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.
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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:
- Dress yourself and your baby as you choose.
- 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.
- Have your head and shoulders well supported. Let your baby’s whole front touch your whole front.
- 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.
- Let your baby’s cheek rest somewhere near your bare breast.
- Help her as much as you like; help her do what she’s trying to do. You’re a team.
- Hold your breast or not, as you like.
- 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. Gua sha
When paired with proper breastfeeding techniques, studies suggest Gua Sha reduces engorgement and discomfort in the immediate postpartum period better than massage and hot packs do.
9. 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.
10. 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.
Get a printable cheat sheet on Oversupply: Tips for Engorgement and Making Too Much Milk.
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Oversupply Tips for Engorgement and Making Too Much Milk Cheat Sheet