While, to people who haven’t experienced it, having too much milk doesn’t sound like a huge problem, oversupply and overactive let-down can lead to a variety of problems for both the mother and her breastfeeding baby.
Fortunately there are some things you can do to manage the problems, should one or both of them happen to you.
Oversupply and overactive, or forceful let-down are often seen together because, when you have excessive milk, it’s common for it to flow very fast. The most common symptoms of a forceful let-down are easy to spot, simply by observing your baby’s behaviour. If your baby frequently pulls off the breast while feeding (often getting a face full of milk in the process!), coughs or chokes uncomfortably, it could be that the flow of your milk is overwhelming her. At its worst, an overactive let-down could cause a nursing strike, so it’s important to identify the problem and try to manage it.
Sometimes there are no apparent causes for oversupply or overactive let-down, but it can be caused or aggravated by excessive pumping. If you have oversupply, you can feel quite engorged and a quick way to relieve the feeling is by pumping. Unfortunately, however, by doing this too often you are telling your body to produce more milk and the oversupply can worsen.
Overactive let-down can cause babies to take in large quantities of air while they’re feeding, which can cause gas, reflux or colic symptoms, making your baby feel uncomfortable. Gripe water may help with these symptoms and most babies do learn to cope with a forceful let-down in time, meaning these symptoms usually diminish. A tell-tale sign that your baby is taking in air while she’s feeding is a clicking sound during nursing.
A simple way to help your baby feed more comfortably if you have a forceful let-down is to have a muslin cloth by you when you feed and, following let-down, let the excess milk spray into the cloth before returning your baby to the breast. You could also try holding your baby in a more upright position for feeding, as this can help to slow the flow of milk. More extreme techniques, such as pumping before a feed, should be used with caution as pumping can increase your supply, possibly compounding the problem in the longer term.
A consequence of oversupply can be the baby not getting enough hind milk. This can lead to slow growth and again, a gassy, irritable baby. A common symptom of fore/hind milk imbalance is explosive poos which may be frothy and/or green. As a mother with oversupply, you could find your breasts leak frequently and you may also feel engorged from time to time.
It’s important to note that before trying to reduce an oversupply, you should ideally see a lactation consultant or attend a breastfeeding support group to verify that you indeed have a genuine oversupply. You will be given advice on how to manage oversupply safely.