Too Much Breast Milk

Last time we talked about increasing your milk supply. I want to emphasize that most women, if they are not over-pumping, will have as much milk as their baby needs. Some women however, will have more milk than their baby needs. Much more. This can present its own set of challenges.

This situation is referred to by different terms, such as over-abundant milk supply, or hyperlactation. It all means the same thing. You have more milk than your baby needs, and it causes a problem.

“Causes a problem” is the key phrase there. Some women have tons of milk and it doesn’t present any kind of problem. Their baby is happy, they aren’t uncomfortable, and everyone lives happily. If this is you, you really don’t have to read this whole article. Just jump down to see what I’ll be writing about next time, and come back and read that article.

Symptoms of Too Much Breast Milk

If you are wondering if the problems you are having might be caused by too much breast milk, keep reading. Over-supply is typically associated with these indications:

• Your baby is fussy and gassy 
• Your baby arches or pushes off the breast, especially with let-down
• Your baby chokes and sputters during the feeding
• Your baby clamps down on the breast (this slows the flow down)
• Your baby clicks when breastfeeding (baby is releasing suction to slow the flow down, and is not a problem if it is the only symptom)
• Your baby spits up very large amounts of milk
• Your baby cries right after feeding
• Your baby has green stools, that may be foamy looking
• Your baby may have poor weight gain
• Your baby may develop breast aversion
• You feel uncomfortably full or engorged often, or possibly all of the time
• You have frequent plugged ducts
• Possibly repeated cases of mastitis

For the list of symptoms in your baby, it is only a problem if your baby is unhappy. If a baby has green stools, is happy and gaining weight, and that is the only symptom, there is no problem, .

Confirming Too Much Breast Milk

If you think you have too much breast milk, it is best to see a lactation consultant to verify it. I know this is a repeated chorus for me, but I have seen people try to diagnose themselves and it has been the opposite problem, or another problem altogether. I have also seen lactation consultants try to diagnose this type of thing over the phone and it has been something else entirely. It’s not unusual for over-supply and reflux to be confused with each other. I’ve also seen a lactation consultant speak briefly with a mom and say, “try block feeding,” and because they didn’t have the whole picture, the recommendation for block feeding wasn’t specific enough, and it didn’t work. I worked with one mom who did block feeding and when she started she had to keep giving the baby the same side every time the baby wanted to eat for 8 hours. This is an extreme case, but I knew the whole story, and after some experimentation, we came to the conclusion that this was how long she needed to go. I needed to get her whole history, watch a feeding, and have her pump, to come up with an accurate diagnosis. The I had to work closely with her for several weeks to see what happened, and adjust her treatment plan when it was needed. It was a difficult time while she down-regulated her supply, but then she and her daughter went on to have a very long and happy nursing relationship.

How To Deal With Too Much Breast Milk

Many moms who have an oversupply, pump a lot to deal with the extra milk. As I discussed in my last post, this can exacerbate the problem. Some moms have a mild oversupply, and don’t mind pumping once or twice a day to deal with it. They may want to get a big stash of milk in their freezer in preparation for going back to work, or just because they are reassured by having that stash. Possibly, they may want to pump and donate to a Milk Bank. We are thankful to all those moms who do!

If an oversupply is bothering you, read on for some ways to decrease your milk supply:

How to Decrease Milk Supply

• The first thing I recommend is to decrease frequent pumping
  • If you start leaving enough milk in your breasts, it will tell your body to stop making so much
  • If you are pumping until your breasts are throughly drained, you are actually telling your breasts to make more milk
  • If you leave a little bit of milk in your breasts, they will make the same amount
  • If you leave more than a little milk in your breasts, they will decrease how much milk they are making
  • You may be slightly uncomfortable as this happens. Ice packs can help
  • If you have been pumping a lot, you may feel very uncomfortable and need to continue pumping, but not removing as much milk when you do pump will probably work best for you. I recommend pumping 1-2 oz. less milk than you have been. Put a piece of tape on the bottles so you can see when to stop. After your body adjusts to that amount, then decrease by 1-2 oz. again, and repeat this routine until you don’t need to pump anymore
• Peppermint is very effective to reduce milk supply. Start with one cup of plain peppermint tea a day. Wait for about a week, and then increase by a cup each week as needed. Peppermint candies work also
• Sage, either as a tea, in food or in a smoothie, or taken as a supplement, also will decrease milk supply
• Pseudoephedrine can decrease milk supply
• Birth control pills can decrease milk supply

Those last two should only be attempted with professional supervision

If You End Up With Not Enough Breast Milk

A common question I get is, what if I decrease it too much, and then don’t have enough? This is one reason I don’t recommend trying any of these things until your milk supply is established. It takes about 4-6 weeks to establish a milk supply. After that, your breasts will increase and decrease according to what you tell them to do. They do this by how much milk you are removing or leaving in your breasts. Therefore, if you start telling them to make more milk by more frequent stimulation, or more thorough draining, your breasts will respond by making more milk.

Photo credit: Alessandro 😉 via VisualHunt.com / CC BY-SA

Insurance Pumping – Good or Bad?

Sometimes in the very early days, I will recommend that a mom do some insurance pumping to help establish a good milk supply. An example of when I would do this is if she has a smaller baby, one under 6# 8oz is the cut-off I use. I recommend she pump after 4-6 feedings every 24 hours. Some moms are afraid if they pump then they will end of with too much milk. I tell them that there is also the risk that they might end up with not enough milk if they don’t pump, and too much milk is an easier problem to resolve. If a lactation consultant has told you to do some extra pumping, and someone else tells you to stop, you might go back to the first lactation consultant and ask why she gave the advice she did, if she still thinks it is appropriate and how long she thinks you should do it.

Reasons for Insurance Pumping When Baby is Feeding Well

• Small baby
• Late preterm baby
• History of breast surgery
• History of low supply
• Excessive blood loss
• Supplementing baby

One Last Thought

When I think about oversupply, I remember a mom I met at the gym I used to go to. She said she breastfed her first baby without problems, but had to stop early with her second, because she got mastitis and the milk made her baby sick. With some gently asked questions from me, I realized she had probably been overproducing, which may have been why she got mastitis and almost certainly was why her baby was so unhappy and spitting up so much. I explained this to her. It had been 15 years, but I could see the relief spread over her face, realizing that her milk hadn’t “made her baby sick.” She told me that it made her feel so much better to know that.

Don’t let someone tell you that you are lucky to have so much milk, if it is causing problems. There are things you can do to help your situation.