to comfort if the unused breast feels too full. If you don't notice an improvement after doing this for several days, increase the number of hours in your block. Some mothers find that they need to go 12 hours in a block!
#6: Try full drainage block feeding (FDBF)
The idea with this method is to use mechanical means to empty the breast as much as possible. So, about an hour before you expect your baby to nurse, pump both breasts until you don't see any more milk flowing. Then block feed as above. Rather than expressing to comfort, wait until the opposite breast becomes unbearably full, and switch to that side for the next block of time. To decrease the risk of plugged ducts, you may need to go back to the pumping part of the process more than once each day. After doing this for a few days, you should no longer need to pump but you may still need to block feed.
#7: Cabbage leaves may work to reduce your milk supply
Though there's very little research to support its use, many women have found that consistent use of cabbage leaves effectively reduces supply. Wash some whole cabbage leaves and remove the hard spine, then place them inside your bra until they wilt. Use caution with this method since could decrease your supply too much! One recommendation is to use cabbage leaves 20 minutes at a time three times per day and stopping as soon as you notice a decrease.
#8: Herbs and medications can be used, if necessary
Examples of herbs that can decrease milk supply include sage, jasmine and peppermint. If you'd like to give this a try, work with someone knowledgeable about the dosing and side effects of the herbs. Pseudoephedrine, an ingredient in many cold medications, may help decrease milk supply. Hormonal contraceptives (like “the pill”) containing both estrogen and progesterone may cause a drop in milk supply. If you've tried everything else, these medications may be a good last resort.
What Should I Watch For As I Work On Regulating My Supply?
As with any milk supply problem, whether too much or too little, one of the most important things you can do is to watch your baby's wet and dirty diapers to be sure he is getting enough to eat. A newborn should have 6-8 really wet cloth nappies/diapers each day, and at least 3 bowel movements each day after day 4. They should be yellow, seedy and non-formed. Some older babies (after the age of one month) have fewer bowel movements, though they should still wet plenty of nappies/diapers.
It's also important to keep your eye out for a plugged duct ” especially if you're block feeding. A plugged duct is more likely if milk isn't being removed fully enough. Signs of a plugged duct include a lump or hard spot in the breast that may be tender, warm and red. Nursing may be uncomfortable, but usually the breast feels better after a feeding. If you have some of these symptoms and develop a fever and malaise, as well, you may have mastitis (breast infection). You will need to talk to your healthcare provider or a lactation consultant if this happens. To treat a plugged duct, keep nursing as often as possible. Use heat and massage on the area of the plug, and try breast compressions during the nursing session.
Some moms worry that their supply has disappeared when the oversupply finally gets regulated. Their breasts no longer feel engorged all the time, and don't leak copiously as they did before. The best way to know if you've still got enough milk is by your baby's behaviour and his output. If he's having enough wet and dirty diapers, he's not fussy and is meeting developmental milestones, and he is growing well, then your supply has just down-regulated to perfectly meet your baby's needs.
As your baby grows, you may notice that oversupply is less of an issue. Baby gets more efficient at nursing, better at handling the flow and bigger to handle more milk. But until this happens, you want to do what you can so that you and your baby can enjoy breastfeeding. Oversupply is challenging, but not something that can't be tamed. Go with the flow and eventually you'll find a good balance for your body.
- Bonyata, K. 2011. Too much milk: sage and other herbs for decreasing milk supply.
- La Leche League International. 2010. The womanly art of breastfeeding. New York: McGraw-Hill.
- Mohrbacher, N. 2010. Breastfeeding answers made simple. Amarillo, TX: Hale Publishing.
- van Veldhuizen-Staas, CGA. 2007. Overabundant milk supply: an alternative way to intervene by full drainage and block feeding. Int Breastfeed J. 2, 11.