Before she gave birth to her first child, Brittany worried about not producing enough milk to feed her baby. But that ended up not being an issue with her first, who is now 4-and-a-half. Nor was it a problem with her 2.5-year-old or her 7-month-old. On the contrary, Brittany’s breasts practically overflowed with the stuff, like two small firehoses she couldn’t turn off.
“My kids would all start choking,” explained the 31-year-old, who lives in Kansas. “They’d pull off and when it’s very forceful like that, it’s like a sprinkler going off. It’s like, ‘Get me a rag!’ You’re getting it all over them. They’re upset. You’re upset.”
“Sometimes,” she said, “I just wanted to scream, what am I doing wrong?”
In breastfeeding support groups and consultations between dazed new moms and lactation consultants, the words “supply problem” generally mean one thing: insufficient milk. Estimates suggest that between 30 and 80 percent of breastfeeding moms believe they’re unable to produce enough milk, whether or not that’s actually true.
But for a smaller, often-overlooked subset of mothers, the problem isn’t making too little milk; it’s making too much of it. And while an abundance of milk may sound like a pretty damn good problem to have, mothers and lactation experts say it is actually extremely painful and emotionally grueling ― an ongoing battle between supply and demand that can lead to swollen, aching breasts and unhappy babies.
Though there isn’t a hard-and-fast definition, oversupply is essentially a mismatch between what a mother makes and what her baby can comfortably take in.
“The baby put in an order for, say, 24 ounces of milk, and the mom is putting out 30 ounces,” Linda Smith, an Ohio-based International Board Certified Lactation Consultant, told The Huffington Post. “If it’s not removed, she is in pain. If too much is removed, her body makes more.”
That’s because ― broadly speaking ― milk production is controlled at the breast. When a baby empties the breast, they’re sending a signal to their mother’s body to produce more milk.
With oversupply, that balance may be thrown off because of a problem on the baby’s side (like, a tongue- or lip-tie that prevents them from emptying the breast, Smith said) or because of an issue on the mom’s side (perhaps she is pumping as she stocks milk before returning to work and over-stimulating her breasts, or in rarer cases, has a hormonal imbalance, Smith explained). Sometimes it is a combination of factors that throws off the delicate relationship between supply and demand. Smith added that she usually doesn’t consider a mom to be having an oversupply issue in the first six-weeks postpartum, because at that point many women and their babies are still finding their rhythm.
“Mothers are held hostage to their pump ... they're at-risk for getting sick with mastitis, which is miserable.”
- Leigh Anne O' Connor, lactation consultant
One of the biggest challenges associated with oversupply is having an overactive or forceful letdown, which means moms have to watch as their sweet nursing babies are quickly overwhelmed by their breast milk. As a result of gulping down air in an effort to keep up with that fast flow, many babies become gassy and cranky. “A baby who gets too much milk very quickly may become very fussy and irritable at the breast and may be considered ‘colicky,’” Dr. Jack Newman a Canadian pediatrician and lactation consultant explains on his website. Often, babies will pull off the breast or simply refuse to nurse.
Then there’s the breast pain. Women with oversupply get little relief from breasts that feel uncomfortably full, hard or leaky. And because their breasts may not sufficiently drain, they are at risk for painful plugged ducts and mastitis, an infection that leads to searing pain, redness and high fevers that moms have described as “pure misery” or the “red-eyed breastfeeding monster.”
“Mothers are held hostage to their pump,” Leigh Anne O’Connor, a New York City-based International Board Certified Lactation Consultant, told HuffPost. “They’re not free to move around, for one thing. They’re at-risk for getting sick with mastitis, which is miserable. And then having a baby who is gulping down milk is miserable as well.”
Lindsay, a 32-year-old from Chicago who has a 7-and-a-half-month-old daughter, says that in her early breastfeeding days, her milk would just “shoot out.”
“My daughter was, like, choking and flailing around, and then she would be really gassy and had stomach issues, which they said might be because the milk was coming out so fast and so hard,” she said, adding that you could see that her breasts were bulging with liquid.
Lindsay worked with a lactation consultant who reassured her that her supply would eventually settle down, and it did to some extent ― but only after she settled into an aggressive pattern of pumping five to six times a day, often before and after feedings. And only after she developed mastitis when her daughter was 3 months old.
“Complaining about oversupply can feel like going into a Weight Watchers meeting and lamenting that it's just too easy for you to drop pounds."”
“I still get annoyed at night when I’m really tired, or I’ve fallen asleep on the sofa but I have to pump otherwise I’m going to wake up in pain ― and I’m terrified I’m going to get that infection again,” she said, adding that she has burned through three power cords on her breast pump since her daughter was born.
Sometimes the fix is clear. If the issue is simply that a mom is pumping too much and overstimulating her breasts, cutting back can make a big difference, said Smith. Different holds can help babies manage the milk flow better, and pumping a bit before and after feedings can help moms find a better balance, she explained, adding that women should certainly seek out help from a lactation consultant, doctor or support group.
But other times, it’s about moms and babies working together to find that delicate balance that works for them, feeding after feeding and day after day.
For Brittany, that has meant learning to hold her each of her babies in a particular way so that they don’t choke on the fast flow of milk, and pumping a little before she starts a feeding so she gets immediate relief ― and so that the letdown isn’t quite so intense.
It has also required some emotional gymnastics, working hard to view her oversupply as a good thing. Brittany has been able to donate her excess ― three coolers full of milk, as well as four garbage bags ― to a local milk bank, where it has been pasteurized and given to babies who need it. That, at least, has helped give her a sense of purpose and calm during her more dispiriting breastfeeding moments.
Dealing with oversupply can be isolating, both in terms of how it keeps many women at home and close to their pump and how it affects their ability to commiserate with other breastfeeding women. Moms know how it sounds to complain about making too much milk when so many other moms are struggling to produce enough. Going into a breastfeeding support group and complaining about oversupply can feel kind of like going to a Weight Watchers meeting and lamenting that it’s just too easy for you to drop pounds.
“I’ve been facilitating groups for moms for years and one of the things that is so hard is that these women don’t want to talk about their problems with a woman who makes four ounces in 24 hours,” said O’Connor, the lactation consultant, who added that many times women will only speak up, somewhat sheepishly, five minutes before a support group is set to end ― and then try to minimize their problem lest they come across as ungrateful.
“You go to these groups and you almost feel bad bringing up the fact you have too much milk,” said Brittany, who wrote a blog post on the topic so other moms wouldn’t necessarily feel as lonely as she did when she was struggling to nurse her first baby. “But there really are challenges on both sides.”
