Some women have such an abundant supply of milk it results in health issues for mother and/or baby.
What causes milk oversupply?
Oversupply can be simply that – a mother’s body making more milk than is necessary for her baby. However, before concluding this is the cause, other factors need to be evaluated. Perhaps a mother’s milk supply is what is necessary for her baby, but the baby has tongue tie or some other sucking issue that prevents him from nursing effectively. If the baby consistently chokes when feeding, make sure to have the baby evaluated for gastroesophageal reflux and/or other issues.
Why is it a problem for the breastfeeding mother?
A mother with milk oversupply can live in a constant state of full, engorged, and/or painful breasts. She may leak milk, even through bra pads, and soak her shirt. It can be embarrassing when out in public. Her baby may chew or bite the breast in order to try to slow down the flow of milk causing pain and cracking in the nipples. Being very engorged with milk can lead to plugged ducts and mastitis. Some babies become reluctant to breastfeed or even go on a nursing strike.
How does oversupply impact my baby?
When nursing at the breast, a baby whose mother has an oversupply of milk may cough, choke, gag, twist, and/or pull off the breast to try to control the fast flow. The baby may swallow a lot of air from gulping, which can then lead to excessive spit up or gas. He may always seem hungry, showing feeding cues even after having just breastfed; or, he may be fussy between feeds. A baby may have green stools, watery stools or blood or mucus in the stools. His weight will usually increase more quickly than the average of ½ pound each week.
Many of these symptoms can also occur in babies who have colic, allergies, or reflux disease so it is important to have your baby evaluated, especially before taking measures to reduce your milk supply.
If I have plenty of milk, why does my baby always seem hungry?
Research has shown that though a mom may actually have an over-abundance of milk, her baby is constantly hungry and trying to nurse. Due to the large quantity of milk in the breast, her baby may eat often but never actually get to the creamier “hind milk.” The initial milk, especially in a full breast, is higher in sugar and lower in milk fat content. 1 (It is incorrect, though, to assume the first milk is always low in fat as it depends on how full the breast is. The initial milk at one feeding may contain more fat than the last milk of another feed, especially when the breast is full.) Milk with a lower fat content is not as filling and will not leave a baby satisfied for as long as milk that has “cream” along with it. This is what causes a baby who is eating often to continue to feel unsatisfied.
Interestingly, because of eating mostly high sugar milk content – the skim milk rather than the cream – is what also causes a baby to have the green, watery, frothy, bloody, and/or mucousy stools.
What can I do if I have oversupply?
Usually, if you are nursing your baby on demand and not pumping additional milk, oversupply will self-regulate itself after your baby is a few weeks old and your body adjusts to the amount of milk it needs to make. If the oversupply is caused because of a sucking issue with your baby, just waiting until the baby is a few weeks older can also improve the problem. A baby’s suckling coordination almost always improves over time. 2
Other measures to improve the situation include laid-back nursing, using only one breast at a feed, or “block feeding” for certain periods of time. Laid back nursing can be helpful because gravity allows the baby control the milk flow. In “block feeding” a mother may set an arbitrary time of say four hours and decide to only nurse her baby on one side during that block of time. During the next block she would then switch to the other side, and so forth. There is no rigid rule of how to schedule block feeds. Some moms might find it easier to say between breakfast and lunch is the right side; between lunch and dinner is the left; etc.
Are there any herbs/medications to reduce my supply?
Herbs that have been used in cultures around the world and noted to decrease milk supply include sage, peppermint, parsley, and jasmine flowers.
Though not intended for this purpose, it has also been noted that birth control pills, especially those containing estrogen, decrease milk supply as do some decongestants, including pseudoephedrine. 3
- Smillie, C.M. et al. (2005) Hyperlactation: how left-brained ‘rules’ for breastfeeding can wreak havoc with a natural process. Newborn and Infant Nursing Reviews 5(1): 49-58. ↩
- Riordan, J. & Wambach, K. (2010) Breastfeeding and Human Lactation, 4th ed. Massachusetts: Jones and Bartlett Publishers, p.268 ↩
- Aljazaf K, et al. (2003) Pseudoephidrine: effects on milk production in women and estimation of infant exposure via breast milk British Journal of Clinical Pharmacology 56:18-24. ↩