Oversupply & Overactive Letdown

Many mothers jump to the conclusion that they don’t have enough milk, their milk is not “good enough,” or that their baby may be allergic to something they’re eating. Often, quite the opposite is true. A common and oft overlooked problem is oversupply or overactive letdown. This is when you simply have too much milk! Don’t worry, we can fix it.

 

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Signs of oversupply

  • baby pulls off of the breast repeatedly
  • baby seems fussy at the breast, arching his back, twisting, stopping and whining
  • baby spits up frequently and needs lots of burping
  • baby gulps or “chokes” at letdown
  • stools are green, frothy, or mucousy

Why is oversupply a problem?

Oversupply for some babies is simply the dynamic of milk shooting into their mouth at full force at every meal. As a child, did you ever put your mouth over the end of a garden hose pouring water? Same concept.

The rest of the issue has to do with the composition of the milk he is drinking. Many mothers are told that they have “too much” foremilk and that they need to eat more fats or get more calories into their diets. In fact, your body only makes one kind of milk. This is the illustration I use:

When a farmer milks a cow, all the milk goes into one container. If that container is allowed to sit for a while, all the cream rises to the top. The cream is full of the milkfat. The milkfat separates from the less fatty milk. If a spigot were attached to the bottom of the container, a glass of milk would contain only skim milk unless the jar was mixed up.

Basically, your cream is rising to the top. What we want to do is keep the fattier milk mixed with the skim.

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What do I do?

  • Laid-back nursing. Try leaning back with baby on your chest when nursing to reduce the force with which your milk pours forth.
  • Let down into a cloth or bottle, then reattach baby when the flow has slowed.
  • Try a different position, preferably one where baby has control of the amount of milk entering his mouth, such as side-lying or straddling.
  • Nurse on only one side each time. This allows baby to finish the breast and get to “dessert”… the fatty milk that has risen in the milk ducts.
  • Discuss block feeding with your IBCLC. Block feeding is nursing on one side for more than one nursing session. Experiment to find how long works for you. This could mean anything from twice in a row to 4-5 hours. Remember to let baby have a sip from the unused side, or pump enough to relieve pressure, so that you don’t end up with a plugged duct.

Galactagogues (Supply Boosters)

A galactagogue is a substance that increases milk supply. There are herbal galactagogues, like fenugreek, and prescription medications. Before you decide to use a galactagogue, ask yourself why you think you need to.

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  • Do you think your supply is low? Many women think they have low supply when really their supply is perfectly fine. Babies — especially newborns — nurse often; they nurse for long periods of time, they enjoy comfort nursing, and they nurse for everything (not just food). As long as baby is having plenty of wet and dirty diapers, is gaining weight, and is happy, there’s no supply issue to worry about.
  • Click here to read about what to expect in the early weeks of breastfeeding  http://kellymom.com/bf/normal/newborn-nursing/.
  • If your baby isn’t having adequate output, isn’t gaining weight, and isn’t happy, you should see a lactation professional for an in-person evaluation.
  • Click here to find an IBCLC in your area http://www.ilca.org/why-ibclc/falc.
  • Click here to find a LLL leader or group near you http://www.llli.org/webindex.html.
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The average mother does NOT need galactagogues to increase her supply. Here are some examples of situations when galactagogue use may be helpful:
  • Some working mothers use herbs to increase their pumping output, even though their supply is fine when baby nurses.
  • Some mothers with a genuinely low milk supply use galactagogues in combination with increased nursing/pumping to increase supply.
  • Adoptive moms may use galactagogues to increase the amount of milk they are able to provide for their babies.
Using galactogogues can often be, at best, a bandage, covering up the actual problem, which doesn’t get resolved and may cause problems in the long run.
  • Galactogogues may cause side effects for mother, baby, or both.
  • The quality and quantity of herbal preparations is not consistent.
  • Galactogogues cost money and time.
  • Suggesting galactogogues reinforces the notion that breastfeeding requires special stuff in order to work.
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The usual, non-herbal, non-medication methods for increasing milk supply are sufficient for most mothers. Click here to read more about Increasing Milk Supply without galactagogues.
If the usual methods have not proven sufficient and you feel that a galactagogue is needed, keep these things in mind:
  • Remember that any galactagogue will be most effective in increasing milk supply when combined with increased breastfeeding frequency and milk removal.
  • Some types of galactagogues work better in particular situations and not in others. You should be working with someone who is knowledgable in their use.
  • All of these galactagogues, whether herbal or prescription medication, have potential side effects and drug interactions that must be considered for each individual mother. You should talk to your health care provider and/or a knowledgable herbalist about whether a particular galactagogue is safe for you.

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