An overabundant milk supply is when your milk production far exceeds the needs of the baby. This is most often the result of baby being switched to the second breast too early, but it could also be that Mom’s milk production rate is so high that baby is unable to even soften one breast each feeding. It can also result from a mother continually pumping to soften her breasts after feedings, which signals her body to continue to increase her production rate.

The signs and symptoms of this particular situation include:

• Over-full breasts that baby cannot completely soften with feedings;
• Frequent feedings, very wet diapers; often baby passes noisy, green stools;
• Baby may cry, squirm, pull off the breast, and/or swallow with clicks or choking sounds as milk lets down in the breast;
• Expressed breast milk still looks like "skim" milk even after baby has breastfed;
• Baby may feed often, yet never seems satisfied, despite obviously taking in lots of milk;
• Baby may be gassy, and uncomfortable during and after feedings;
• Sore nipples, which may result from baby trying to control a flow of milk that is too fast and overwhelming.

These symptoms often begin to show up at approximately two weeks of age. The treatment of an overabundant milk supply will often vary from nursing couple to nursing couple. The most common, and simplest treatment, is to feed baby when she is hungry, by softening the first breast before offering the second. Once the breast is soft, the milk should look like "whole milk." If the second side becomes engorged before the next feeding, express just enough milk to be comfortable but no more. Most mothers see a results after 48 to 72 hours of treatment.

Often babies have a difficult time with the fast flow of an overabundant milk supply. A reduction in milk supply will usually resolve this issue. While waiting for this to happen, nursing positions that work best are those that allow the baby to nurse "uphill," with his head and throat higher than your nipple. In the football hold, you can lean back to keep baby more upright and facing you. In the cradle hold, you can prop your baby in your lap on two pillows and then lean back in a rocking chair or recliner. Lying down on your side to feed baby can also help in the same way. This decreases the effects of gravity, and help reduce, or stop baby’s pulling off, coughing and sputtering. It may be necessary to latch and then recline if latching is difficult for you and baby.

If you are wanting to express milk to store for later use, it is best to delay this, if possible, until your supply is more in line with baby’s needs. Also, you should express at the same time every day.

A mother with an overabundant milk supply is at high risk for plugged ducts and breast infections. Call your doctor if you develop signs of an infection, such as a fever, flu-like symptoms, headache, and hot, sore breasts. Reducing saturated fats and limiting processed and high-sodium foods will help decrease the risk of plugged ducts.

For more complicated situations, a lactation consultant can help. A lactation consultant can complete a comprehensive evaluation and help you develop a plan that can be shared your physician and your baby's pediatrician. To schedule an appointment with an El Camino Hospital lactation consultant please call 650-988-8290 for the Mountain View campus or 408-866-3905 for the Los Gatos campus.