Leigh Anne O’Connor, IBCLC
“Milk Goddess” “Fountains of Glory” “Lucky Mama”
References to making more milk than you need may make you feel like having an oversupply is a gift. Seemingly, it is a great way to be able to build a freezer stash, share some milk with your friends, or donate to the local milk bank.
It is normal to have more milk than your baby needs in the early weeks while breastfeeding is being established, but in some cases a significant excess of milk is produced throughout the period of lactation. Often, the excess doesn’t pose a challenge, and if you have an oversupply you may donate to milk banks or to friends and family who use donor milk, create a freezer stash, or use your extra milk for homeopathic remedies. For some, however, the reality of managing more milk than their baby needs can turn out to be quite a burden. If you are challenged by an oversupply, your breasts may be hard and lumpy. You may leak everywhere and at the most inopportune times. Your baby may gag on the spray of your milk when it lets down.
Too much milk?
Why do you have all this milk? What can you do about it?
First, it is important to know the difference between oversupply and a forceful letdown.
Sometimes you make the right amount of milk but the flow is super fast.
With forceful letdown, your baby gets sprayed, but you may not become engorged or leak as much as someone with too much milk. To manage a forceful letdown, you can press on the breast near the nipple just before latching your baby, and spray the initial streams into a cloth diaper or other vessel.
If you have an oversupply, you may drip milk, have engorged breasts, and be prone to plugged milk ducts and mastitis, an infection of the breast. Your baby may struggle to get milk at a reasonable pace. He may gulp air, bite down to slow the flow, and take in more milk than he needs. Your baby may become full before his sucking needs are met, and become unsettled as he attempts to suck for soothing. Your baby may take in a lot of foremilk and less of the rich, fatty hindmilk, leaving him feeling unsatisfied. A foremilk overload may cause baby to have watery, bright green stools and excess gas. He may gain weight rapidly.
Causes and remedies for oversupply
What causes oversupply? Oversupply can occur naturally, but it can also be created by overstimulating the breasts in the early days and weeks of breastfeeding. Pumping milk from the beginning is often encouraged with the idea that it may help establish a milk supply. If your baby is nursing well, there is no need to pump, as doing so increases the volume of milk. Your body may think there are two or three babies to feed. This makes it challenging to manage all the milk inventory.
Most of us will produce more milk than our babies need in the beginning of lactation. As the weeks go on, the milk supply is regulated by the frequency and duration of baby’s nursing habits.
If you have a true oversupply, one that persists after the period when a milk supply typically regulates, there are some strategies you can use to reduce it. One is block nursing, for which you use only one breast for two nursing sessions in a row, or use only one breast for three- or four-hour increments. If you are pumping, either exclusively or to manage an oversupply, you can slowly reduce the time or frequency that you pump. For example, if you pump for fifteen minutes, you can reduce that to twelve minutes for a couple of days and then down to nine or ten minutes for a couple of days, and so on, until you are in sync with your baby’s needs.
Expressing a small amount of milk by hand just before nursing can help your baby nurse more comfortably when there is an excess of milk in the breast. Side-lying and laid-back nursing positions can help reduce a fast flow.
If your breasts are lumpy, you can massage them gently to work out the lumps and avoid plugged ducts. If you have an oversupply, it is important to avoid wearing a bra, particularly to sleep. A bra can press on the mammary tissue and cause a traffic jam in the milk ducts, creating plugs that can then turn into mastitis. If you leak while not wearing a bra, one strategy is to sleep atop a towel to catch the excess milk. Sometimes, not wearing a bra actually reduces leaking, as there is nothing pressing on the breasts. This concept is much like squeezing an orange that is at rest—if the orange is resting, no juice comes out, but if the orange is squeezed, juice comes out.
Sometimes, plugged ducts continue to be an issue. Taking a daily lecithin supplement has been shown to break up the fat in the milk, thereby reducing the likelihood that plugs will recur.
