8 Frustrating Breastfeeding Challenges—and Solutions

Although concern about not having enough milk is the number-one reason that mothers wean their babies early, having too much milk (commonly referred to as oversupply) can also be a problem.

Symptoms of oversupply for moms are:

• Strong or even painful sensation when milk ejects
• Constant breast fullness or engorgement
• Frequent spraying of milk from one or both breasts
• Excessive leaking
• More than one let-down per nursing session
• Repeated mastitis and plugged ducts
• Sore nipples

Oversupply is equally difficult for Baby. Infants whose moms have too much milk will often exhibit symptoms such as fussing, pulling off the breast, colicky crying, gassiness, spitting up, and hiccupping.

Effects of oversupply on Baby:

• These infants may want to nurse frequently and they may gain weight more rapidly than the average baby (who usually gains 4 to 8 ounces each week during the first three or four months), or they may gain weight more slowly than the average baby.
• Their stools may be explosive, green and watery, and their bottoms may be red and sore.
• The mother's letdown reflex may be so forceful that the baby chokes, gags and sputters as he struggles when her milk lets down.
• Baby may be misdiagnosed by health care providers with colic, lactose intolerance, or GER (gastro esophageal reflux). The diagnosis may result in unnecessary interruption of breastfeeding and unnecessary prescribing of medications.

Causes of oversupply: When a woman has a more than abundant supply of milk and Baby is consuming large quantities of it, an imbalance can occur in which the lactose he is taking in from the breast is not able to be broken down by his own body's lactase (the enzyme that breaks down and helps in the digestion of sugar). The sugar that accumulates in his gut can cause upset and bloating—leading to the fussy behavior and explosive stools.

Dr. Christina Smillie, MD, of Breastfeeding Resources, one of the leaders in hyperlactation research, explains this phenomenon as follows: "Hyperlactation itself is not something inherent in the mother anatomy or physiology or caused by the infants feeding style, but is rather a vicious cycle of behaviors initiated and reinforced by cultural expectations (i.e.; rigid schedules and the idea of having to feed from both breasts) and rules for feeding, which overrule basic instincts toward homeostasis.

Learning to trust her body, to listen to her infant and to let comfort needs guide behavior, can help restore comfort to the feeding situation, and in this way, help them stop the vicious cycle of symptoms of abundant milk supply."

Use these tips to reduce your overall milk supply:

• Try one-sided feedings. Let Baby finish up on one breast without offering the other. Remember—you have plenty of milk. Some moms may even nurse two feedings in a row on one breast. By leaving milk in the "unused" breast, your body gets the signal to slow down production.
• "Pump to comfort" the other breast. You'll feel a lot of fullness on the "unused" side. The tendency is to want to pump to empty the breast. Only pump to relieve pressure. If you are uncomfortable—feeling engorged—you can pump for a few minutes. By removing some milk, it will relieve the pressure but not empty the breast fully.
• Be on the lookout though for plugged ducts or even mastitis.
• Use ice packs to help reduce swelling.