How to create an oversupply of breast milk

Breast Milk Oversupply | Advice for New Parents

Many women naturally make more milk than their infant needs. Sometimes an oversupply is created by over stimulating the breasts doing both breastfeeding and pumping. Having an oversupply of breast milk can be uncomfortable for both mother and her infant.

Signs of Oversupply - Mom

The following are signs of oversupply in the mom:

• Leaking a lot of milk
• Breast pain from feeling overly full
• Nipple pain usually from infant biting, chewing or clenching down to slow a very fast let down
• Recurring plugged ducts or mastitis

Signs of Oversupply - Infant

The following are signs of oversupply in the infant:

• Gulping, coughing, choking or sputtering during feedings
• Frequently detaching from the breast during feedings
• Fussiness between feedings and/or cuing to feed all the time (even after drinking plenty of milk)
• Frequently spitting up
• Passing lots of gas
• Explosive, green, frothy or watery stools; maybe even mucus or blood in the stool
• Overly fast weight gain
• May be diagnosed with “reflux”, “colic”, “lactose intolerance”, or even “failure to thrive”

Since most mothers and infants have symptoms, treatment is often a two-step process.

1. Feedings at the breast must be more comfortable for mother and infant.
2. A small decrease in milk production will make feedings more enjoyable for mother and infant.

Suggestions for making a little less milk

The following are suggestions on how to make less milk:

• Use only one side for a three hour block of time, returning to the same breast if your infant cues to feed again in that time frame. Express a minimum amount from the other breast only as needed for comfort, until the next three hour block.
• Gradually increase the time blocks up to 12 hours per breast, as needed.
• There are medications and herbs that can be used if these strategies do not work for you. Call your lactation consultant or The Center for Breastfeeding Medicine at 513-636-2326 for guidance.

Stop these strategies as you decrease your milk supply and feeds become more comfortable.

Suggestions for managing feedings with a very fast milk flow

Here are suggestions for managing feedings with a very fast milk flow:

• Try feeding when your infant is drowsy
• Offer the breast before it gets overly full
• If your breast is overfull, hand express or pump just the initial fast flow of milk and then latch your infant
• Try feeding positions that use gravity to slow the flow of milk, such as a laid back nursing position
• Burp frequently and give your infant breaks to pace him/herself
• Firmly press the pinky side of your hand into your breast (like a karate chop) during the initial fast let down to slow the flow of milk. As your infants sucking slows down, release your hand to allow milk flow.

Last Updated 03/2020

Reviewed by Barb Chaney, MSN, RN, IBCLC

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Oversupply of breastmilk | Pregnancy Birth and Baby

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A mother’s milk supply usually adjusts to her baby’s needs after about 4 weeks of breastfeeding. Some mothers continue to make more milk than the baby requires, and this is known as ‘oversupply’.

Oversupply can make breastfeeding difficult for both mother and baby.

What are the causes of oversupply?

Breastmilk oversupply that continues after the first 4 weeks or so can have many causes. Feeding patterns may cause the oversupply, such as:

• feeding the baby on a set schedule rather than according to need
• pumping too much before a feed to make the breast soft and easier for the baby to latch onto
• the baby preferring to feed mainly from 1 breast

Other causes of oversupply include:

• an excess of the milk production-stimulating hormone prolactin in your blood (hyperprolactinemia)
• a congenital predisposition

How breastmilk oversupply affects your baby

Your baby may be unsettled or distressed during and after feeding, and it can be hard to know whether they are still hungry or are getting too much milk too fast. Your baby may:

• choke and splutter at the breast due to the high rate of milk flow
• have trouble latching onto the breast
• feed for only short periods of time leading to ‘lactose overload’
• have a lot of urine (more than 10 wees a day) or diarrhoea with green, frothy poos and nappy rash
• have excessive wind, causing unsettled, colicky behaviour
• bring up a lot of milk after breastfeeding
• put on weight quickly

How breastmilk oversupply affects you

Oversupply can also cause problems for you.

You might feel your breasts refill very quickly after feeding your baby. They might feel lumpy and tight after breastfeeding. You might also leak more than usual or have an explosive milk-ejection reflex, which makes it difficult to feed in public, and can cause difficulties for your baby at the beginning of feeding.

You could develop blocked milk ducts or mastitis and breast abscesses.

Oversupply can make breastfeeding a less pleasurable experience for you or your baby. Some mothers think about early weaning if oversupply is not diagnosed and managed well.

How is breastmilk oversupply diagnosed?

It is essential to have a health professional such as a lactation consultant, breastfeeding counsellor, doctor or child health nurse watch your baby breastfeed to diagnose true oversupply. It can easily be confused with breast engorgement or a fast ‘let-down’ reflex.

