Oversupply & Forceful Letdown


Managing Oversupply

As a lactation consultant I sometimes get calls from moms who are struggling with an overabundance of milk. For some moms (especially those struggling with low milk production), having too much milk may sound like nothing to complain about, however an oversupply of milk can be troublesome. It often leads to a mom who is uncomfortable and at an increased risk of blocked ducts and mastitis, and a fussy baby who is being overwhelmed with milk.

When I do get calls about possible oversupply of milk, the first thing I do is figure out if that really is the problem. Sometimes babies will come off the breast choking and mom will be spraying milk everywhere due to having a forceful letdown. Moms with oversupply usually have a forceful letdown due to the sheer volume of milk, but the reverse is not always true. If you have a forceful letdown, it doesn’t automatically mean that you have an oversupply of milk. Moms with an oversupply are frequently engorged and uncomfortable, may have frequent blocked ducts or repeated episodes of mastitis, and their babies may be fussy, and experiencing poop that is green and frothy looking. It’s important to make sure oversupply really is an issue before making any changes to lower milk production.

If you are struggling with oversupply, it is always a good idea to speak to your doctor about having your thyroid levels tested. Thyroid issues are common in postpartum women and they can sometimes contribute to oversupply.

Many women who are having issues with oversupply use block feeding (keeping baby on the same side for several feedings in a row) which is the most common method of dealing with the issue. I prefer to start with a method of switch nursing that I learned about from Joan Fisher. Joan is an IBCLC in Ottawa Ontario who has been working with breastfeeding moms and babies for over twenty years.

With block feeding, mom is going for long periods of time with no stimulation to one breast. I’ve heard of some women going 8-12 hours on one side! The breast that is not being used gets full and uncomfortable (putting mom at risk for blocked ducts and mastitis)  and when baby does eventually feed on that side, they are overwhelmed with milk as the breast is so full. Because the breast is so full, this milk is also low in fat (the emptier the breast the higher the fat content of the milk). Block feeding in women with oversupply can eventually lead to low milk production because the breasts aren’t getting enough stimulation.

With Joan’s method, mom switches sides frequently during one feeding. An easy way to approach it is to switch sides halfway through the feeding (although you can switch sides more frequently if that works better for you and your baby). So if baby normally feeds on one side for 10 minutes, mom would switch to the other breast at 5 minutes (this is the only time that I would recommend that moms watch the clock!). If baby normally feeds for 5 minutes on one breast, then switch breasts at 2.5 minutes (if baby wants to keep nursing past the usual number of minutes mom can keep baby on that side or switch again). By using this method of switch nursing, both breasts are still getting stimulation, but they are also getting the message to slow milk production down a bit because there is milk left over in the breasts. Mom stays comfortable, and the reduction in milk production is gradual and even. Using this method you may have a day or two of a fussy baby (and continued green poop if that was a problem initially) as your body adjusts, but the method does work, and it eliminates the risk of eventual low supply.

Although this is the method I recommend first, that’s not to say that it is the one and only method for all moms. For some moms, simply keeping baby on one side per feed or block feeding for short periods of time will work without any problem. This method is another “tool in the toolbox” that I have found to be very effective and usually more comfortable for both mom and baby. If you are concerned that you may have an oversupply of milk, please talk to an International Board Certified Lactation Consultant (IBCLC) to determine the best plan of care for you and your baby.


Links to Additional Information:

Understanding Oversupply by Diana Cassar-Uhl

Overabundant milk supply: an alternative way to intervene by full drainage and block feeding by Caroline GA van Veldhuizen-Staas

Forceful Let-down (Milk Ejection Reflex) & Oversupply from Kellymom