Oversupply: One breast isn't enough

I have one question. The idea of only using one breast is fine, but my daughter only eats once during a four hour period. When she does eat, one breast is not enough. What do I do then? She has always gulped the milk and the lactation nurse at the hospital said this was normal. That I probably had a "hard" let-down. So is it normal or is there something I can do?

It isn't real bad now, but it used to be. I would let my milk spray into a diaper and reattach the babe after let-down. But she always let go during let-down. Now she tries to keep up. Should I pull her away? She always cries when I change sides too. Somewhat like she is impatient. Also, if the milk isn't coming out fast enough when she first latches on, she cries. I thought she was lazy and just wanted it to run into her mouth. Is there something else wrong?

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ABOUT THE EXPERT

Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

When you say that one breast isn't enough at a feed, I assume you mean that your baby is fussy at your breast and you feel that it would help if you switch breasts. Switching breasts is counterproductive in moms with an overabundant milk supply. Your breasts are constantly producing milk, so your breasts will not be empty a certain number of minutes into a feed. Your little one may be fussy because she is not able to elicit another let-down several minutes into nursing. (Several let-downs per feed are common.) If you notice that she is getting very fussy at your breast, after you've nursed for a while, you might want to try breast compression. Gently massage your breast from the outer quadrants, in toward your nipple. You may notice that your daughter begins more active sucking and swallowing as your milk flow again increases.

When a mother has been having breastfeeding difficulties due to an overactive let-down reflex and oversupply, she may unintentionally space out her baby's feeds. And since babies whose moms do have a very abundant supply are often more likely to self-comfort with their thumb/fingers or a pacifier, this spacing out of feeds can become even more exaggerated. I would recommend offering your breast more frequently than every four hours. (I'm definitely not advising that you force a feed, but allow your daughter the chance to nurse every two hours or so during the day.) The more frequently your baby nurses, the more easily she will be able to handle your milk flow. You will find that with more frequent feeds your flow will be less intense and more manageable.

It isn't necessary to take your baby off your breast unless you notice she is having difficulty handling the flow of milk. Watch your baby. If she's comfortable, allow her to control the feed. You mentioned that your little one cries when you switch breasts. Again, even if you do decide to offer the other breast during a feed, allow her to come off the first breast offered on her own. As the feed progresses, your milk transitions gradually from a high volume feed of primarily foremilk, to a lower volume and higher fat feed (hindmilk). Taking her off the breast after an arbitrary period of time may prevent her from getting the higher fat milk available toward the end of a feed. She knows best when she has had enough.

You mention that your daughter sometimes cries at the start of a feed, as if your milk isn't letting-down quickly enough for her (now.) One of the things that can happen when a mom has an overabundant milk supply is that her previously overactive let-down reflex does not seem to function as well. This usually starts to happen around the time a baby reaches 3 months of age. A mom may notice that her baby seems impatient at the breast and fussy until the milk ejects several minutes into the feed. The reason this happens is because her sucking pattern has changed due to your overabundant supply. She may have needed to allow your milk to flow into her mouth, so she wouldn't become overwhelmed. This altered sucking pattern can affect your let-down reflex.

How has your daughter's output and pattern of weight gain been? Has she been growing well? She should be wetting 5 to 6 diapers each day and having regular, substantial bowel movements. Normal weight gain (until a baby reaches 3 to 4 months of age) is 4 to 8 ounces each week. If your daughter is falling slightly below this level, it could be due to the spacing of her feeds. Encouraging your little one to nurse more frequently and offering one breast per 3 to 4 hour period should help begin resolving some of her breastfeeding difficulties. Best wishes!

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