Oversupply: Tips for Engorgement and Making Too Much Milk

As nursing mamas, we often hear what to do to boost milk supply. But what if we produce too much milk? It may sound like a luxury to have, but, believe me, oversupply can be extremely frustrating for everyone involved. I experienced it with both of my babies and it took me some time to learn how to handle it. In this post, I’ll share some ways to handle engorgement and oversupply.

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Difference between engorged and fullness

Sometimes with oversupply, you are also going to deal with engorgement. Engorged breasts are painful and usually occur shortly after birth and subside within 5 days postpartum. If they continue, this is probably more breast “fullness” than engorgement, which is an inflammatory response that occurs with the onset of nursing. Either way, we’ll talk about some measures to help ease the discomfort of engorged breasts and oversupply in this post.

Main issues with oversupply and engorgement

While certainly not pleasant, issues related to oversupply and engorgement can usually resolve in the first few weeks to months of having your baby. The two most problematic consequences include:

Foremilk and hindmilk imbalance

Having too much breast milk can result in baby consuming too much foremilk and not enough hindmilk. Foremilk is the thin, watery, and lactose-rich component of breast milk that is great for hydration and quick energy. Hindmilk is the creamy and fat-rich part of breast milk that provides nourishment, satiety, and contentment. It’s vital that baby gets a balance of both parts of milk to ensure optimal digestion and assimilation (not to mention a happy baby).

Breastfed babies who receive too much foremilk suffer with excess gas (thinking farting, lots of belching, hiccups, etc.), hunger and even colic. That’s because the foremilk can digest too quickly, without the fat of hindmilk to slow it down, resulting in malabsorption and intestinal distress, not to mention frequent feeding (and sore breasts!) since the milk isn’t as satiating. You can massage the breast during a feeding can also help mix up the milk so baby gets a more balanced feed.

Too fast or overactive letdown

And hand in hand with oversupply is often too fast of a letdown, which is often referred to as overactive letdown. Signs of fast letdown include baby choking, coughing, or pulling back at breast. Baby may also squeal, squeak, or gulping excessively while nursing because the breast milk is coming out too fast. For strategies for how to manage overactive letdown, see this post. Overactive letdown doesn’t always occur with too much milk (or oversupply) and vice versa. They each have their own set of issues and solutions. This post will focus on those who struggle with oversupply and engorgement.

Please note: the below suggestions would only be appropriate if your baby is gaining weight at a normal to above average rate.

Oversupply and engorgement suggestions

1. Give it time

Know that your oversupply is partly by design. In fact, most mamas have some degree of oversupply in the first 4-6 weeks postpartum to be sure baby has enough milk and there aren’t twins to feed. Coupled with this, most babies have an immature digestive system, are still learning how to extract milk effectively and usually have some sort of acid reflux.

As a result, we see babies struggling regardless of how much milk you have (or how fast your letdown is) because they are learning how to assimilate food outside of the womb. Take warm baths to soothe your engorged breasts and try to ride it out those first several weeks if you can. Many moms who struggle with engorgement and oversupply will self-regulate without any further action.  

2. Block feedings

Since milk production is generally based on a supply and demand loop, meaning the more you stimulate the breast, the more milk it will produce, you may want to offer just one breast per feeding. This tactic is called Block Feeding.

I remember thinking this would never work and I would get too engorged in the other breast, but I was wrong. While there were a few days of discomfort, my breasts quickly adjusted and this is how I ended up nursing Griffin throughout our entire breastfeeding relationship. For mom’s with severe oversupply issues, you can even offer that same breast for the next feeding and then offer the second breast five to ten minutes later. That way you can be sure baby will get all of the good hind milk, and it will probably be a more pleasant nursing experience, since the milk letdown won’t be as rapid as the breast empties.

You can also try massaging the breast during a feeding can also help mix up the milk so baby gets a more balanced feed. Block feeding will also help to regulate your overall milk production, since you’re not stimulating both breasts at each feeding. Be sure to work with a Lactation Consultant to decide if block feeding is right for you, and if you are in fact, dealing with oversupply.

3. Laid back breastfeeding

Also called biological nurturing, this often overlooked breastfeeding position is great for babies and mamas who are struggling with oversupply (and the digestive distress it can cause). When baby nurses from above the breast (lying tummy to tummy on a reclining mama) he is able to deal with overactive let down much better, since gravity is on his side.

