Oversupply Syndrome: Too Much of a Good Thing?

Yes, I produce way more milk than my single baby could possibly consume. No, I’m not complaining. As my Dutch grandfather, who was known for his frequent use of proverbs, was fond of saying: “Beter mee verlegen dan om verlegen” or roughly “Better too much than not enough.” And when it comes to breastmilk, that’s surely a fair comment.

However…..

That doesn’t make it easy. My fourth child, who was born quite the chunker at 10 pounds 11 ounces, would get all the milk she needed in just four minutes. Four! And that would last her a good three hours. Meanwhile, my body kept on making milk like it was going out of fashion. Or like it was preparing to encounter a whole horde of hungry babies (but more on milksharing and cross nursing in another post).

So I experience my share of challenges along the way as I get breastfeeding established with each of my children. I’ve breastfed each one through a rocky start although it took me a couple of babies before I learned I even had an oversupply issue, or Foremilk-Hindmilk Imbalance, and that not everyone exeprienced what I did. You’d think it would get easier with subsequent babies, but I get to start at square one each time. It took me 6 weeks to get fairly comfortable nursing my fourth child. But I digress.

What it means for mom

There can be some real challenges when you have too much of a good thing. Having your breasts swell to preposterous proportions is not comfortable. It downright hurts. And no bra can adequately support you during this adjustment phase. I felt like I had to pick up two bowling balls just to move from room to room. You can get so much milk in there that your nipples flatten out making it hard for baby to latch on well. And we all know how important it is for baby to get a proper latch, because otherwise you go down that road toward cracked and bleeding nipples. And NO ONE wants to go down that road. Trust me.

Emotionally, it becomes very difficult when you associate nourishing and sustaining your newborn child with pain. Personally, I honestly prefer the pains I experience for labor and birth to the weeks of breastfeeding pain I go through after birth. It feels awful when you try to find ways of delaying feeding your hungry baby (“I need to go to the bathroom first! I need to get a drink ready! Maybe we should change her diaper first!”) because you fear the pain. You feel guilt. It feels awful to feel resentment swell inside you as you look at those tiny innocent needy jaws that are coming at you to clamp down on your tender aching breasts. Even when you know they’re only clamping down instead of latching on in an effort to slow the flow. It’s self-preservation. But it hurts.

I called my sweet little baby girl my ‘frenemy’ for several weeks. She was causing me such pain, creating such havoc in my breasts, and yet I needed her to relieve that pressure as well. We needed each other. I made sure to consciously cuddle with and cherish her when she did not need feeding so I could associate her with love and joy and wonder and admiration – anything but pain.

Mothers with oversupply syndrome often complain of constant leaking, painful let-downs, excessive engorgement, breast pain, plugged ducts and/or mastitis. They often have sore nipples as the nipple leaves baby’s mouth pinched instead of round with a yellow or white ridge along the nipple face (from that clamping down). A mom may even feel that her baby does not like her or her milk as baby pulls off from the first breast after just minutes and then refuses the second breast, and that feeling of rejection hurts. She may even have begun an elimination diet thinking that her baby’s discomfort has to do with her own diet causing colic. In other words, there is potential for mothers with an oversupply to feel extended physical pain, to misdiagnose their situation, to select a treatment that does not correctly address the problem (and in fact may exacerbate it) and to suffer emotional pain that interferes with bonding and recovery from birth.

What it means for  baby

It can be hard on baby too. Trigger that let-down and it’s like getting dinner blasted into your mouth at pressure-washer speed. The poor baby hardly knows what’s hit her, quite literally, in the face! That over-active let-down causes choking, gagging, gulping and milk coming out her nose, which doesn’t really make for a pleasant feeding experience on her end either. Not to mention other physical discomforts that an abundance of foremilk can cause baby to have: an upset tummy (which an infant often wants to comfort with more nursing, which is an unfortunate cycle), green frothy poops, and monstrous burps from gasping for air between floods of breastmilk, which are painful if not belched out soon after feeding.

