Let's set the record straight. If you've clicked on this link then there are two things that have happened. One, your curiosity about the phenomenon of breast milk oversupply brought you here. And two, you are going through the same problem and need to understand it better.
Either way, you have come to the right place.
Hyperlactation
While you may have heard many new mothers complain of low milk supply, there is also such a thing as breast milk oversupply. It is often described as hyperlactation or a mother 'having too much milk,' 'fast flow' or even 'overactive let down.'
On one hand, this can be beneficial for a baby because she can gain weight easily and remain well-nourished. On the other, some babies might struggle to cope with the milk flow and volume. They may become fussy, cry, and come off the breast as milk spurts everywhere.
In some cases, it may even lead to babies spitting the milk out or as it is commonly called reflux, lactose overload or colic.
As for mothers, an overflow of breast milk can lead to engorgement, plugged ducts and even mastitis. It could also be painful because the letdown is forceful and fast. These are initial signs that indicate that you might have too much milk.
All of this should not discourage you from continuing to nurse your baby. Instead, you should try to understand the causes of breast milk oversupply, recognise its signs, and learn new ways to manage it and how to continue breastfeeding with it.
What Causes Hyperlactation
Breast milk oversupply shouldn't worry you too much unless it becomes completely unmanageable for your baby as well as for you. Most of the time, it boils down to how you sync your feeds with your baby's demands.
If you have already synced your feeds and you are still producing more milk than needed, then first understand why this may be happening.
- Foremilk/hindmilk imbalance: One of the biggest reasons you have excess milk is because there is an imbalance between the intake of foremilk (the thin, sweet milk rich in lactose that comes at the beginning) and hindmilk (the fat-rich, high-calorie, thick milk that comes at the end of the feed).
Let's assume that an 'average' mother produces half an ounce of foremilk and two ounces of hindmilk. So her baby on an average will get 5 ounces (if he nurses from both breasts). But a hyperlactating mum can produce one ounce of foremilk and three of hindmilk. So in this case, the baby will get four ounces from one breast. By the time you switch him to the other breast he will be so full, that he'll only consume a bit of foremilk (from the second breast). This will lead to an imbalance in his body because foremilk is high in lactose, he may become gassy and spit up. And because he isn't getting much hindmilk, he may feel empty and hungry more often.
- Excessive alveoli: While most 'average' mums have 100,000 to 300,000 alveoli per breast, a hyperlactating mum would have more than the average number. Alveoli are the milk-producing glands in the breasts and therefore, an excessive count leads to higher milk production.
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Overstimulation: Frequent or prolonged breastfeeding sessions can stimulate milk production beyond the baby's needs.
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Pumping Excessively: Regular and aggressive pumping, especially between feeds, can signal the body to produce more milk.
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Hormonal Imbalances: Certain hormonal issues, such as polycystic ovary syndrome (PCOS), can lead to an oversupply.
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Overactive Letdown Reflex: An overactive letdown can result in excessive milk flow during feeds, causing the baby to struggle with the flow and pull off the breast.
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Supplementing with Formula: Introducing formula in addition to breastfeeding can signal the body to produce more milk to meet the perceived demand.
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Diet and Hydration: Consuming excessive fluids and lactogenic foods (like oats or fenugreek) can contribute to oversupply.
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Stress and Anxiety: High stress levels may disrupt the balance of hormones involved in milk production.
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Medications: Some medications, like certain birth control pills, may inadvertently increase milk supply.In such a situation, you must first look for signs of breast milk oversupply.
What are the Signs of Hyperlactation
If you are producing more milk than your baby can handle, despite having a good latch and good tongue movement, he will still exhibit signs that give away his inability to feed. Look for these signs of breast milk oversupply
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Your baby appears fidgety during feedings, possibly crying or repeatedly detaching and reattaching from the breast.
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Your baby exhibits symptoms such as coughing, choking, spluttering, or swift gulping while nursing, especially during each let-down.
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Your baby might bite down on the nipple in an attempt to control or slow down the rapid milk flow, potentially leading to sore and creased nipples.
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They may arch their back or stiffen their body, often accompanied by painful cries.
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Each feeding session feels like a challenging and arduous task.
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Feeding intervals are brief but frequent because the baby fills up quickly on air and the lower-fat milk from the initial part of feeding, missing out on the higher-fat milk that becomes available later.
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Your baby may pass green, loose, or explosive stools, and some may exhibit signs of blood.
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Your baby has excessive gas and frequent, substantial spit-ups.
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Your breasts may seem like they are never completely empty and rapidly refill after each feeding.
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You experience recurring issues with plugged milk ducts or mastitis.
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How Can Breast Milk Oversupply Affect You and Your Baby
The good news is that overproducing breast milk or hyperlactating means that your body is able to match your baby's growing feed demands, and there is enough milk to keep your baby nourished and well-fed.
The bad news is that if a baby is unable to handle the excess flow of foremilk he may become colicky, fussy and even gassy. It may also interfere with his growth and development because he is unable to consume enough hindmilk and spurts out whatever he consumes in the first place.
For mothers, it may lead to discomfort, engorgement, and a higher risk of plugged ducts or mastitis. Maintaining a healthy milk supply balance can be demanding.