Sometimes, inflammation is the root cause of oversupply or forceful letdown. Anecdotally, it has been found that eliminating dairy or other triggering foods from the diet can improve oversupply by reducing inflammation. If there are foods that cause muscle aches, sleeplessness, or stomach upset, you can eliminate these foods from your diet for a few days and note whether there is an improvement with oversupply and forceful letdown. You may find that you feel better overall.
“I had no idea most newborn babies would fall asleep at the breast until I went to a La Leche League meeting when my baby was three weeks old. In seated positions with me reclined back, she would stare at me, leaking milk, popping off, fussing. She would only fall asleep if we were nursing side-lying, but there would be a milk puddle outlining her head.
I only later realized that my oversupply and fast letdown contributed to her not sleeping while nursing. She didn’t really nap for the first six or so months, until I realized the connection between my milk flow and her sleep.
I had a lot of pain in my breasts; they felt like a bag of golf balls in the early months. I didn’t even realize it was oversupply until a meeting at four months, where someone noticed her popping off and on.
I continue to have issues with clogged ducts if I don’t take sunflower lecithin. The moment I forget or try to decrease from two times [a day], my boobs turn back into the bag of painful golf balls.”
“I had an oversupply issue with my first. Paired along with it was an overactive letdown. I didn’t even know I had an issue until around three or four weeks in, when my son was having lots of green frothy diapers. I worked with a lactation consultant and did block feeding for a few days and his diaper improved, and from then on, I was told to only nurse on one breast during a feeding. When I pumped at work, I only pumped one side and I would get between six and eight ounces from one breast within six minutes of pumping. I know some women struggle with an undersupply, so I hate complaining, but I did not like having an oversupply at all. I constantly had clogged milk ducts and got mastitis four times the first six months. I could not wear a nursing tank, or even a bra on my breasts. They would cause me to get a clogged duct. I wore loose T-shirts when I was home and when I was back at work I wore loose layered shirts and a cardigan with no bra and I was embarrassed to not wear one.”
“We had a lot of trouble latching in the beginning and I had to pump. I would sometimes pump sixty to seventy ounces a day. It was great when I was nursing my twins, but not great for a singleton. I felt tied to the pump. I was engorged before I knew it. Every time I tried to slow down, I’d get plugged ducts. Finally, my baby transitioned to the breast fully and after several months I was able to wean from the pump. I just pump once now after baby goes to bed and my four-year-old enjoys it in his cereal! I was able to feed several babies and one in particular for ten months, so that was a plus.
“Oversupply was terrible. The worst part was going to a breastfeeding support group and feeling alone. I wasn’t experiencing lack of supply or bad latch. My baby was thriving and growing, just choking when he started to feed. I felt the other women didn’t want to hear about my over-engorged boobs. I just remember feeling like I was struggling, too, but everyone was dismissing it because, “How bad could too much milk be?” Tell that to the milk blister and clogged milk ducts. It regulated eventually, and I know it’s amazing that I still produce milk and he’s almost four years old, but those first few months were ROUGH.”
“I didn’t know that everyone didn’t leak, pump sixteen ounces at a clip, live with painful engorgement, and need to wake up to “relieve” themselves even when their baby was sleeping. I was the only person I knew who breastfed back then. I left my handy hand pump at my bedside and attached the eight-ounce bottle when I needed relief, pumped and put it on my bedside table, and went back to sleep. When I nursed I needed a cloth diaper under my bra, so I could catch the fire hose spray if the baby popped off. It was very uncomfortable.”
“I had to pump for a week while my daughter was in the neonatal intensive care unit, and the nurse said I had enough for triplets. When we got home, I was choking her.”
People who have not had an oversupply may see it as a gift and may even be envious if they struggled with low milk supply. However, oversupply can be physically and emotionally unpleasant, as the mothers’ stories shared here reveal. Someone in this situation needs to be heard and supported. With some mindful strategies and patience, an oversupply or forceful letdown can be remedied, and nursing can be a pleasant experience.
Leigh Anne O’Connor is a La Leche League Leader and IBCLC. She lives in New York City with her husband and their three children.