If you have looked through my testimonials page, you may have noticed a theme…..a lot of my clients have mentioned that I have helped them manage their oversupply of breast milk issues. This pattern has not escaped my attention either.
 
To start with I thought  “Oh how fortuitous that I have had this client with oversupply, I will really be able to help her, not just from professional experience, but also because I have had it myself” then I thought “Well this is strange that this lady also has oversupply.... just a coincidence” and then I thought “I am diagnosing oversupply in all these women because I am subconsciously expecting to find it?” but realised, that couldn’t be the case since if I was mistaken in my diagnosis, then the solution would have in fact created more problems; instead, it solved the problems and the babies thrived. These women definitely had oversupply.
 
After a while I realised that more of my clients have oversupply than not and this had gone on for too long to be a coincidence. What I have come to believe is that oversupply is in fact normal when we manage feeding the way that we do in our western culture.
 
First of all, mother nature likes to err on the side of caution and makes allowances for just how useless many babies are at feeding in the first few days and weeks of life. Human babies have to be born more or less helpless, neurologically and physically immature, since as a species we are bipedal which affects the shape of our pelvis and we have a large skull to house our large brain. Walking on two legs and birthing large babies means that our babies have to come earlier than they really should and though adorable are quite pathetic little bundles! For this reason, we have to be excellent mothers to keep them alive (remember: when you are feeling low – you are awesome and your baby is rubbish – it’s usually them creating the problems!). When we have had a straightforward labour and a good first feed, a cascade of hormonal and physiological events take place which initiate plentiful lactation.
 
Every woman is different, some women never leak, while others run like a dripping tap at regular intervals in the early weeks. Some women never feel a sensation with let down, others find it quite painful in the beginning and can be very trigger happy, with any thought about feeding sending milk shooting out.  However, regardless of whether you are aware of it or not, in the first few days after your milk comes in, those horrendously engorged breasts will often dribble milk into your baby’s mouth even if he is improperly latched. This is like the insurance policy to keep him alive while he learns to feed. It’s this that can often account for a surprisingly acceptable regain of birthweight at the second and third weigh, even in a baby who is feeding poorly. This then leads the Mum to think that everything is going well, but if he still doesn’t learn to latch properly and drain the breast effectively, then her body will not continue to produce the milk required, nor dribble out milk effortlessly and the baby will stop gaining weight.

In a mother-baby pair where breastfeeding is going really well, then the body continues to err on the side of caution in the first 6-10 weeks and this creates the natural tendency to oversupply. I believe that this is then reinforced in our Western Culture rather than gradually resolved, because even if we baby wear, we tend to frequently swap our baby between breasts, at almost every feed and see feeds as discrete events which have a start, an end and which can be counted. We also prefer our babies not to suckle on and off almost continuously. This regular swapping coupled with less frequent feeding means that Western babies ingest a lot more foremilk and our breasts are stimulated differently than those of  women in traditional cultures.
 
In traditional cultures, when babies are ‘worn’ they are often worn naked or semi naked and in direct contact with a breast, with direct access to a nipple. The baby may be left strapped to that one side for a number of hours before being unstrapped and placed on the other side, ensuring that each breast is drained as much as possible several times per day and that the baby gets plenty of the fattier milk.
 
I don’t see that there is anything wrong with our Western way of feeding providing our child’s needs are met and we as mothers are also managing okay. I see so many cases of oversupply that I do think it is something induced by our way of feeding. I’m not suggesting that you need to strap your child to one breast for many hours whilst digging your garden though! With a little scientific understanding we can find simple solutions to the problem of oversupply. If we try to self-diagnose and fix things without professional help then sometimes it can actually make things worse. For example, some Mums might not be able to recognise the difference between sucking and actually feeding, so their baby may actually be being underfed in spite of spending many hours at the breast. However, once you have had some help and fully understand your physiology, then oversupply is usually easy to manage by yourself.
 
Signs of over supply include:

• A baby who is gaining a lot of weight but always seems hungry
• Though sometimes they have slow weight gain
• Baby only settles for short period
• Very full or leaky breasts, sometimes accompanied by forceful let down reflex which leaves the baby choking
• Easily pumping large volumes of milk (the reverse is not true – if you have trouble expressing it is not indicative of low supply if baby is doing well. Also, not getting large amounts when expressing doesn’t rule out oversupply – some women just don’t respond well to a pump instead of a baby)
• Baby wees and poos excessively
• Poos may turn green and frothy
• Baby cries a lot with tummy ache, farts and cries before / during poos
• Hearing baby swallowing after every suck or after every few sucks, long into the feed i.e still swallowing a lot after 20+ minutes
• Hearing/seeing/feeling multiple forceful let downs per breast within one feeding session
• Still being able to hand express and have milk shoot across the room after baby has had a long feed on that breast

 
 
If you think you have oversupply and are not sure what to do about it please contact someone like me or a Lactation Consultant.

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