For help with the diagnosis and treatment of oversupply, contact a health professional, such as a lactation consultant, breastfeeding counsellor, or child health nurse, or call Pregnancy Birth and Baby on 1800 882 436.

How is breastmilk oversupply treated?

The aim of treatment is to reduce your milk production. This is best done while you are being supported by a lactation consultant, breastfeeding counsellor, or child health nurse.

‘Block feeding’ is a method that can help reduce milk supply in just a few days:

• Choose a time frame, usually from 3 to 4 hours, and feed your baby from only 1 breast during that time.
• Then change to the other breast for the same time period.
• Continue this pattern for a few days.
• You might need to hand express a small amount from the unused breast to relieve pressure or discomfort, but don’t empty it — the residual milk in the unused breast triggers the reduction in milk production.

Block feeding ensures that 1 breast always contains residual milk. This will trigger both breasts to reduce milk production, and should gradually resolve oversupply of milk. How long it takes depends on your situation.

Block feeding will also help to reduce the amount of thinner foremilk consumed by your baby. As your baby gets to drink more of the creamy hindmilk, you’ll see your baby’s stools get thicker. This tells you that you are on the way.

If your milk supply does not respond to block feeding, talk to your doctor.

The Australian Breastfeeding Association website has more tips about managing oversupply.

Sources:

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Last reviewed: January 2021

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The information is not a substitute for independent professional advice and should not be used as an alternative to professional health care. If you have a particular medical problem, please consult a healthcare professional.

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Too much milk? Reduced lactation

Sometimes you may feel like you are producing too much milk, especially in the first weeks of breastfeeding. After reading our article, you will find out if you really have too much milk, and what can be done to reduce it.

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Breast milk is very healthy, so it's good to have a lot of it, right? However, this is not always the case. Babies can sometimes have a hard time coping with the rapid rush of milk that usually accompanies excess lactation. And mothers who have too much milk often experience discomfort due to the constant leakage of milk and often suffer from mastitis.

Fortunately, there are a number of ways to help in this situation. But before you use them, answer two important questions:

Do I really have too much milk?

Some of the symptoms of over-lactation (listed below) may occur for very different reasons. You should not try to reduce the production of breast milk, if you are not sure that it is the overabundance of it that is the main problem. Otherwise, this can lead to the fact that your baby will produce less milk than your baby needs, especially in the critical first month when production is just being established.

Is being overweight a problem for me or my baby?

If you are sure that you have an excess of milk, but this does not cause problems for you and your baby, you do not need to do anything. In most cases, everything returns to normal within the first few months. As the baby grows, he will learn to better cope with the rapid flow of milk and will feed with pleasure.

Leakage is not always a sign of too much milk

During the first four to six weeks of your baby's birth, the level of prolactin, the hormone responsible for milk production, will rise each time the breast is emptied. In these first weeks, the breast learns to produce milk in the amount that the baby needs, depending on the time of day. Therefore, excessive leakage, rapid filling of the breast, and even splashing of milk during a rush are the norm. ¹

At the same time, your baby is learning to suck and swallow milk, so you shouldn't be surprised if he suddenly coughs or chokes when he suckles.

After about four to six weeks, the spikes in prolactin levels will begin to fade and milk production will become more balanced, adjusting to your baby's needs on a supply and demand basis. ² However, given the many hormonal changes that occur in the body of a young mother, such a restructuring may take some time. In some mothers, milk production is established quickly, in others a little longer.

Behavior of the child, which may indicate an excess of milk

When overproduced, milk is usually released very quickly, especially during the first flush. As a result, the baby may cough or choke at the beginning of a feed, push back, or hold the breast loose in the mouth. The baby may pull away from the chest, frightened by a quick rush, and then cry because he hasn’t eaten. He can swallow milk in large volumes and with a lot of air, and after that he will spit up a lot. Try to be as careful as possible when you help him burp - sudden movements combined with a full tummy can cause the baby to vomit and scare him even more.

At the start of a feed, milk is relatively low in fat and consists mainly of lactose (sugar) and proteins. As the breast is fed and emptied, the fat content constantly increases. In the case of excess milk production, your baby may feel full before he completely empties his breast. This means that he will get a lot of lactose-rich milk, but not enough fat-rich milk that comes towards the end of a feed. Excess lactose instead of a balanced diet can make digestion difficult and cause hard, frothy, and greenish stools.

Oddly enough, in such a situation, the baby may constantly want to eat and behave restlessly between feedings. Despite the high calorie content, the low fat content of milk prevents it from being fully satiated. It is the fat contained in food that gives us a feeling of satiety. What happens if you eat a few dozen rice crackers or a slice of cheese with a cookie instead? You will fill up on cheese faster, as it is more saturated with fats.