The best thing to do in this situation is to manage the excess milk smartly.
Mum with Hyperlactation: "Our entire lives revolved around my pumping schedule."
In a heartfelt essay featured on Today.com, one brave woman shared her personal journey of grappling with hyperlactation syndrome.
Elisabeth Anderson-Sierra, a mum of three in Oregon who has hyperlactation syndrome recalled how she learned about her condition. When a midwife visited their home a week into her journey of nursing her first child, she went straight to their freezer, and then to the outdoor one, her reaction a mixture of surprise and concern.
“'I’ve never seen anything like this,' she said to me. Not exactly words of comfort, but validation that what I was experiencing was far outside the norm," she said.
So unconventional was her case, that she described the oversupply as both dramatic and life-altering.
"I’ve been told by medical professionals that without medical intervention — either non-FDA-approved medication or a double mastectomy — my production won’t stop," shared Elisabeth.
She even made it to the Guinness Book of World Records for “Most Breastmilk Donated by an Individual,” for donating 54,000 ounces to a milk bank between February 2015 and June 2018.
"But that doesn’t count the whole picture — the number of total ounces I’ve donated is closer to 350,000," she said.
The mum admitted that at some point, she resented having the condition. For one, as a result, most of her and her family's lives revolved around her pumping schedule.
"Sure, I made the best of it with extension cords and tried as best I could to be productive, but leaving for long periods of time wasn’t an option. Nor was staying at any place other than home — so many events were cut short because I needed to get home to pump," she said.
"While the mental and emotional toll of this diagnosis is the one that wears on me the most, there’s a very real physical toll, too. Breastfeeding is taxing on the body and I have been admitted to the hospital on several occasions for dehydration and malnutrition," added Elisabeth.
As of writing, the mum of three has yet to decide if she will be undergoing medical interventions to correct her condition.
"I’ll have to decide what course of medical intervention to take to end this part of my life’s journey, and all of it seems scary. Until then, I try to focus on the positive that’s come out of my diagnosis and the many babies and moms I’ve helped over the last eight years."
How to Manage Breast Milk Oversupply
You can try to manage excessive breast milk supply by trying new positions, offering single breast and limiting pumping. Here are a few things you can do at home:
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Offer one breast at a time
Allow your baby to nurse on a single breast. Ideally, he should be latched on for a minimum of 15 to 20 minutes. If he has nursed for less time, then you should put him back on the same breast. Do this until he feeds for the complete 15 to 20 minutes. Do not offer the second breast after this time, unless he demands it.
Remember that newborns will still ask for the second breast even if they are not hungry. That's because they love to suckle and not necessarily because they are hungry. If your other breast gets engorged, try to pump some milk, but do not empty your breasts completely.
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Alter your nursing position
Sometimes lying in positions that allow gravity to slow down your milk can also work. For instance, try lying on the bed with your baby facing the nipple. You can also lean back slightly and place your baby on top of your chest. Or you can try the football hold, placing your baby's head above the rest of his body. This will also allow him to be more in control of the flow. Just make sure you are ready with a towel to wipe off any leakage.
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Relax the letdown
Before putting him on the breast, collect the first spurts and the first forceful sprays in a bottle. Or you can wipe that off and then put the baby on the breast. If you notice your baby gagging on your milk, simply express a little and then put him back. All these techniques will ensure that he is feeding on normal flow. Follow this up with burping your baby to help him digest better.
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Use excess breast milk elsewhere
If nothing works and you still have a lot to offer, you can donate your breast milk. There are many human milk banks in the market now, and they cater to preemies who desperately need breast milk. So while managing your oversupply, you can help somebody else's baby as well.
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Ask for help from a lactation consultant.
Consulting a lactation counsellor can be a game-changer when dealing with an oversupply of breast milk. These experts are skilled in assessing your unique situation and providing tailored guidance. They can help you establish a pumping routine that relieves engorgement without overstimulating your breasts, ensuring your baby can latch comfortably.
A lactation counsellor can also offer advice on block feeding techniques and recommend positions to manage the oversupply's impact on your baby, such as faster milk flow or gassiness. Their support and knowledge can make navigating oversupply challenges less overwhelming, promoting a more positive breastfeeding experience for both you and your little one.
Can I Pump If I Have an Oversupply of Breast Milk
Pumping allows you to express and store excess milk, providing relief from engorgement and preventing issues like plugged ducts or mastitis. It's essential to pump carefully and not overstimulate your breasts, as this can exacerbate the oversupply. You can pump between feedings or before nursing to soften the breast, making it easier for your baby to latch and feed comfortably.
Typically, the problem of breast milk oversupply gets solved when your baby matures and is able to handle the excess. By that time, your body also gets used to the amount of milk your baby demands and so both the 'giving' and 'receiving' gets synced.
Just remember that like all breastfeeding issues, this too shall pass. If you are feeling overwhelmed about this condition, do not hesitate to reach out to a lactation consultant in your area.
Here at theAsianparent Singapore, it's important for us to give information that is correct, significant, and timely. But this doesn't serve as an alternative for medical advice or medical treatment. theAsianparent Singapore is not responsible for those that would choose to drink medicines based on information from our website. If you have any doubts, we recommend consulting your doctor for clearer information.