Oversupply Of Breast Milk

Introduction

Oversupply of breast milk, also known as hyperlactation, refers to a situation in which a lactating individual produces more breast milk than their baby needs for adequate nourishment.¹² While breastfeeding, it is normal for the body to produce an amount of milk that matches the demand of the baby.³ However, in cases of oversupply, an excessive amount of milk is produced, which can lead to challenges for both the lactating (breastfeeding) individual and the baby.⁴

Reputable organizations like the World Health Organization (WHO), UNICEF, and the National Health Service (NHS) support breastfeeding as an essential practice for infant health.

The exact cause of oversupply is not fully understood, but it is believed to be influenced by factors such as hormonal imbalances, ineffective milk removal from the breasts, overstimulation of the breasts, or excessive milk production due to an overactive let-down reflex. The condition can occur in both new and experienced breastfeeding individuals. The issue of an oversupply of breast milk can have a significant impact on breastfeeding, both for the lactating individual and the baby.⁵

Causes of oversupply

The exact causes of the oversupply of breast milk, also known as hyperlactation, are not fully understood. However, several factors have been identified as potential contributors:

1. Hormonal factors: Prolactin Levels: The high levels of the hormone prolactin, which stimulates milk production, may contribute to oversupply. Hormonal imbalances or increased sensitivity to prolactin can lead to excessive milk production.⁶

2. Breast stimulation and emptying: Frequent or prolonged breastfeeding sessions, pumping, or nipple stimulation can signal the body to produce more milk than the baby needs. This can result in an oversupply of milk.

3. Overactive let-down reflex (Forceful Milk Ejection): Some lactating individuals experience an overactive let-down reflex, where milk is forcefully ejected from the breast. This can lead to a rapid flow of milk, causing difficulties for the baby to handle and regulate the feeding.

4. Poor latching or ineffective breastfeeding techniques can indeed contribute to an oversupply of breast milk. When the baby has difficulty latching onto the breast properly or is not able to effectively remove milk during feedings, it can lead to a build-up of milk supply. This can trigger the body to produce more milk than necessary, resulting in an oversupply.

5. Breast surgery or trauma: Certain breast surgeries, such as breast reduction or augmentation, can disrupt the normal functioning of the milk ducts and glands. This can result in oversupply or other breastfeeding challenges.

6. Other factors, such as stress or anxiety associated with maternal health conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders, may influence milk production and contribute to oversupply.⁷

Signs and symptoms of oversupply

The signs and symptoms of an oversupply of breast milk can vary from person to person, but here are some common indicators:

1. Engorgement: The breasts may feel excessively full, firm, and uncomfortable, even after a feeding or pumping session.

2. Rapid milk flow: The milk may come out forcefully and quickly during breastfeeding, causing the baby to choke, gag, or pull away.

3. Baby's behaviour during feeding: The baby may exhibit signs of frustration, such as clamping down on the nipple, pulling away, or showing difficulty in maintaining a latch.

4. Excessive weight gain: If the baby is gaining weight at a rapid rate, well above the expected range, it could be a sign of overfeeding due to oversupply.

5. Frequent spitting up or reflux: The forceful flow of milk can lead to the baby swallowing air, resulting in frequent spitting up, reflux, or signs of discomfort after feedings.

6. Fussiness and gassiness: The baby may appear fussy, irritable, or gassy due to excessive milk intake or difficulty handling the fast flow of milk.

7. Green, foamy, or explosive stools: The baby's stools may be greenish in colour, foamy, explosive, or appear frothy, which can be a result of consuming an excessive amount of lactose-rich foremilk without getting enough hind milk.

8. Breast leaking: The breasts may leak milk frequently between feedings, even when not engorged.

It is important to note that experiencing one or more of these signs or symptoms does not automatically mean there is an oversupply issue.

Impact of oversupply of breastmilk on breastfeeding

Oversupply of breast milk can have various impacts on the breastfeeding process, both for the lactating individual and the baby. Here are some common effects of oversupply:

1. Difficulty with latching: The forceful let-down reflex and rapid milk flow associated with oversupply can make it challenging for the baby to latch properly. The baby may struggle to establish and maintain a secure latch, leading to feeding difficulties and frustration.

2. Ineffective milk transfer: The fast and forceful flow of milk can result in the baby swallowing excessive air and struggling to coordinate sucking, swallowing, and breathing. This can lead to inefficient milk transfer, causing the baby to take in more foremilk (low-fat, high-lactose milk) and less hindmilk (higher-fat, calorie-rich milk).

3. Fussiness and discomfort: Babies who are feeding from an oversupply of milk may experience discomfort, gassiness, and colic-like symptoms due to excessive intake of lactose and fast milk flow.

4. Weight gain and growth concerns: Some babies may exhibit rapid weight gain beyond the expected range due to overfeeding from an oversupply. This can raise concerns about appropriate growth and development.

5. Engorgement and mastitis: The overproduction of milk associated with oversupply can lead to frequent engorgement, making breastfeeding uncomfortable for the lactating individual. Engorgement increases the risk of developing mastitis, an inflammation of the breast tissue, which can lead to pain and swelling and potentially require medical intervention.