However, all these symptoms can be caused by completely different problems, such as reflux, allergies, or even vice versa, insufficient milk production. An excess of breast milk can indeed cause these symptoms, but only if they are accompanied by excessive weight gain. Children usually dial around 900 g per month, but in the case of an excess of milk, they can gain much more, often almost twice as much. ¹ If you feel like you are having too much milk but your baby is gaining weight normally, contact your lactation consultant or your healthcare provider.

Symptoms that may indicate an excess of milk in mothers

Mothers with an excess of breast milk often experience swelling and tightness in the breast, which constantly seems full. ³ As already noted, the leakage of breast milk in the first six weeks does not indicate its excess. However, if this continues at every feeding and after this period, it may be that the problem is in the overabundance.

A baby cannot always empty a full breast, so when there is an excess of breast milk, blockage of the milk ducts or periodic bouts of mastitis often occur. However, these problems can also be caused by other reasons.

How to reduce milk production

If you have found that you have too much breastmilk and this is causing you concern, here are a few simple things that can help. For some mothers, they are enough.

• Try feeding in a relaxed position. Reclining or lying down feeding will allow the baby to better control the process. In this position, the baby sets the rhythm of feeding himself and can always raise his head to take a break if the milk is released too quickly. Don't forget to put a towel over to soak up spilled milk.
• Release pressure. If full breasts make you uncomfortable, try expressing some milk by hand or with a breast pump, but try to express as little milk as possible. Every time you empty your breast, you send a signal to her to produce even more milk. Therefore, pumping provides short-term relief, but with prolonged use, it can only aggravate the situation. If you need to express and store milk to feed your baby when you are not around, it is best to address the problem of excess production first.
• Try bra pads. If you have milk leaks, put special pads or pads in your bra to collect milk* to keep your underwear dry. If your milk leakage is moderate and already decreasing, or your breasts leak slightly during pregnancy, ultra-thin disposable pads will help you feel confident in any life situation.
• Avoid teas and lactation supplements. If you have been drinking teas, eating special biscuits, or taking supplements to improve breast milk production, this should be stopped now to resolve the problem.

"Breast Watch" to reduce milk production

If all the above methods fail, you can try a technique called "Breast Watch", which allows you to better control milk production. However, before trying this method, check with a lactation consultant or healthcare provider.

On breastfeeding, you feed your baby on demand, but only on one breast for four hours. The second breast during this time is strongly filled. Since breast milk contains what is known as a "feedback lactation inhibitor", due to overfullness, the body sends a signal to that breast to slow down milk production. This is a natural way to protect the breast from endless filling.

This technique must be applied for 24 hours, changing breasts every four hours. If the milk does not become less, try increasing the duration of the "watch" to six hours.

Complete emptying and “breast duty” technique

If after another day there is still a lot of milk produced,
you can try another version of this technique, which is recommended in cases of extreme overabundance. It is called "complete emptying and duty of the breast." ³

In this method, both breasts must be completely emptied in the morning with an electric breast pump and breastfeeding should be started immediately. The flow of milk will be weaker and allow the baby to eat calmly. In addition, he will get more fat-rich milk, which comes at the end of feeding, which means he will feel more full.

After that, you can continue the "breast watch" for four hours, as described above. If that doesn't help, try increasing the interval to six, eight, or twelve hours the next day, depending on the extent of the problem. Before using this technique, be sure to consult with your doctor.

You may not need to completely empty your breasts after the first use of this technique, but some mothers have to do this once or twice. Improvement usually occurs within the first two days or a little later, but in no case should "breast watch" be used for more than five days.

Literature

1 Morbacher N. Breastfeeding answers made simple. Amarillo TX , USA : Hale Publishing ; 2010. - Morbacher N., "Simple answers to questions about breastfeeding." Amarillo, Texas, USA: Publishing Hale 0106 et al . Blood and milk prolactin and the rate of milk synthesis in women. Exp Physiol. 1996;81(6):1007-1020. - Cox D.B. et al., Effects of blood and milk prolactin on milk production in women. Exp Physiol. 1996;81(6):1007-1020.

2 Pang WW, Hartmann PE. Initiation of human lactation: secretory differentiation and secretory activation. J9 Mammary Gland Biol Neoplasia . 2007;12(4):211-221. - Pang, W.W., Hartmann, P.I., "Lactation initiation in the lactating mother: secretory differentiation and secretory activation." G Mammary Gland Biol Neoplasia. 2007;12(4):211-221.

3 Cadwell K. Latching - On and Suckling of the Healthy Term Neonate: Breastfeeding Assessment. J Midwifery & Women ’ s Health 2007;52(6):638-642. — Cadwell, K., "Latching and sucking in healthy newborns: evaluation of breastfeeding." F Midwifery Women Health. 2007;52(6):638-642.

4 Colson SD et al. Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding.

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