Tips and Tricks for Oversupply

It seems as if I’m treading territory that is not well documented with regard to my oversupply of breastmilk.  Everything is trial and error because the how-tos of breastfeeding are not written with oversupply in mind.  Since I’ve seen quite a few oversupply searches land on my page, I figured I’d throw out some things I’ve learned about oversupply while I battle yet another plugged duct that is trying to turn into mastitis.  Most of this is contained in this wonderful article by LLL but I have added my own experience in, as well.

How to AVOID oversupply:

  • Don’t switch breasts too often (i.e. finish the first breast); some moms only ever nurse on one breast per feeding
  • Don’t routinely pump in addition to breastfeeding (thereby creating a demand that is bigger than what your baby actually needs), especially in the early days when you are establishing supply.  If you need relief from engorgement, pump the minimum amount possible to relieve the pressure without emptying the breasts (which sends the signal to make more milk).
  • Know what real undersupply looks like, and don’t be proactive about trying to build your milk supply with supplements (fenugreek, etc.)

What oversupply can look like:

  • Typically starts after 3-6 weeks
  • A fast letdown with spraying milk, many times resulting in baby gulping noisily or even choking during a feed (you’ll want to keep towels handy to mop up milk dribbles)
  • Breasts are engorged often, and leaking is a real problem (washable breast pads won’t do, and you’ll be changing disposables a couple times a day)
  • Baby’s stools are green, runny, explosive, mucousy, and/or foamy and baby is very gassy
  • Baby nurses constantly and is fussy between feedings (this is totally normal during a growth spurt, but if paired with other symptoms on this list or lasting for weeks, you should suspect oversupply.  Baby nurses more often not only because he gets a large portion of foremilk which digests more quickly, but also because he seeks comfort for resulting indigestion.)
  • Baby latches shallowly due to the engorged breast, or chomps down to deal with the heavy flow of milk, resulting in sore nipples
  • Baby latches on and off, fussing at the breast (especially worse in the morning)
  • Baby has an outrageous number of diapers (for the first few months of Jack’s life, we went through 18+ a day)
  • Baby gains a lot of weight rapidly (Jack gained 1.5 lbs within 10 days of leaving the hospital and the weight gain didn’t slow until after he was 6 months old - he was in the 85th percentile for weight)
  • A lack of comfort nursing, or baby gets angry when attempting to comfort nurse (as he can’t help but get milk)

Things not to do if you have oversupply:

  • Don’t take galactogogues or hot showers
  • Don’t pump extra (if you pump at work, try shortening sessions rather than skipping them)
  • Don’t skip feedings or pumping sessions (you will so regret it!)
  • Don’t switch breasts when baby pops off – offer the same breast again (especially if you can squeeze milk out!) and if baby refuses, he’s probably done eating
  • Don’t make sudden schedule changes with pumping or nursing – your breasts may need an especially long time to adjust to less demand
  • Don’t pump when you can nurse directly – the baby is going to be more efficient at getting the milk out, which will result in less plugged ducts

How to handle oversupply:

  • block feed (I only offered one breast for any feedings in a 4-6 hour period, then switched.  If one breast gets too uncomfortable, pump only until letdown to relieve the pressure.)
  • nurse uphill (let gravity help slow the flow of milk)
  • burp frequently (even if baby gets pissed when you unlatch him)
  • unlatch baby when you letdown so that you can catch the overflow of milk in a towel
  • if extreme, use cabbage compresses
  • be prepared for a cranky baby once you get your supply adjusted down, as often they get used to a faster flow (this is when Jack started a semi-strike, right around four months, and it lasted for quite some time)

Anyone have anything to add?

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Comments

  1. Excellent excellent excellent.
    Another symptom I found was she’d eat so much that it’d all come up – because my breast wasn’t empty yet or I was trying to adhere to the both breasts rule and we both just didn’t know any better.

    That’s the big one for me and you hit it off the bat. It took me too long to know that it was OKAY TO ONLY NURSE OFF ONE BREAST PER FEEDING. I yelled that because I don’t want another mother to feel like she’s doing it wrong because that’s what she does. My healthy baby girl nursed off from one breast for no more than 8 minutes and she’s doing great.

    Thanks for this info! Spreading the word is so important in helping other mothers nurse and stay nursing as long as baby needs to.

  2. I should say that she nursed per session for no more than 8 minutes…

  3. That is a great point, B! Jack is the same way – only nurses about 5 minutes on a breast (exceptions being first thing in the morning and going to bed at night).

    We were somehow lucky that Jack did not do a lot of burping up, but that was definitely worth mentioning.

  4. I doubt I have an oversupply issue, but it’s SO GOOD to hear someone say “you don’t have to switch sides” that was just one piece of info that confused me in the early days. Guh.

  5. I’m curious how you managed to fight off plugged ducts while block feeding and trying to keep down your milk supply. Currently I’m trying to get my supply down by blockfeeding, but then I keep getting plugged ducts and I don’t know how to manage them with out pumping too much and continuing to get my supply down.

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