Oversupply and Foremilk Imbalance
Oversupply refers to when a mother produces more milk than what baby needs, it is also commonly called “hyperlactation”. An oversupply of milk can often lead to lactose overload / overabundance of foremilk (watery milk at the beginning of a feed)
Fore-milk contains much less fat than what hind-milk contains (the milk that comes closer to the end of a feed). Fore-milk is also high in lactose which can cause difficulty of digestion, since baby may not have enough Lactase available to break down the Lactose in the small intestine.
Symptoms of lactose overload / Foremilk imbalance
You may experience one or more of the following:
• Baby may pick up weight slower, normally or more than expected. Some babies may gain too much weight, about 1kg every month.
• Colic symptoms including inconsolable crying for more than 3 hours every day, for more than three days every week and for more than three weeks.
• Watery, green, foamy and explosive stools.
• Fussiness while breastfeeding, more towards the end of a feeding session.
• Flatulence (gassiness) and signs of abdominal pain.
Symptoms of oversupply
(Not all moms with oversupply issues have babies that struggle with foremilk imbalance)
• Baby may gulp and choke at the breast. (this can also be a sign of a fast let down reflex)
• Mom’s breasts always feel full and fill up very quickly after a feed.
• Mom’s breasts are constantly leaking.
• Pain within the breast with a let-down (when the milk starts flowing).
Correcting and dealing with oversupply
• To correct oversupply Mom needs to get baby to drink more of the fatty hind-milk. She can do this by allowing baby to alternate breasts by feeding from only one breast for a 2 to 4 hour period (depending on how severe the oversupply issue is) The other breast should be pumped just a little for comfort, so that it does not become engorged. Some Moms have such bad oversupply issues, that they may only need to switch breasts every 6 hours. Mom should first start off with a two hour gap and then increase this, if the issues persist.
• Breastfeeding baby in a reclined semi upright position can help if baby struggles with the flow of the milk.
• Let baby breastfeed on demand and let baby decide when he/she has had enough. Do not keep baby on a strict feeding schedule.
While Mom is trying to correct these problems, she should also take into account the amount of wet diapers and bowel movements baby is having as well as keep an eye on baby’s weight gain.
Tracy Behr, CBC, CLD (CBI)
Reference: Breastfeeding counselor course through childbirthinternational.com on the physiology of breastfeeding / Breastfeeding problems, Other problems / oversupply and foremilk imbalance.
Other pages on breastfeeding problems in connection with this page on breastfeeding and oversupply.
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