Breastfeeding: Oversupply or forceful let-down? 10 tips that may help

Do you find your baby comes on and off the breast several times during a feed, leading you to believe that you may not have enough breast milk to satisfy your baby? Is your baby very fussy or cries a lot when trying to breastfeed? While breastfeeding can you hear your baby loudly gulping breast milk, coughing or choking?

You may actually have the opposite problem – you could have a forceful letdown or overabundant breast milk supply. It’s even possible that you could have a combination of both!

As a nurse who provides breastfeeding support on the phone, in parents’ homes, and in breastfeeding clinics, new parents often tell me that they feel they aren’t making enough milk to feed their baby. However, almost everyone can make enough breast milk to satisfy their baby and help their baby grow and develop well.  In fact, perceived low milk supply is one of the most common reasons why parents stop breastfeeding or start supplementing with infant formula.

Common symptoms of a forceful milk letdown or overabundant milk supply:

Baby:

• Choking or coughing during breastfeeding
• Loudly gulping breast milk
• Fussiness or gassiness due to air being swallowed during breastfeeding
• Spitting up excessively after breastfeeding
• Coming on and off the breast repeatedly during a feed
• Poor or shallow latch
• Explosive and watery green bowel movements

Parent:

• Breast milk spraying when baby comes off the breast
• Breast milk squirting from one breast while baby is feeding on the other breast
• Pain during the first letdown due to stretching of the milk ducts
• Breast milk leaking from breasts between feeds
• Nipple pain due to a poor latch
• Recurrent plugged ducts and/or breast infection (mastitis)
• Very full or painful breasts between feeds

If you or your baby are experiencing any of these symptoms or have any other breastfeeding concerns, it is important to get support by visiting one of our free breastfeeding clinics.

10 tips to help with forceful breast milk flow and overabundant breast milk supply:

1. Breastfeed early and frequently.
   Breastfeed when your baby shows early signs of hunger (e.g. rapid eye movements, sucking or licking, hands to mouth, increased body movement, and making small sounds).
2. Breastfeed when your baby is calm.
   Try to breastfeed before your baby gets too hungry or frantic.
3. Breastfeed in a calm and relaxed atmosphere.
   It will also help to breastfeed with your baby clothed in diaper only.
4. Change your position.
   Try a variety of positions such as laying back while supporting your baby’s back so that your baby is in a vertical position, chest to chest, or side-lying.
5. Initiate your letdown reflex before breastfeeding.
   Choose a quiet, relaxed place and use relaxation strategies. Gently roll your nipples between your thumb and index finger for several minutes or until the letdown reflex occurs and breast milk leaks. You can also express some breast milk first before putting your baby on the breast. The first letdown reflex is usually the most forceful. Then latch your baby onto your breast when your breast milk stops spraying and changes to dripping.
6. Offer only one breast at each breastfeeding session.
   
7. Offer the same breast from the previous breastfeeding, if your baby wants to breastfeed within 1 to 1 ½ hours of the last breastfeeding.
8. Offer the same breast for two breastfeedings in a row if your supply is very abundant.
9. If your breasts are very painful between feeds, express just enough breast milk to relieve the pressure.
   This may help you feel comfortable. Try not to hand express or pump your breasts often as this can increase your breast milk supply.
10. Burp your baby frequently.
    This helps especially if your baby is continuously gulping loudly throughout the breastfeeding.

These strategies will gradually decrease your breast milk supply over a period of weeks and months so your breasts don’t make too much breast milk but just the right amount to meet your baby’s needs.

As your breast milk supply adjusts, you may need to begin to offer both breasts at each feed.

If you have any questions or concerns about breastfeeding, feel free to chat with us online, call Toronto Health Connection at 416-338-7600 or visit one of our free breastfeeding clinics.