By Laura Silvas, RN IBCLC

One of the biggest concerns that mothers experience and often reach out for help is a low milk supply. If you are breastfeeding exclusively and you aren't pumping, it can be hard to know how much milk your baby is getting. Another issue mothers often face is oversupply. While it may sound like a good problem to have, oversupply can pose an issue for both mother and baby.

What is oversupply?

While oversupply may not sound like a problem (especially to mothers struggling to keep up with their baby's demands), it comes with its own set of problems. In simple terms, oversupply is when your body makes more milk than your baby can consume, known as hypergalactia. In the first few weeks of breastfeeding, your breasts become engorged (known as the engorgement phase) as your body learns how much milk to make for your baby. Over time, typically between weeks 4-6 postpartum, your body regulates how much milk is produced. This process is called supply and demand.

How do I avoid oversupply?

During the engorgement phase, women are often encouraged to pump after a feeding session to empty the breasts and relieve the fullness. However, if you pump after a good feeding session, it sends your body the message that it should remake all the milk you just used, increasing or continuing the supply and demand.

Engorgement is uncomfortable and can often cause issues for both the newborn and the mother. It is better to hand express the milk than pump it to relieve the engorgement. With hand expression, you remove a smaller amount of milk, which causes your breasts to slow down production. In addition, hand expression before feeding helps soften the breast, areola, and nipple, allowing your baby to latch more easily.

What are some complications of oversupply?

Oversupply comes with a completely different set of issues than under-supply. Mothers may experience persistent engorgement, leaking, and discomfort. In addition to difficulty with latching and emptying, there is an increased risk of clogged ducts and mastitis. Mastitis is an infection in the milk ducts. While mastitis can develop from a break in the skin or bacterial infection, it can also develop when the breasts do not drain fully. Signs and symptoms of mastitis include inflammation, heat, redness, pain, and streaks in the affected area. If this develops, reach out to your healthcare provider, as you may need antibiotics. Another issue that some women experience with oversupply is difficulty keeping their baby latched at the breast for the duration of the feed.

Oversupply can also cause a heavy letdown due to the amount of milk built up in the breast, causing choking, coughing, and your baby pulling off the breast. If you see this happen, try hand expressing before feeding and feed in a reclined position so that gravity slows the milk flow. You can place your baby in a kangaroo/ koala or "biological nurturing" position. See below for more details:

Treating Oversupply

As mentioned previously, hand expressing helps with oversupply before and after feeds. It can also help reduce engorgement. To reduce the inflammation and discomfort, apply an ice pack, and if there are no other contraindications, taking ibuprofen is generally considered safe while breastfeeding. In fact, most women are sent home with ibuprofen following delivery.

Traditionally, cabbage leaves were used to reduce engorgement and oversupply, but they may dry up the milk considerably. Additionally, avoid binding or tight bras such as sports bras, as they can press and clog the milk ducts. Use washable breast pads made of cotton, which are helpful for leaking, and always use breathable material to help avoid infections such as yeast or thrush.

If you are struggling with oversupply, pump less frequently. This will help reduce the supply and demand cycle. The goal is to decrease the amount of milk your body produces while keeping up with your baby's demands. It is also best to consider working alongside a lactation consultant to develop a plan to combat oversupply.

What should I do with the extra milk?

Everyone has seen the glorious pictures of the "freezer stash." Many of these women have oversupply issues. If you are wondering what to do with the extra bags of liquid gold, there are many options available. If you have space for storage, stashing the milk away for your baby is a great idea. The pumped milk is great if you have to work and cannot breastfeed your baby and make baby food. It also works wonders for applying to rashes and pink eye - endless possibilities.

The standard freezer attached to your refrigerator keeps the milk good for about 4-6 months, and if you own a deep freeze, the milk can be stored for up to 12 months!

Local milk banks are also a great option, as they provide milk to NICU infants. A simple online search will locate the closest to you. If there isn't one, contact one and ask about registering. Often, they will send an ice chest and dry ice for mailing it. Other mothers have donated locally or through groups on online forums.

Conclusion

While oversupply may seem to be a blessing, it can also have downfalls. If you are concerned about managing oversupply, showing signs or symptoms of mastitis, or are struggling with your baby coughing and choking at your breast, reach out for help.