6. Shortened feedings and frequent nursing: Babies may have shorter feeding sessions as they quickly fill up with milk. They may also want to nurse more frequently to alleviate discomfort caused by oversupply.

7. Foremilk-hindmilk imbalance: Oversupply can disrupt the balance of foremilk and hindmilk. The baby may consume an excessive amount of foremilk, which is lower in fat content, leading to green, frothy stools and potential digestive issues.

Strategies to manage oversupply

Managing the oversupply of breast milk involves strategies to regulate milk production and improve breastfeeding outcomes. Here are some common strategies that can help:

1. Block feeding: Feed the baby on one breast for consecutive feedings, allowing them to drain the breast before switching to the other side. This helps regulate milk production and reduces stimulation of the other breast.

2. Express or pump: Before breastfeeding, express or pump a small amount of milk to relieve breast fullness and reduce the forceful let-down reflex. This can help slow down the milk flow and make it easier for the baby to handle.

3. Adjust feeding positions: Experiment with different breastfeeding positions to find ones that allow the baby more control over the milk flow. Positions such as laid-back breastfeeding, side lying, or using a reclined position can help slow down the flow and reduce discomfort for the baby.

4. Feed in upright positions: Feeding the baby in an upright position can help reduce the force of the milk flow and minimise the swallowing of air.

5. Use breast compression: During breastfeeding, gently compress the breast behind the areola to slow down the milk flow. This can help the baby better manage the flow and consume a balanced amount of foremilk and hindmilk.

6. Offer a pacifier or finger feeding: Offering a pacifier or using finger feeding with a clean finger can help satisfy the baby's need to suck without triggering excessive milk production.

7. Consult with a lactation consultant: A lactation consultant can provide personalised guidance, support, and tailored strategies to manage oversupply based on your specific situation.

Tips for maintaining milk supply

To maintain a healthy milk supply while breastfeeding, here are some tips:

1. Establish a strong breastfeeding routine: Breastfeed your baby frequently and on-demand, allowing them to nurse whenever they show hunger cues. This helps stimulate milk production and ensure an adequate milk supply.

2. Ensure proper latch and positioning: Make sure your baby has a proper latch and is positioned comfortably during breastfeeding. A good latch ensures efficient milk transfer and helps maintain milk supply.

3. Empty the breasts fully: Encourage your baby to nurse from both breasts during each feeding session to ensure thorough milk removal. Emptying the breasts signals your body to produce more milk.

4. Avoid long gaps between feedings: Try to avoid long periods without breastfeeding or pumping, as this can signal your body to decrease milk production. Breastfeed at least 8 to 12 times in 24 hours to maintain a healthy milk supply.

5. Practice skin-to-skin contact: Spend time with your baby in skin-to-skin contact, especially during the early days after birth. Skin-to-skin contact helps stimulate milk production and strengthens the breastfeeding relationship.

6. Stay hydrated and well-nourished: Drink plenty of fluids and eat a balanced, nutritious diet to support your overall health and milk production. Adequate hydration and nutrition are important for maintaining the milk supply.

7. Avoid excessive pacifier or bottle use: Limit the use of pacifiers and bottles, especially in the early weeks of breastfeeding. Excessive use of pacifiers or bottle-feeding can interfere with milk supply regulation and hinder breastfeeding.

8. Get enough rest and manage stress: Rest and self-care are important for maintaining milk supply. Fatigue and stress can affect hormone levels and milk production, so prioritise self-care and seek support when needed.

9. Consider pumping or hand expression: If you need to supplement breastfeeding or build up a freezer stash of breast milk, consider pumping or hand expression after or between breastfeeding sessions. This can help stimulate milk production and maintain supply.

10. Additional support and resources: Joining local breastfeeding support groups, seeking advice from online communities or forums, consulting with a lactation consultant or breastfeeding specialist, utilising mobile applications or tools for tracking breastfeeding sessions, reaching out to healthcare professionals for personalised assistance

Summary

In summary, an oversupply of breast milk occurs when a lactating individual produces more milk than their baby needs. Hormonal factors, frequent breastfeeding or pumping, an overactive let-down reflex, a poor latch, or stress can all contribute to it. Signs of oversupply include engorgement, rapid milk flow, the baby's feeding behaviour, excessive weight gain, spitting up, fussiness, and green stools.

Oversupply can affect breastfeeding by making latching difficult, causing ineffective milk transfer, discomfort, and growth concerns. Strategies to manage oversupply include block feeding, expressing milk before breastfeeding, adjusting feeding positions, and seeking help from a lactation consultant. Tips for maintaining milk supply include establishing a strong breastfeeding routine, practising proper latching and positioning, emptying the breasts fully, avoiding long gaps between feedings, and practising skin-to-skin contact.

Additional support and resources are available through breastfeeding support groups, online communities, lactation consultants, and healthcare professionals. By addressing oversupply and seeking assistance, individuals can have a successful breastfeeding journey.

N.B.: Remember that every breastfeeding journey is unique and that individual milk supplies can vary. If you have concerns about your milk supply, it is advisable to seek guidance from a healthcare professional or lactation consultant for personalised support and advice.