When you’re browsing the “breastfeeding aisle” of any store or scrolling through new mom blogs, you see countless products and tips for increasing breast milk supply or ensuring your baby has enough. But what about the opposite problem? Where is the help for women who have a hard time managing because they have too much milk or an oversupply?
Full lactation is about 750-1000 ml of milk per 24 hours or 25-34 ounces of milk production per day. This is roughly the amount of milk a baby will need throughout their breastfeeding journey, whether they are 1 month old or 15 months old. Since your body is designed to provide for your baby, this is the amount to expect once your milk production has been regulated. It can be nice to have a little extra to build up a stash (for travel, appointments, return to work, maternal illness, etc.), but when you produce significantly more, it can make breastfeeding harder. Here are some common problems with overproduction and ways to manage them.
*It is important to note that your breast milk supply can take weeks to regulate. Engorgement and too much milk in the first few weeks can be common. Use the comfort measures and information in the engorgement blog post to help you manage. If you are within your first 6 weeks of breastfeeding, I would not recommend any drastic measures to down-regulate supply, especially without IBCLC help. If you have historically overproduced or think that your supply is out of control, make sure to work with an IBCLC to help with management so that you do not jeopardize your supply moving forward.
Common Oversupply Problems & Solutions
Fast or aggressive let-down: Let-down is the contraction of the breast alveoli (milk storage units) caused by the release of oxytocin in the brain. Typically, it is stimulated by baby latching and suckling at the breast. In most cases babies will just adjust their suck-swallow pattern to handle this rush of milk, but in some women the flow is too fast or strong, especially if they have a lot of milk. This will cause the baby to choke, sputter, or pull off of the breast, disrupting latch and getting milk everywhere. It can make it much harder to get a feeding started. If this is the case try to express a little or get the milk flowing prior to latching the baby. You can also use your hand to sort of hold back the milk or compress the nipple pores to ease the flow. Finally, let gravity help. Feed in a laid back position, naturally slowing baby’s milk flow. Usually, this problem will not last for long as the baby grows, their mouth will get bigger and their ability to handle more milk at one time improves.
Obliterated Nipples Impacting Latch: This is when the swelling, fluid, and/or milk in the breast makes the breast, areola, and nipple too hard or firm for the baby to latch. There is nothing for them to grab on to with their mouth and draw in to the back of the palate. It can make a deep latch and adequate milk transfer impossible. Hand expressing a little milk to make the breast less firm can help. Also a technique called reverse pressure softening can be used to make the nipple softer for easier latch.
Little Tummies in the Early Days: At 2 weeks old the average baby consumes 1-3 ounces of milk per feed. With 8-12 feeds being typical this means the baby eats 12-36 ounces of milk in 24 hours. If your production far exceeds this you can get very uncomfortable, even if you are managing engorgement appropriately. At the beginning it is important to try to stay comfortable but to not drastically change your milk production. Allow the baby a chance to grow into a more stable feeding pattern and time for the supply and demand principle of nursing to be established. Do what you can to not make the supply worse or more. Do not pump or allow the baby extra time for comfort suckling at the breast.
Painful, engorged breasts: Engorgement is not uncommon, especially in the first few weeks of breastfeeding. It can be very uncomfortable and a cause of premature weaning when you don’t know how to manage it. Check out this blog post on engorgement management to know how to best control it. For women with true oversupply that uncomfortable, overfull feeling will often last well outside the first few weeks or just when the baby starts sleeping through the night. If you are managing an oversupply, coming up with a stricter feeding schedule and sticking to a routine is important. Being calculated and disciplined with your milk expression will pay off; it just unfortunately doesn’t usually offer immediate relief.
Oversupply Management: Feeding/Pumping Schedules & Appropriate Down Regulation
Schedule for Feeding at the Breast: If you have an oversupply, most likely you will block feed or only feed on one side with each feeding. This will allow for the baby to get foremilk and hindmilk. You should alternate the side you start on with each feeding. Use of a ladybug or haakaa on the other side can help to balance your breasts out a bit between feedings. Be careful not to use the haakaa too much. Pull off just enough milk to comfortably make it to the next feeding, maybe 1-2 ounces. Try not to let it fill up or completely empty the breast as that will promote production and exacerbate the oversupply problem.
Schedule for Pumping: If you pull out your double electric pump to help find a little oversupply relief, be careful! If you are latching a baby to the breast regularly in addition to pumping your body is getting the message that it needs that much milk and will continue to overproduce. Try to wait at least 3 weeks into your breastfeeding journey to use the breast pump if you have adequate or over supply. If you absolutely have to use it to get some milk out for comfort, use it for the shortest amount of time possible, not until the breast is completely empty. You may also want to consider hand expression instead. If you are an exclusive pumping mama and have oversupply try to adjust your pumping frequency in addition to length of pumping. No one should pump for longer than 20 minutes at a time so if you overproduce consider pumping for 10-15 instead. You may also want to space out the pumping sessions if you find that you overproduce, pumping with less frequency than the typical 2-3 hours. Be careful with this though! Space out slowly and track output over weeks. Dropping milk supply takes less effort than trying to build it up again.
Down Regulation- Decreasing supply but not too much: Rapid or abrupt weaning is never recommended in breastfeeding if it can be avoided. Keep this in mind when you are trying to get a handle on oversupply. Typically, you will not achieve your goal or get to ideal production overnight. It will take days, weeks, or even months of patient work. Remember that cutting down breast stimulation can be done via feeding and pumping patterns but also via feeding or pumping time. You do not need to empty both breasts completely with every feeding or every pumping session. Feed off of one breast completely before offering the other breast and make sure to alternate the first side with each feed. Pump for 10-15 minutes, instead of a full 20. If you are uncomfortable or overfull do not empty but instead hand express just what you need to feel okay. Ice and ibuprofen will be your friends as you ride out slowly decreasing your supply to something manageable. So will a supportive but not tight bra or tank.
Over supply can be extremely discouraging and, in some instances, cause early weaning in mamas with no help or information on managing. Hopefully, this post will help some of the super producers out there get some control or learn ways to find comfort and control of their breastfeeding journey. Remember though, you are not alone! If you have tried some of these strategies and are not getting the results desired, reach out. Talk to your provider, baby’s provider, or seek help from an IBCLC. You got this modern mama, trust yourself!
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