Babies on the receiving end of foremilk-hindmilk imbalance often gain weight quickly (1-2 pounds per week), seem colicky or gassy, spit up a lot and often, have 10-15 wet diapers per day, have a full and distended abdomen, especially after feedings, and pass large liquidy stools. They usually have short feedings (under 7 minutes), pull off the breast frequently, and may want to suck their hands or pacifier often. Some may experience ear or sinus infections or have a stuffy nose after feedings. In other words, babies too have very real and often uncomfortable consequences from mom’s oversupply.

A more minor yet still significant inconvenience in that early postpartum period is that soppy spillage everywhere. Not just on your clothes and baby’s clothes, but I mean the sheet-soaking, stack the towels on the bed sort of spillage. Ugh. Such a waste! And the kicker is that you can’t pump and save all that excess milk! Because in those early weeks when you’re trying to balance that whole supply and demand thing, pumping can really mess things up more. It urges your body to produce more than it needs to and if you think that couldn’t possibly happen, think again. Sometimes I had to use a manual pump a few times just to extract the flattened nipple enough for my baby to be able to latch on but I would not pump milk until things calmed down for us, which was at least a couple of months.

So, what can you do if you have an oversupply of breastmilk?

The good news is there are lots of things you can do to try to reduce your discomforts as your body eventually finds its balance. You should contact your midwife, La Leche League leader, lactation counselor or childbirth educator to discuss your situation so that she may be able to guide you in your specific circumstances as there may more at issue with you or your baby than simply oversupply, or it may in fact be something else entirely. Among other things, with varying success and in no particular order, I used:

hot/warm compresses

Soak a cloth in hot water and apply the moist warm compress to the painful or infected area of a breast to stimulate circulation and ease tension in swollen breast tissue. Soaking breasts in a sink full of warm water can help clear a clogged duct. Warm/hot showers can help ease the let-down. It’s best to use these techniques several times a day for 5-10 minutes than to do it only once for 30 minutes.

cold compresses

A cold compress on the breast between feedings can help ease inflammation and discomfort. You can use crushed ice in plastic bags or a bag of frozen veggies wrapped in a tea towel. You can then switch to a warm compress five or ten minutes before a feeding.

castor oil packs

I poured castor oil on a washcloth, wrung it out, applied it to the painful breast, covered it with plastic wrap, and got in a long hot shower or bath. Read more on castor oil pack therapy here.

cabbage leaves 

I’ve heard such great things about the effectiveness of placing a green cabbage leaf or two or three on the breast inside the bra to relieve engorgement that I’ve tried it in two postpartum periods. Sadly, it doesn’t seem to work for me, but hey, it was worth a try! Try it for yourself – you may have better luck than I did! This is actually supposed to dry up the milk so it should be helpful for engorgement and maybe it did dry up some but I just had so much that I couldn’t tell a difference.

nipple butter or lanolin cream

Gotta soothe those poor nipples between feedings! I’ve used Lansinoh lanolin cream as well as Earth Mama Angel Baby organic nipple butter and I think they’re both fantastic. A little goes a long way. But you know what else works well? Breastmilk!! Express a little, rub onto the skin, let air dry, repeat. You can’t get more safe and natural – and readily available! – than that.

ice cold drinks with a strong flavor

I found it very helpful to have iced juice with a strong flavor ready – pomegranate, cranberry or blueberry – to suck through a straw to overpower the metallic taste of blood that would often flood my mouth as my babies first latched on. I needed the help of my hubby or older kids to hold the glass for me as my hands were full. It was quite a production. But it helped and gave me something to distract from the initial pain too!

homeopathic remedies

I used several homeopathic remedies over the course of getting our breastfeeding relationship established, depending on the symptoms I was experiencing at the time. These included arnica, belladonna, bryonia and phytolacca.

herbal remedies

I was fortunate to not experience my first bout of mastitis until my fourth baby, but when I did, wow! Body aches, fever, chills, fatigue – it came on fast and knocked me down for a good 24 hours. It also brought me to tears of frustration as another painful hurdle we had to get past. This is not unique to moms with oversupply issues but is common when you have so much milk. I used echinacea and goldenseal capsules.