Also, because fat floats he is more likely to get a balance of foremilk and hindmilk, stopping the cycle of oversupply. Here are some tips on how to do laid back breastfeeding from the La Leche League international website:

  1. Dress yourself and your baby as you choose.
  2. Find a bed or couch where you can lean back and be well supported— not flat, but comfortably leaning back so that when you put your baby on your chest, gravity will keep him in position with his body molded to yours.
  3. Have your head and shoulders well supported. Let your baby’s whole front touch your whole front.
  4. Since you’re leaning back, you don’t have a lap, so your baby can rest on you in any position you like. Just make sure her whole front is against you.
  5. Let your baby’s cheek rest somewhere near your bare breast.
  6. Help her as much as you like; help her do what she’s trying to do. You’re a team.
  7. Hold your breast or not, as you like.
  8. Relax and enjoy each other.

4. Avoid galactagogues

Say what?! A galactagogue is a food that promotes lactation in breastfeeding moms. Examples include: oats, brewer’s yeast, flaxseed, hummus, papaya, spinach, carrots, asparagus, salmon, and apricots. Lactation-promoting herbs include: roasted dandelion root, fenugreek, blessed thistle, and red raspberry leaf. Try to avoid heavy consumption of these foods and definitely avoid the herbs if you want to keep from making too much milk. And while my lactation cookies are delicious, keep them off the menu 🙂

5. Consider donating

If you have a large milk supply beyond the 6-8 week mark, consider donating your excess milk. You can pump once or multiple times a day, depending on what works for you and how much you enjoy pumping ;), and set this milk aside for a baby in need. This is such a tremendous service you’re giving another mama and baby. I’ve donated milk before and it’s such an amazing feeling! Check out Eats on Feets or Human Milk for Human Babies for donation needs and locations. Of course, for working moms, you can also pump and store your excess milk in your freezer for your own baby. Here’s a post all about pumping and storing breast milk. Both donating and storing extra is one of the blessings of oversupply.

6. Use cold compresses

Cold compresses help to reduce breast inflammation, blood flow and milk production. Start with 10 minutes on each breast and work up to 30 if needed. Always take at least an hour break between compresses. This should help ease the pain of full or engorged breasts.

7. Slight hand expression

If you don’t want to donate milk, do not pump within those first 4-6 weeks as this will only increase your supply. If your breasts are so engorged and the inflammation is painful, you can get in a warm shower and hand express a little bit of milk to offer relief. Obviously, you don’t want to expel a lot of milk as this will only set yourself up for more production. However, using hand expressing strategically can be a great aid when you’re struggling with oversupply and engorgement.

8. Try this sage advice (with caution)

If it’s really bad… and you need to relief… you can try adding more sage to your cooked foods or even sage tea. Due to naturally occurring estrogen, sage helps to reduce milk production. Use very cautiously though, and definitely under the care of a lactation consultant or doctor. In addition, you can use cold cabbage leaf compresses, a natural remedy used to ease tender, engorged breasts for centuries. You simply take green cabbage leaves and store in refrigerator or freezer so they are nice and cool. Apply to breast for 20 minutes up to 3 times a day. Again, only do this under the supervision of a IBCLC, as this can reduce breast milk supply.

9. Get help

This goes without saying and really should be the first action step. There are so many great resources out there so no need to struggle alone! I always recommend a check up with a properly certified lactation consultant (and have done so myself with both of my kiddos.) They are worth their weight in gold and give you hands-on help with oversupply/too fast of letdown issues. You can find one in your area here. Additionally, consider attending a local La Leche or Breastfeeding USA meeting. These organizations are helping nursing mamas for decades…. and they’re FREE!

It will pass…

While oversupply is certainly uncomfortable, it definitely can be a gift. The important thing is to give your body, boobs and baby time to adjust to breastfeeding. Trust the process; get help; and use some of the above aids and you should be able to ride through the issue of engorgement, breast fullness and oversupply.

When I was feeling frustrated, it helped to remember how beneficial breastfeeding is and know that it’s hard for nearly everyone for those first 6-8 weeks. By 3 months, you’ll be getting into the swing of things and by 6 months, you and your baby will be pros. Hang in there, mama! You’re doing great 🙂 and this too shall pass.

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24 Comments

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  1. Wow, really useful. My son is just give weeks and I noticed I have an oversupply. But while reading I discovered much little mistake. I do pump and store hoping it would be better only to find it bigger than before few hours later. Thanks for this article. You’re the best.

