August 1, 2018

Breastmilk oversupply — Is this a problem?

You may be aware of the benefits of breastfeeding and/or breastmilk for both the baby and the mother. These include, but are not limited to fewer and shorter illnesses for the baby and reduced cancer risk for moms. The American Academy of Pediatrics "recommends exclusive breastfeeding for about 6 months, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant." Most mothers in the US attempt to breastfeed and one of the most common hurdles mothers face is low milk supply. The opposite of low milk supply, oversupply can also be a problem. One may wonder why oversupply is a problem, more of a good thing is usually good, right? 

Problems with oversupply

Breastmilk oversupply may cause problems for both baby and mom. When mom's breasts make more milk than the baby needs, it can cause engorgement and pain for the mom.  Left unmanaged, it can lead to clogged ducts and mastitis (breast infection). If the milk flow is too fast for the baby, it can cause them to gulp, cough and even choke while they are breastfeeding. Baby can also have reflux symptoms if he is eating large volumes at one feeding.

Oversupply management

Breastmilk production works in a supply and demand manner. The more a baby eats (or more a mom pumps her breasts) the more milk is produced. This information can be used to decrease supply to more manageable levels. Many moms with mild oversupply don't need to make any changes. As the baby takes less the body responds by making less, and in a few weeks, mom and baby are in sync.

Sometimes mothers have continued issues with oversupply. Management usually involves some minimal pumping (as to not overstimulate production), cold packs, over the counter pain medication and time. It is possible to make the oversupply worse by pumping after the baby eats. Removing the extra milk tells the body it should continue to make more milk and can lead to a vicious cycle of overproduction  That said, one should always be cautious when decreasing supply, as it could lead to low supply and poor weight gain in baby. Consult a lactation professional if you have concerns about your milk supply.

Here are some suggestions for preventing feeding problems for baby:

  • Try pumping for a few minutes before putting the baby to breast. This may help decrease the amount available and slow the initial milk flow.

  • Position the baby at the breast so baby is side lying with his head higher than hips. This makes it easier for baby to manage the flow.

  • Another tip that works well when moms have oversupply is to pace the feeding. When the baby is gulping and/or starting to get overwhelmed with the amount of milk available, break the latch by putting a finger in the corner of the baby's mouth. This gives baby a break. If milk is still flowing, use a burp cloth or something else to catch the milk as it sprays. Once the baby is recovered and milk spray stops, baby can go back to the breast. Working with an Internationally Board Certified Lactation Consultant (IBCLC) can help you create a plan specific to your needs.

Extra milk

If you have oversupply, you may end up with extra milk in your freezer. If you have more milk than your baby needs right now, you have a few options. If milk has been stored according to guidelines it can be given to the baby or child in a bottle or cup as they get older. Moms that have a large surplus may choose to donate their extra breastmilk. I would recommend a HMBANA milk bank or an organized local milk sharing group that screens donors. The closest location HMBANA milk bank to Wisconsin is the Mothers' Milk Bank of the Western Great Lakes and they have drop off locations throughout Wisconsin.  The Mothers' Milk Alliance is in the Madison area and is a milk sharing group that screen their donors. After a thorough history and screening intake, the milk is made available to babies with medical challenges.