Herbs can be very effective remedies for a number of situations, including increasing and decreasing how much milk a woman produces. Some herbs known to decrease milk supply include peppermint, parsley, sage, oregano and thyme. If you’re dealing with oversupply, you want to avoid the herbs known to increase milk supply, such as fenugreek, alfalfa, brewer’s yeast, blessed thistle, nettle, goat’s rue and raspberry leaf.

breast shells

Not to be confused with nipple shields! Breast shells are hard plastic do-dads which you wear inside your bra to help draw out flat or inverted nipples. You remove them before breastfeeding so they never come into contact with baby and there’s no risk of causing nipple confusion or interfering with the symbiotic relationship involving baby directly at the breast. I used them to draw out a nipple, especially sore ones, but also sometimes simply because doing so caused a little extra leakage, which relieved some pressure without the tenacity of a pump.

different nursing positions

Cradle hold, cross-cradle, football hold, side-lying, hanging over baby to drain the breast…. Try them all! When your baby gets her fill in 4 minutes, you want to use varying positions to make sure she drains different parts of the breast to help prevent mastitis.

a manual pump

I prefer a simple and cheap manual pump. Early on, I use it primarily to help extract the nipple (which also drains just a little milk) so it’s easier for baby to latch on well. Later, when things are a bit more balanced, I find it very adequate and effective for pumping if I need to leave baby for a few hours. Others prefer electric pumps – find what works best for you.

massage 

It helps to massage the breast gently from the outside toward the nipple as baby nurses to relieve any ducts that may be even thinking of getting clogged, but this must be done very gently because even gentle pressure can cause tidal waves of breastmilk to flow into baby’s mouth, causing gagging and choking. If you need one hand to hold the breast and the other to hold the baby, you may have to ask dad to help with this massage.

rest, rest, rest 

Take it easy. Do not try to do too much. Honor yourself in this postpartum time. Cuddle with that baby when she’s not feeding. Sleep when you can. It helps!

hydration

You have to keep up with all this milk production! Dehydration can cause a host of other problems you don’t want to deal with, such as fever, rapid pulse, headache, increased susceptibility to infection, and fatigue. Try to have a drink within reach at all times, especially before you sit down to nurse.

vitamin C

I ramped it up with some emergen-C to help protect myself from infection (mastitis).

lots of nursing on cue (even when it really hurt)

Don’t give up. This too shall pass. You can and will have a wonderful breastfeeding relationship once you achieve balance. Continue to nurse on cue. Forget routines, forget the clock, listen to your baby.

block nursing 

This is when you use only one breast per feeding or for several feedings over the course of a number of hours. I found this probably to be the single most helpful technique in reducing my milk supply to a manageable level. (Actually, by 6 months, and for various reasons, like her brother before her, my daughter was a one-sided nurser almost exclusively, which makes for a somewhat lopsided mom, but that’s OK. I’m good with that.)

and a heavy dose of pure sheer determination.

I’m just stubborn, I guess.

I’ve worked hard to make my breastfeeding relationships work. And I’m so glad we’ve done it!! Once they eventually stabilized, I breastfed my babies for 14 months, 27 months and 36 months, with baby #4 on month 8 and counting. I know it’s worth it, for all of us.

 

For more information on oversupply issues, contact me and we can commiserate or visit:

If you had an overabundant milk supply, what helped you the most? 

 

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celebrate world breastfeeding week on npn

I’m celebrating World Breastfeeding Week with Natural Parents Network!

You can, too — link up your breastfeeding posts from August 1-7 in the linky below, and enjoy reading, commenting on, and sharing the posts collected here and on Natural Parents Network.

 

(Visit NPN for the code to place on your blog.)

 

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