Is Too Much Milk Bad For A New Born? by Michelle Roth, IBCLC
Too Much Milk Part 1: Oversupply
Your baby is growing well – in fact, he’s huge for being just a couple months old. And your breasts are plenty full – they leak all the time, and milk sprays all over the place at the slightest let-down. But breastfeeding isn’t any fun. Your baby chokes and sputters, then arches away from you and finishes his feeding in minutes. But he wants to nurse again in an hour. You’re worried about whether or not he could be getting enough. It’s confusing because he is having plenty of wet and dirty diapers, though his bowel movements are greenish. Sound familiar? Then you probably have an oversupply of milk.
Sometimes called overabundant milk supply or hyperlactation syndrome, an oversupply of milk is sometimes just as challenging as a low milk supply. Sometimes the symptoms even seem the same – a fussy baby who isn’t satisfied at the breast. Pinpointing the problem while keeping your baby comfortable is a puzzle.
Most of the time, a baby’s hunger drives the milk supply. The more a baby nurses, the more milk the mother’s body makes. Eventually her body adjusts to make just the right amount of milk for that baby. With oversupply, the body makes too much milk independent of baby’s needs.
If a mother has too much milk, she may notice the following behaviors in her baby:
- The baby gulps, chokes, sputters, or coughs while nursing, and milk may leak from the sides of his mouth.
- If the baby releases the breast, milk sprays everywhere. Sometimes the unused breast sprays, too, as the baby nurses.
- It feels as if the baby is biting or “chomping” on the nipple, and the nipple is misshapen after a feeding.
- The baby has a “love-hate” relationship with nursing: he wants to nurse but he holds his body stiffly, sometimes screams when at the breast, comes on and off repeatedly, and often arches away from mom during a feeding. He never wants to nurse just for comfort.
- Nursing sessions may be very short – 5 or 10 minutes – because the baby gets so much so fast, but then he’s hungry again within a short period of time.
- The baby is fussy, irritable, and “colicky.”
- The baby may need to be burped often, may spit up a lot, and may seem gassy and uncomfortable between feedings.
- The baby may have green, watery, foamy, explosive bowel movements.
In addition, a mother’s breasts may be full most of the time, and may leak often. She may have problems with recurrent plugged ducts or bouts of mastitis, or she may be experiencing sore nipples. When each individual symptom is taken on it’s own, it looks like a variety of different issues with different solutions. But when multiple symptoms are happening together, the constellation is called oversupply or overabundant milk supply. The good news is that an overabundant milk supply can be normalized so that feeding at the breast is no longer a struggle. Most of the time, the way a mother is feeding her baby contributes to the problem, so changing the breastfeeding management may help.
- Start by finishing the first breast first. For some mothers, a pattern of scheduled feedings leads to not enough milk being removed from the breast. When the amount of time the baby is allowed to stay on one breast is dictated by the clock, the baby may not take enough milk from the breast, or may take only the more watery milk at the beginning of a feeding (see Too much milk Part 3 for more information). By allowing the baby to completely finish on the breast he starts with, then switching to the opposite breast for as long as the baby dictates, the mother’s supply can begin to even out according to the baby’s needs.
- Get the best latch and positioning. A baby trying to manage an oversupply of milk sometimes needs to be held in a more upright position. In addition, he will often use his tongue and gums to staunch the flow of milk, causing sore nipples for his mother. Working on getting the baby’s mouth wide open and onto the breast in an asymmetrical latch may alleviate the soreness.
- Nurse often. This may sound counterproductive since the body makes more milk the more the breasts are stimulated. But, if your baby signals he is hungry, nurse again even if it’s been only a short time since the last feeding. These more closely spaced feedings will be higher in fat content, and may help if the main issue is an imbalance between foremilk and hindmilk (see Too Much Milk Part 3 for more information).
- Be sure it’s not problem with the baby. Sometimes the inability to handle milk flow stems from a physical problem for the baby, whether from reflux, respiratory problems, sensory integration issues, or from an anomaly such as a cleft in the soft palate or a “tongue tie.” Have the baby fully evaluated before taking any measures to decrease the milk supply
- Try block feeding. Most mothers with oversupply end up doing some sort of “block feeding” to down-regulate their milk supply. Block feeding works because a substance in the milk signals for the body to make less when the breast stays full.
- Feed on only one breast for a certain period of time. Start with three hours – any time the baby is hungry during that period, put him to the same breast. For the next three hours, use the opposite breast. Continue to alternate throughout the day. Most mothers who do this use both breasts at night.
- If the unused breast feels too full, pump or hand express just enough for comfort (usually less than a minute). Do not pump too much or you will signal to your body to make more milk.
- If after several days of block feeding, you do not notice an improvement, extend the “block” by increasing the number of hours one breast is used before switching. Some mothers go as long as 12 hours on one side, then use the other side for the next 12 hours. Add time in increments of one hour.
- If you still have issues, a modified block-feeding schedule may help. Start by pumping both breasts until you no longer see any milk being expressed. Do this about an hour before a feeding. Then feed on one breast for two or three consecutive feedings. When the opposite breast becomes unbearably full, switch to that side for several feedings. You may need to start at the pumping phase more than once per day to minimize the change of plugged ducts. Following this pattern for several days should help, after which time you should no longer need to do the pumping.
- Use cabbage leaves. This may sound like an old wives’ tale for soothing engorged breasts, but cabbage seems to have an effect on milk supply, too. Wash some whole cabbage leaves, remove the hard spine, and place them inside the bra against the breasts. While no research evidence backs this approach, be cautious because it can cause a decrease in supply beyond what you want. One source recommends using the cabbage leaves for only 20 minutes no more than three times per day and stopping as soon as a decrease in supply is noted.
- Use herbal remedies. Sage, jasmine and peppermint can decrease the milk supply, as can a variety of other herbs. If you choose to try one of these remedies, work with a naturopath, homeopath, or herbalist to understand the dosage and duration of treatment.
- Talk to your doctor or lactation consultant about medications. Pseudoephedrine, a common decongestant, can be very drying, and this includes inhibiting the milk supply. Some moms find a single dose before bed is enough, while other mothers use a lower dosage spaced throughout the day. Another drug that may have the effect of slowing milk production is a combined oral contraceptive, meaning “the pill” containing both estrogen and progesterone. Drugs should be a last resort, and should be used under the supervision of a lactation consultant and the baby’s doctor.
As you are working on managing your milk supply, watch the number of wet and dirty diapers your baby is having to be sure he continues to get enough milk. A baby typically has six to eight wet, cloth diapers each day, and at least three bowel movements daily. The number of bowel movements may slow down after the first month or so – some babies only have one huge bowel movement every few days. Also, if you notice a plugged duct, be sure to treat it right away so that it doesn’t develop into an infection.
Most babies “grow into” an oversupply, as well, meaning they get more efficient at handling the excess milk as their bodies grow and all of their systems mature. While milk supply problems are one of the top reasons for weaning, the problem of too much milk can be solved readily so breastfeeding can be an enjoyable part of your parenting journey.
- Bonyata, K. 2011. Too much milk: sage and other herbs for decreasing milk supply. Accessed online at http://kellymom.com/bf/can-i-breastfeed/herbs/herbs-oversupply/.
- Mohrbacher, N. 2010. Breastfeeding answers made simple. Amarillo, TX: Hale Publishing.
- Riordan J & Wambach K. 2010. Breastfeeding and human lactation. Boston: Jones & Bartlett.
- van Veldhuizen-Staas, CGA. 2007. Overabundant milk supply: an alternative way to intervene by full drainage and block feeding. Int Breastfeed J. 2, 11.