Friday, January 18, 2013

Things nobody tells you about nursing: oversupply

Trigger warning!  This is about that whole breastfeeding thing, and it's mostly about mechanics.  I should write another post about emotions that went with it sometime, because it was an emotional experience for all 13 months we did it (note: not mostly happy, cheery, oh how wonderful is this! emotions that you hear so much about).  But that will come at some point.

Obligatory silly picture, this time of a guinea pig in a bonnet!

You will find lots and lots of information all over the internet about what to do if you really want to breastfeed and don't have enough milk (or someone has told you that you don't have enough milk, which many times is untrue).  However, there's a lot less around about what to do if you have way too much milk (and there was hardly any 5 years ago when we dealt with it).  But for the curious, here's an article by an expert that links to some other articles too!  Here's my experience with it with the kid.  I'm not a lactation consultant or trained in any way, so if you've got this problem too, check with someone who is trained for their specific advice for you and your small person.

I started off with a vast supply of milk.  When my milk came in, it didn't stop at "in" but moved right on into leaking.  Lots.  And this was at 18 hours post-delivery, so the kid wasn't really interested in much milk just yet as a snoozing brand new baby.

The first time I talked with the lactation consultant (about 2 hours postpartum) I felt pretty confident about the whole thing.  My mom was a La Leche League leader or whatever it's called and nursed the sibling for 3.5 or 4.5 years (me more than a year but well less than 2), my MIL nursed both her kids for at least 6 months exclusively and in part for a few months after that.  Heck, my grandma nursed all three of her kids too.  I felt like I had a supportive environment and some experienced ladies around to support me (when they were around, which wasn't that much).

The second time I talked with the lactation consultant was a few hours after my milk came in, when she told me "your supply should regulate itself in a few weeks, so if it hasn't, come back in a couple and we'll talk."

So we nursed on demand, as long as the kid wanted, and it went fairly well latch-wise.  I started pumping before the occasional feeding (on the same side of course) and would feed the kid after I'd pumped 2-4 ounces at about 3 weeks old, but I was hesitant because I didn't want to suggest my body make any more milk.  I spent my time wearing a bath towel with my robe and changing towels every few hours when they were totally soaked through.

My doctor said the same thing, that it would be better in a few weeks (at the kid's 2 week visit, where I had to change nursing pads after the 25 minute appointment because they were soaked).  Then I got a depo.provera shot at the 6 week postpartum visit, and heard again that "this will help regulate your supply" and that having my period back should also help (yes, period at 6 weeks postpartum, silly overachieving body must have been proud about getting the pregnancy thing right).  It didn't.

So what's so bad about oversupply aside from being sopping all the time?  The balance of foremilk (mostly water) and hindmilk (much higher in fat) is totally off.  The kid would nurse for 15-20 minutes, burp, spit up most of what she'd eaten (or at least a whole lot, but being pretty happy), wait a few minutes, then act hungry again and eat another 10 minutes, then repeat for about half the feeds of the day.  Yep, the kid was gaining weight all along, but she wasn't a happy kid.  She spent several hours after her evening cluster-feeding suffering from colic.  Nobody knows what causes colic, it just happens.  However, since she got better at the same time I quit oozing milk constantly, I figure the two were related.

The thing that did help was nursing on one side only in blocks of several hours, but we didn't figure this out until maybe 10 weeks along.  First we tried 2 hour blocks for 3 days with no change, then 4 hour blocks, then 6 hour blocks (which hurt the other side a great deal).  That finally helped settle things down.

I also think that me going back to school when the kid was 12 weeks old helped too.  As much as "nurse on demand" is generally a great idea, when she could, the kid was snacking every hour during her "day" and this encouraged my body to produce too much.  When I wasn't right there for snacks, she suddenly decided to eat half as often but would nurse longer (and I presume took more by bottle, but since she'd had two bottles ever prior to that, there's no way to compare).  With pumping, I found that if I pumped at about the same time as her regular meals (but for much longer because I apparently don't do super well at pumping) I had no trouble keeping up the daytime schedule.  We did have some trouble when I didn't pump enough during 2 days we were mostly apart (I didn't pump during her night feeds) but it was just a hitch and my supply stayed right on track with her demands until I broke my ankle when she was 11 months old.

Short version of what helped with oversupply: pumping first, then nursing made for a happier baby, block nursing only on one side for several hours in a row rather than switching every feed helped, and some separation helped prevent snacking that my body was over-responding to.  Also lots of towels in the beginning.

General nursing things nobody tells you: the first 6 weeks are horrific, and the next 6 are often also not fun, but after that, it gets better and it's so much simpler to grab a diaper or two and a baby than to fuss about with bottles and formula.  I think the reduced time burden of not having to fuss with bottles really kept us sane when the spouse got a job and I was in school full-time, so I'm doing it again, despite being fairly ambivalent about how "wonderful" nursing was.  Let's face it, I'm lazy.  It's so much easier to yank my shirt around than to measure formula and water and mix it, and there's less fussing from the baby if the food is available faster.


  1. Oh man, I had the opposite problem, but this sounds like no picnic. I have a friend who used some sort of contraption (easily available on the internet) to catch the leaking milk throughout the day. She stored a lot that way without even having to pump!

  2. I had a HUGE over supply in the beginning. I cried at all the lost milk, but as a pump dependent mom I was thinking how many feedings I lost in all of those lost ounces of milk. During one session with the LC I collected 3 ounces on one side at two weeks while she nursed the same amount on the other. Not pumping, just in a collection contraption. I couldn't believe it, especially since I was still able to pump a good 4 ounces after that(total). This is definitely good info for nursing moms. Hopefully I'll get to use this if I ever get pregnant again.....