Too Much of a Good Thing

"I don't know what's wrong, but {my baby} gets latched on and then he starts choking!" I can hear the fear in this mama's voice as she keeps telling me why she is calling. "I feel like I have a good milk supply. I mean, I have to pump sometimes after he gets done eating or else my boobs hurt." I already have a pretty good idea what the issue is, but I ask how often she pumps. "Oh, I have to pump at least, like every two hours or I'll get mastitis again. I always have these big lumps along the side of my boobs." Yup. I tell her I think she might have an oversupply and that I can help her.

Most breastfeeding mamas learn, in the hospital, that once their milk "comes in" (meaning the increase in volume that happens 3-5 days after baby's birth, when prolactin levels surge), milk supply is based on demand. The math is simple: the more often baby empties mom's breasts, the more milk her body will produce. This makes some moms assume that the ultimate goal in breastfeeding would be to produce as much milk as possible. They pump after feedings to create more demand. They try to completely empty their breasts every time with the hope of making even more milk. The problem is this.......if mom is making more milk volume than baby can empty from the breast (if he/she is breastfeeding on demand and at least every 2-3 hours), she may have an oversupply.

So that's a good problem to have, right? Not necessarily. Ideally, mom's breasts would make about the volume of milk baby needs every 2-3 hours to support healthy growth and weight gain - maybe 20-30% more than that. If mom is producing much more milk than this, she is at risk for problems like a forceful let-down, blocked milk ducts and mastitis. Additionally, an oversupply of milk can be the culprit if baby is getting choked when mom's milk lets down, having frothy-looking greenish poop, spitting up after feedings, or seems very gassy all the time.

What's the solution? Mom should contact a Lactation Consultant (I know one!) who can assess her situation and provide an individualized plan to safely regulate her milk supply down to a level that is still adequate to supply baby. Lactation professionals are trained in how to safely accomplish this and we are here to help!