A breastfeeding oversupply happens when your body starts producing more milk than your baby needs. This is actually a problem, because babies often won't receive enough nutrition if mom is putting out too much milk. It can be uncomfortable for both the mother and baby, and can make a baby fussy. Here is what you need to know about a breastfeeding oversupply, and what you can do about it.
Symptoms of Breastfeeding Oversupply
A forceful letdown of milk from your breast is one of the most common symptoms that can tell you that you have an oversupply. Milk will often leak or even squirt out when the baby releases from the nipple. Imagine trying to drink from a fire hose, and that's an approximation of what a baby goes through when drinking from an overfull breast. The excess pressure from too much milk is more than the baby can handle.
Babies will often exhibit some of the following symptoms from a breastfeeding oversupply:
- Choking, coughing or sputtering during feedings
- Frequent burping and gas between feedings
- Crying and general fussiness, similar to colic
- Biting the nipple during feedings
- Green, liquid or foamy stools
Mothers can look for the following signs of a breastfeeding oversupply in themselves:
- Milk ducts frequently become plugged
- Sore nipples
- Milk sprays out when the baby releases the nipple
- Breasts feel overfull most of the time
- Short feedings of 5 to 10 minutes
Foremilk and Hindmilk
It is important to understand foremilk and hindmilk when you are dealing with an oversupply. The foremilk is what comes out initially during a breastfeeding. It is high in lactose (milk sugar), but it doesn't have as much milk fat. The hindmilk is creamier, and contains the milk fat that babies especially need. The milk fat has more nutrition and fills the baby up.
When you have a breast milk oversupply, the baby will be drinking foremilk until he fills up, but might not be receiving any hindmilk. As a result, he will soon be hungry again. Think of it like this: If you're really hungry, you can fill your stomach up with juice. This will make you feel full and will even give you some calories. However, you will soon be hungry again, because you didn't receive any substantive nutrition from the juice. This is what life is like for a baby that drinks mostly foremilk.
Causes of Breastfeeding Oversupply
For some mothers, an oversupply just happens. Their body is stimulated to be producing milk, and it puts out over and above what's needed. In other cases, some mismanagement and outdated lactation advice can contribute to the problem. For example, if a mother is experiencing forceful letdowns, she may pump a lot of milk out prior to feeding, in order to ease the force of the milk pressure. While this will make it easier for the baby to feed, it sends the mother's body a signal that it needs to produce more milk! The body then "reprograms" itself to overproduce milk.
It is a common belief in many cultures that you should nurse the baby for a few minutes on each breast at every feeding, so that you don't drain the breast completely. However, this is not a good practice because it causes the baby to fill up on the foremilk in each breast, and never consume enough hindmilk. This, in turn, causes the baby to consume too much milk sugar, causing digestive problems. If you have an oversupply of milk and use this breastfeeding tactic it can be stressful for you and your baby. The best strategy is to drain each breast completely during a feeding, even if baby only nurses from one breast during an entire feeding. You can switch to the other breast at the next feeding.
Dealing with a Breastfeeding Oversupply
It will take a little bit of work, but you can help your body adjust to producing less milk and therefore make feeding time healthier and more enjoyable for both of you. Start feeding on just one breast if you're not already doing so. Let the baby fill up on one side, and then feed on the same side at the next feeding. Switch to the other breast at the following feeding. This will gradually slow your milk production, because your body will realize that it doesn't need to produce as much milk. Note that this can make you uncomfortable in the breast that's not being used for feeding. You can hand pump or express small amounts from the "off breast" to relieve discomfort, but don't do this excessively. Otherwise your body will continue overproducing milk.
If the strategy to reduce your milk production doesn't work, you might have to take it to a more extreme level (consult with a lactation specialist first, though). One strategy that is recommended is to thoroughly pump both breasts about an hour before feeding time. Do this until the breasts are soft but not empty. Then feed the baby on one breast until it feels very soft (empty), and the other side feels extremely full. Switch sides at this point, and feed until that breast empties and the other side refills. You might need to pump both sides a second time during the day to prevent plugged milk ducts. Your body should start producing less milk in a few days.
Some slight pumping may be necessary to relieve the pressure from forceful letdowns. This can be counterproductive, though, because it can trigger your body to start overproducing milk. Another strategy is to change the position of the baby during feedings. Leaning back in a reclining chair and having the baby lay across you in an upright position can help. This position allows gravity to help, because the milk has to travel upward. Feeding in a side position (lying down with the baby next to you) can also help, because the excess milk can dribble out onto a towel, reducing the downward force of the milk as seen with the classical feeding position (baby in your lap and positioned beneath the breast). If you gently pinch the nipple between two fingers while feeding you can reduce a forceful milk flow.