(originally posted on my other blog, Becoming a Midwife)

I couldn’t wait to start breast-feeding – I believe it is one of the most beautiful, loving, nurturing, and intelligent things you can do as a mother. I read several books, including the classic The Womanly Art of Breast-feeding (the La Leche League’s official book), and I’ve even had experience doing breast-feeding counseling during my time as a NICU nurse. I knew that breast-feeding can often take some learning and adjustment for both the mother and baby, but I was confident that it would work out just fine.

I knew to expect the common breast-feeding difficulties – latching on, engorgement, and sore nipples. But, I was not prepared for the problem of oversupply. It may be just as frustrating as some other problems, and unfortunately, there is a lack of support and advice for this issue. At about one week old, my daughter Selah became incredibly fussy. Family and friends began to use the dreaded description of “colic”, and we tried every soothing technique and remedy we could find. A lactation consultant watched me nurse and was amazed at the amount of milk and force of the spray. We talked about some interesting positions for holding the baby while nursing, burping techniques, cabbage leaves – meanwhile, milk soaked through several receiving blankets as Selah fussed and tried to burp. As days went by and I reported continued fussiness and crying while feeding (both baby and I), I was finally encouraged to cut dairy out of my diet and try other major dietary changes. However, my research and mother instincts told me otherwise – this was not colic, Selah was not crying for no reason, and there had to be something I could do to help my baby. I knew that I had an abundant milk supply, but I did not realize what an effect it can have on breast-feeding. When I found a La Leche League articleand read a list of the characteristics of true oversupply, it was like reading a perfect description of my daughter and me! Here are some of those classic symptoms:

  • crying, irritable, restless baby
  • baby gulps, chokes, or coughs while nursing
  • milk sprays when baby pulls away from the breast
  • baby seems stiff, screams, and nurses fitfully off and on
  • short breast-feeding sessions, only 5-10 minutes long
  • “baby may seem to have a ‘love-hate’ relationship with the breast”
  • frequent gas and explosive stools

Midwives, lactation consultants, and well-meaning family and friends all had similar advice. They suggested pumping (I did hand-express milk, which helped, but I knew that regular pumping would just cause me to make more milk) and continued to suggest that it was a dietary issue (because Selah seemed so uncomfortable after eating). Conventional wisdom says that babies should nurse on both breasts at each feeding, often for about 10-15 minutes on each. However, I learned to dig deeper until I found a solution that actually made sense and worked for my baby and I. Just as I was beginning to doubt myself, and ready to begin the no-dairy diet, I found an amazing article from the Australian Breastfeeding Association. As much as I hated to admit it, Selah’s symptoms really did sound like lactose intolerance. Yet, this article explained that severe oversupply can lead to “Lactose Overload”, which actually mimics intolerance and is often misdiagnosed. The following paragraph from that article explained my experience perfectly, helped me realize what was causing Selah’s symptoms, and gave me the confidence to reduce my milk supply in the way they suggested.

“There is a vicious cycle here – a large-volume, low-fat feed goes through the baby so quickly that not all the lactose is digested. (More fat would help slow it down.) The lactose reaching the lower bowel draws extra water into the bowel, and is fermented by the bacteria there producing gas and acid stools. The latter often causes a nappy rash. Gas and fluid build-up causes tummy pain and the baby ‘acts hungry’ (wants to suck, is unsettled, draws up his legs, screams). Sucking is the best comfort he knows, and helps move the gas along the bowel. This tends to ease the pain temporarily, and may result in the wind and stool being passed. Since the baby indicates that he wants to suck at the breast, his mother, logically, feeds him again. Sometimes it is the only way to comfort him. Unfortunately this provides another large feed on top of the other one, which hurries the system further, and results in more gas and fluid accumulation. The milk seems to almost literally ‘go in one end and out the other’.”

I was able to solve my oversupply problem by nursing on only one breast at a time, often even focusing on just one breast for up to six hours at a time. This type of feeding signals the body that it does not need to produce so much milk. Engorgement is often a problem with oversupply, and may get much worse (with hard, hot, full breasts) when one breast is ignored for several hours. I found that the breast not being nursed on would leak profusely, solving much of the engorgement problem. If one really did become extremely uncomfortable, I would use a warm compress and express a small amount of milk – just enough to feel slightly more comfortable, without signaling my body to make more milk.

Selah’s extreme irritability, explosive stools, and screaming at the breast was mostly resolved within several days. She can still be fussy sometimes, and she still does not like that initial spray of milk during the letdown process, but she is now one of the happiest babies I have ever known. She often lays down after nursing, smiles, and talks sweet baby coos, as if to say “Yum, yum…Thanks, Mom!”.

My personal story is not a typical breast-feeding experience. If you experience an oversupply, talk to your midwife, doctor, or lactation consultant, do your own research, and decide what is right for you and your baby. If you do not have an extreme oversupply, use caution with this method of feeding, using cold compresses, or cabbage leaves – protect your precious supply of breast milk! I wrote this article primarily to remember my interesting experience with breast-feeding, and I hope that it will encourage others to do their own research and think for themselves! Feel free to write me with questions or for other breast-feeding encouragement.