  2. Thank you so much for this article. You have given me hope! I am suffering quite bad from engorgement everyday and night to the point i cant move my arms (breasts swollen and painful to even under armpit) and i feel like giving up bf altogether. My baby is 7 days old today and is tongue tie… that reaaally doesnt help!! But, your advice, at least about riding it out is very plausible. I will buy cabbage today! Im bookmarking this page 🙂

    Thank you xx

  3. You mention to only use these tips if LO is gaining weight normally or above average. What do you recommend if they are NOT gaining weight? My daughter was born 7 lbs 3 oz and dropped to 6lbs 7 oz within a few days. Now at 3 weeks, she is still 6 lbs 11 oz (hasn’t gained any weight in over a week). Feeding always seems to be battle, she is almost always hungry, but chokes often and pulls away after 10 minutes or so. She spits up a lot and seems to have a lot of tummy trouble. She has a great latch (when she will take the breast), changing my diet hasn’t helped, and I always have more milk to give, over supply is the first thing that has made sense, but I don’t know how to solve it for her. Have thought about feeding expressed milk, but don’t want to make the problem worse by pumping. Please help, I feel like I’m watching my little girl starve.

    • I would pump out a few ounces first, then offer her the breast. This will solve 2 problems: first, she will get more calories from the richer hind milk, 2, the let down gets less severe the more empty you are.

      • Also, this will make her less gassy and have less digestive problems because she will be getting more than just the foremilk, which causes digestion distress, which is all she was getting the first 10 minutes. 3 problems fixed!

  4. Breast massage and Healthy nursing tea are the two ways I used for boosting my low breast milk production and got my milk supply increased so that I can exclusively breastfeed my little one.

  5. Any tips on how to wean with oversupply, besides the typical advice of doing it slowly? No duh. My babe is 2 and a half and I think I am more scared for myself to wean rather than him. I struggled for over 4 months with extreme oversupply and reoccurring plugs/mastitis and eventually abscess. It got better but I am so scares it will happen all over again as we try to wean. :/

    • I know doing it slowly seems like a no-brainer, but doing it reeeaaallly slowly might be the best way to go. Try dropping 1 feed no more than every three days.

      • I mean no LESS than every 3 days. 🙂

    • Try taking enzymes to help with clogged ducts. I use high potency body ecology enzymes and haven’t had a clog since!

  6. Very helpful indeed

  7. Please help. It’s been a month and I am suffering with such pain. I want to keep breastfeeding but I’m not sure I can keep doing this. My breasts refill and become engorged and painful after every feeding. I try ice packs and hand expressing little amounts for comfort. I don’t pump, I do the laid back position so baby won’t get frustrated with too much milk. It’s not getting better. Everyone keeps saying give it time it will get better. But it’s not. Some days seem worse. I mentioned cabbage leaves to my LC but she’s worried that will dry me up too much. I’ve already had mastitis and i fear I’m going to have it again.

    • Look up reverse pressure softening. I only did this a few times and only a few minutes prior to feeding in order to facilitate a latch. My LO is also lip tied. Apparently some engorgement is related to IV and oxytocin.

    • Block feed! It’s the only that saved me, in the begining I stayed on each breast multiple times, so that there was more like 4-6 hours in between before I went back to the same breast. Does that make sense? Example: right breast whenever baby is hungry and don’t switch to the left until the right has been completely emptied then switch and do the same. This was the only thing that helped me, cabbage did nothing. Once you get mastitis you are more susceptible to getting it again, not to mention everything you have to do to get rid of mastitis encourages more oversupply. Vicious cycle. Trust your instincts rather than purely what the lactation consultant says.

  8. To increase breast milk, healthy nursing tea by secrets of tea is the perfect solution.

  9. If you tandem nurse (nursing 2 babies or 1 infant and 1 older one), it can cause oversupply. I experienced that for quite a while – it’ll pass. And donating milk is a great option. I know you feel like a machine, but you will make it through. It was 8 months of craziness oversupply issues, but ended up blessing tons of people with thousands of ounces of milk. Hang in there, moms!

  10. You should NOT pump if you have an oversupply. That only makes it worse!

    Also, block feeding DID give me mastitis. If you start feeling heavy fullness or definitely pain in the other side, stop block feeding and NURSE! Also, wear a very loose bra.

  11. There’s also a connection between tongue/lip ties and thyroiditis! Thanks for this helpful post!

  12. Oh, this topic just makes me mad! Because with my first four babies, I was so engorged within 2 days that there was nothing for the baby to latch onto. All the breast feeding nazis kept telling me that if I would just get a clue and persuade the baby to latch properly, I’d not be blistered. But when you are swollen to the point of having the shape of a cantaloupe, there is nothing for the baby to get hold of!

