Breastfeeding and Oversupply

Oversupply and Foremilk Imbalance

Oversupply refers to when a mother produces more milk than what her 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 holds (the milk that comes closer to the end of a feed). Fore-milk is also high in lactose, which can cause interrupted digestion.  This is because her 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 mothers with oversupply issues have babies that struggle with foremilk imbalance)

• The baby may gulp and choke at the breast. (this can also be a sign of a fast let down reflex)
  
• The mother’s breasts always feel full and fill up very quickly after a feed. 
  
• The mother’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 a mother needs to get her baby to drink more of the fatty hind-milk. She can do this by allowing her baby to alternate breasts by feeding on 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. A mother should first start off with a two-hour gap and then increase this if the problems persist.
  
• Breastfeeding a baby in a reclined, semi-upright position can help if the baby struggles with the flow of the milk. 
  
• Let your baby breastfeed on demand and let Baby decide when he/she has had enough. Do not keep your baby on a strict feeding schedule. 

While a mother is trying to correct these problems, she should also take into account the number of wet diapers and bowel movements her baby is having, as well as keep an eye on baby’s weight gain. 

How to Handle a Fast Let Down

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.