Overabundant Milk Supply with Overactive Letdown

It would seem that every breastfeeding mother would desire to have a milk production, so big that you would have endless freezers full of expressed milk, your baby would always be blissfully full and content, and your breastfeeding worries would be over. Surprisingly, this is not always the case. In fact some women actually suffer from an overabundant milk supply.  Although that may seem like every lactating woman’s dream,to have too much milk, for those women who do have an overactive let down or an overabundant milk supply it can be rather bothersome. Sometimes the supply is so powerful that is makes it difficult for the baby to stay latched on, as the flow is too strong. This can cause a fussy baby, more gas, and ultimately more spit up. The baby may come off the breast quickly or cough and “sputter” due to the spray of milk which can be frightening to any new mommy. If  the mother is constantly making large quantities of milk she may  be facing frustrating breast conditions such as the risk of frequent clogged ducts, mastitis, or painful engorgement.  

If this sounds like you here are some tips to help reduce the milk flow to a level that the infant can handle as well as reduce your milk supply to match the needs of the baby.

• Try feeding with one breast per feeding session. Waiting up to 3 hours between feedings may naturally decrease your supply by decreasing the demand. It is always recommend to feed your baby on demand, but instead of switching breasts stick to the one side allow to empty before offering the other breast. If the baby wakes up and wants to return to the breast in less than an hour, offer the baby the same breast that was used at the previous feeding. If it has been over an hour then I would recommend switching to the other side. If your other breast (the side that the baby did not feed on) is uncomfortably full, you can choose to pump it out, however I would not pump for longer then 10 minutes as this may send a mixed message to your brain to produce more. Remember your breasts work by supply and demand. You want to pump long enough to empty for comfort, but not too long to tell your brain to make more. 5-10 minutes is appropriate.
• For a strong overactive let down, try pumping or hand expressing for a few minutes just prior to the feeding to allow that first initial forceful spray to happen. This way it wont spray into the back of the baby’s throat. Your baby may be inclined to bite down, which does not feel good! A baby will bite or clamp down, institutionally to help slow down the flow. By pumping off that first let down you can avoid this from happening.  Pumping can then be discontinued usually after 1 week as the supply will begin to decrease slightly. Try to make a conscience effort to relax during the first milk-ejection reflex.
• Latch the baby and breastfeed in a more reclined position. Try lying down have the baby more “tummy to tummy” so that the baby is coming towards you. This will be going against gravity, assisting in less of a forceful spray.
• Try other nursing positions such as football hold with your baby’s head higher than the rest of his body. If you choose to use the cradle hold, be sure to have good pillow support, and lean back. Position the baby so that he is straddling your leg, directly facing the breast with his head slightly above the nipple.
• Apply direct pressure with the base of your hand to the opposite breast you are feeding from, to help control the flow.
• If your baby has begun to choke or gag because he/she received too much milk too fast, de-latch the baby gently from the breast, hold him upright, burp him, and calm him down. Continue to then hand-express some milk till the spray has slowed, then resume nursing.
• Try not to let the opposite breast become engorged. Hand expressing or pumping just enough to relieve some ductal pressure will help, but remember to avoid vigorous pumping. Pump only if it is necessary for comfort.
• Important to watch for signs of mastitis. If you feel like you are coming down with the flu, experience sore, red breasts, headache, fever, body aches, and other flu-like symptoms call your OB or other caregiver as an antibiotic will be needed.
• Once your body has figured out how much milk to make, resume breastfeeding on both breasts at each feeding. Usually within a week your milk supply should have regulated.

If you are continuing to have overabundant supply, consult with a Board Certified Lactation Consultant or your physician to see if there may be an underlying health condition causing an increase in supply.

Copyright© 2013 Danielle Gauss,IBCLC,ICCE/ JustBreastFeeding.com. All Rights Reserved