    They kept telling me to pump to reduce the engorgement before I nursed the baby, as though that would soften it up enough. But it did not. They stayed rock hard. They were just as hard after the baby nursed as they were when the baby started in.

    You see, the thing that they never understood, nor admitted, is that I wasn’t really engorged. Not in the way you think of engorgement in being full of milk. There was actually VERY LITTLE milk in there!

    It is just that my milk came in so fast that the milk ducts ended up stretched, and that caused edema in my breasts. It wasn’t the ducts that were full, causing the hardness, it was the tissues between and around them that was swollen and bruised. My boobs stood out like I’d invested in quite a bit of silicone, I did not even need a bra for support they were so perky! But the nipple also swelled and stretched so that the baby could not latch on. It was like trying to get a baby to latch onto an egg – so swollen that everything was just round.

    After quite a bit of effort with each nursing, the baby would manage finally to reduce the edema enough to at least feed, but it was extraordinarily painful, and the fluid refilled all the tissue as soon as I was done nursing. It generally lasted about three weeks. Three whole weeks of kicking my feet and trying not to cry every time the baby nursed.

    Four children with that. Another three with about half of that. And twice when my milk came in, and there was no baby to relieve it. When I’d have gladly endured the pain and kicked my feet and bit my lip to keep from crying from that pain, rather than cry from the loss of those cherished little girls.

    Nipple shields were useless – they just put another layer of something to rub between baby and me. Ointments, teabags, drying out, all that, never helped. There was nothing to do but endure, while the engorgement persisted for two weeks, and then another week for the blisters and bleeding scabs to heal.

    I WISH I had the answer to this. The only answer I came up with was this:

    With the babies I had that nursed within an hour or two of birth, I had LESS engorgement than I did with those that did not nurse for a few hours after birth. And the WORST one, was the one that was born with a bowel problem, and I pumped some before she came home, but my milk barely came in (it just did not let down for the pump). Then when she began nursing full time, it came in with a bang, and was worse than with any of the others. SOOOO bad. I layed on my back in bed and cried because it hurt when she wasn’t nursing too.

    That is the only thing I figured out. Prevention where possible, because when the baby nurses soon, the milk comes in more gradually. If the baby waits, it seems to come in more suddenly, and cause more edema. I didn’t always have control over WHEN they nursed after birth, my labors and deliveries were not exactly normal.

    With the three that I was able to nurse soon after birth, there was far less engorgement. I still had edema, and was still sore. I still got blisters, but one or two, and not covered in them. No bleeding scabs. And it was over with in about a week and a half.

    Yeah… it was bad. But truthfully, I’d do it again if that is the price for giving a baby all that is best.

    • I’m sooo sorry for your losses….been there.

    • I know this post is a little old but I am having the same problem, Laura. Did you have to go to a Dr for the edema? I am in so so much pain and am only 3 days Post partum. The lactation consultant I giving me all these tips to relieve it but nothing is helping. I don’t want to develop mastitis and am worried I will get infected. Poor baby boy can’t nurse but even when he does my breasts don’t feel any better.

      • This happened with my first baby & I am having the same problem now, only my baby is 6 days old. I am on day 3 of severe pain in breasts & each day has gotten more painful.
        It’s very hard to sleep or relax.

        I was told to pump until breast felt soft but after pumping, hand expressing, or nursing they swell up & harden just as bad with no relief. My milk comes out easily & quickly. My baby has acid reflux & chokes a lot while nursing, burps a lot afterwards, winces, spits up large amounts & cries in pain a lot. She latches on well though.

        This same thing happened with my first child. (This is my 3rd) I had so many blisters, scabs, & raw nipples for months. I’m so nervous it will be that bad again as they are already so hard, lumpy, & painful!!

        Any good advice would be so helpful! I hope others with this problem can find answers as well!

        • With my first it was constant engorgement every 3-5 days for the first 2 months. With my 2nd it was under control in 2 weeks.

          I pumped each side till fully empty either right before or right after nursing on that side. I drank sage tea. And I did block feeding. I ended up having to go almost 24 hours on one side and then 20 on the other before they regulated. When they were too hard I also soaked and massaged/hand expressed milk with either olive oil or inserted in a bowl of warm water till they were softened enough for baby to drink. After nursing I used cold compresses (frozen bags of peas) to relieve pain and swelling.

  13. Hey Genevieve.

    I had this issue in the beginning and it could have very well been from those foods, I ate them quite frequently!
    Now almost a year breastfeeding I still leak from time to time… I was wondering if leakage ever goes away! I would love to go bra-less or at least without breastpads …. Any tips???!

    Thanks.

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