Too Much Milk?
One of the most common worries from breastfeeding parents is the concern about whether their baby is getting enough milk. You can find a lot of information about building your milk supply.
What isn’t as talked about is the challenge of making “too much” milk. Also known as oversupply, this can lead to a very fussy baby, with reflux-like symptoms. Oversupply can lead to nursing strikes and be stressful for the breastfeeding dyad. Sometimes moms with oversupply have very fussy babies that can be misdiagnosed with reflux.
This blog is going to explain oversupply and some ways to work through it.
How Does Oversupply Occur?
Your breasts contain an intricate duct and alveolar system. During pregnancy, these ducts and alveoli develop and mature in the mother and this is where breastmilk is made. Breastmilk is made using a supply-and-demand feedback system, which utilizes a polypeptide contained within the milk called “Feedback Inhibitor of Lactation” (FIL). As your baby drinks your breastmilk, the levels of FIL fall, telling your body to make more milk. If the levels of FIL remain high, milk production stops which protects our breasts from becoming overfull.
The tricky part is — ducts and alveoli proliferate more with each subsequent pregnancy. If you had an oversupply with your first baby, you will likely have it again with your second, third, and so on, leading to a fussy baby. Often these babies can be misdiagnosed with reflux.
An oversupply can also be created mechanically. If you breastfeed your baby and pump your breasts for example (maybe to build a freezer stash) you are draining your breasts more often, dropping your FIL levels. The low FIL level triggers your milk production, which in turn increases your supply. This may cause oversupply symptoms in your baby, as well as leave you prone to inflammatory mastitis.
Oversupply signs can be seen in both mom and baby.
- Very full engorged breasts all the time
- Strong let down (when you unlatch baby during let down your milk sprays)
- Frequent ductal narrowing (previously called plugged or blocked ducts)
- Frequent or recurring mastitis
- Frequent spitting up
- Arching and stiff at the breast while nursing
- Crying, gagging, and choking during feeds
- Difficult to burp
- Quick weight gain
- Green frothy stools
- Fussy and/or difficult to settle
- Wants to feed frequently
How to Resolve Oversupply
The good news is, I have worked with thousands of women struggling with oversupply, who have gone on to nurse their babies comfortably.
We can work together to slow your body’s milk production. This needs to be done carefully and with the help of a feeding expert or healthcare provider. All nurses here at The Mama Coach are personally mentored by me, and we can help you. Find the nurse nearest to you here — we can see you in your home or virtually.
It is important to have a full oral assessment of your baby done before working on settling your supply, as often the oversupply is compensating for an oral restriction in your baby and a milk transfer issue. If this is missed, you can end up with an undersupply, which comes with its own challenges.
While you wait for your consultation, consider implementing the following strategies…
The Dinner and Dessert Method:
- This ensures your baby receives more hindmilk (which is higher in fat and leaves your baby feeling settled for longer).
- Often with oversupply, babies drink a lot of foremilk quickly (high in carbohydrates), which can make them gassy and leave them less satisfied and wanting to feed again within a short period.
- Feed your baby off one breast and do not time the feed.
- When their suck slows to more of a flutter (comfort suck), consider trying a few breast compressions, then attempt a burp,
- After the burp, choose to offer the same breast again, or offer the second breast (dessert).
Other things to try:
- Do not pump or handexpress — this includes passive pumping, such as with the Haakaa silicone breast pump. Any extra stimulation will drain your breast of FIL, encouraging your body to make more milk, which will in turn increase your supply.
- Lean back when you are nursing — gravity will help slow your flow and give your baby more control over the feed. The Football position can be helpful here — check out this blog to learn how to do it.
- Take your baby off your breast when you feel your let down (if you can feel it) and spray into a towel, then relatch your baby. This will help ensure your baby doesn’t receive a flood of foremilk at the beginning of the feed, encouraging them to stay at the “dinner” breast longer.
If you are struggling, please remember you deserve support! It can be stressful for families as often babies are fussy and unsettled. Often moms with oversupply baby’s are put on reflux medication with little relief – a thorough feeding assessment can help settle your baby.
We would love to help you. Reach out to your nearest nurse here.
Please know I am sending you so much love and support. You are exactly what your baby needs, even on days it doesn’t feel like it.
Carrie Bruno RN, IBCLC, MSCP