Managing Breast Milk Oversupply

Painful, engorged breasts and an unhappy baby – do I have a breast milk oversupply?

While plentiful breast milk is a blessing, an overabundant supply can be uncomfortable, exasperating and downright distressing. Happily, it’s often only temporary, and even when it isn’t, there are steps you can take to manage it.

In today’s blog, midwife, nurse, lactation consultant (IBCLC), and mama of three, Kate Visser, chats with us about dealing with breast milk oversupply. Kate is the founder of Milky Business and offers breastfeeding mamas and postpartum professionals support via consultations, courses, and her online store.

Kate tells us why breast milk oversupply is an issue, how to work out if you have an oversupply, and how to manage it if you do.

Oversupply is simply when you produce more milk than your baby (or babies, if you have multiples) needs. It’s a problem because it can cause breastfeeding complications for babies and issues for mamas, too. 

Having a breast milk oversupply can lead to a fussy or gassy baby who pulls on and off the breast, which is incredibly frustrating for mamas and might result in the baby not getting the ideal balance of milk intake, Kate explains. Mamas who produce too much milk and have it sitting in their breasts for too long can experience pain and discomfort and have an increased risk of mastitis. “As much as we say it’s a great problem to have too much milk, the reality is for mums who have an oversupply, it’s an awful problem to have, and it can be really frustrating and lonely,” Kate says. Oversupply becomes a cyclical issue, and unless we get to the root cause and understand why it’s occurring and how to manage it, it can feel never-ending. 

The good news is that oversupply is often only a temporary problem. Kate explains why.

“In the beginning, we start with very little milk - just small amounts of colostrum. Once we birth our placenta, our milk supply shoots through the roof and stays quite high until our hormones regulate. Our supply is also regulated by our baby feeding well. So, in that period where our body is regulating our milk supply, lots of mums feel that they have an oversupply. They might have full, engorged breasts. What we want to do is try and let our baby regulate that supply and lower it bit by bit over time until it's the perfect amount for our baby. So, delaying that diagnosis of oversupply as long as we possibly can, at least four to six weeks, if not 12 weeks, before we say, “Yes, this is definitely an issue”, is really important. Because a lot of the time our supply will settle down as our hormones settle down and our baby is feeding well.” 

Because many symptoms of breastfeeding complications overlap, Kate says a professional diagnosis of oversupply by a lactation consultant is vital. “It's really important - I can't stress this enough - that mums don't self-diagnose oversupply,” she says. Why? If a mama takes steps to reduce her breast milk supply when it’s actually normal and not overabundant, she runs the risk of the opposite problem – low milk supply. 

Sometimes what seems like oversupply can actually be a case of baby not removing milk from the breast well. Our body is making the milk, but it’s being left behind, causing the same symptoms as oversupply, such as breast engorgement and a strong let-down. Kate says there’s a myriad of reasons why a baby might not be feeding well, and that’s another reason why an assessment with a lactation consultant is so important. They can observe a breastfeed to see how well baby is feeding and carry out an oral assessment to check for problems like tongue or suck-swallow issues. 

Kate says that many new mamas have never seen someone else breastfeed, which makes it hard for them to know what to look for when their turn comes. “A true oversupply is rarer than we think it is, and it doesn't happen very often. There's more often an issue around babies feeding well, and mums really need good support with what a good breastfeed looks like.”

If you suspect you have an oversupply, Kate recommends working one-on-one with a lactation consultant and trying to manage it as simply as possible for as long as you can. “More often than not, it does actually resolve with really simple stuff,” she says. 

• Change your breastfeeding position. Experiment with positions that give more control back to baby, such as a ventral position (when mama leans back and baby is more on top of the breast) or a side-lying position on a bed. 
• Manage your let-down. Sometimes that first let-down has a fire-hydrant-like flow which makes it difficult for baby to feed. Easing that flow by hand expressing a little milk before a breastfeed can help, but avoid expressing any significant volume of milk because it will encourage your body to produce even more. The other problem mamas with oversupply sometimes experience is a lack of let-down because their breasts are so engorged. A very gentle breast massage with a Lactamo ball mimics the stroking action of a baby’s hands and can provide tactile stimulation to encourage a let-down.
• Try feeding your baby when they’re asleep. “Sometimes feeding to sleep or as they're waking up can work well, as they can handle the flow a little bit better.”
• Consider shorter, more frequent feeds. This can sometimes help to regulate breast milk supply. 
• Discuss block feeding with your lactation consultant. Block feeding is feeding off one breast for a specific period of time to reduce breast milk supply. This technique needs to be done in consultation with a lactation consultant. 
• Manage your mastitis risk. One of the risks of oversupply is milk stasis, where milk sits in the breast for an extended period. Mastitis can occur when that milk leaks out of its capsule in the breast and causes inflammation. Gentle breast massage with a Lactamo ball can help to break up the milk and send it in the right direction, mobilise the fatty walls in the glandular tissues and relieve sore spots in the breasts. 
• Think about milk donation. While Kate generally doesn’t recommend pumping for mamas experiencing genuine oversupply (as it encourages the body to make even more milk), she does like to raise awareness of milk donation. “Sometimes mums with oversupply don’t want to risk down-regulating their milk supply, and they’re happy to pump. So, if they’re very strict about when they pump and how much they pump, and not letting it get away from them, they can become incredible milk donors.”  

If in doubt, please always consult your healthcare professional.