Oversupply and fast letdown

Some parents make more milk than their baby needs. Fullness is normal in the first several weeks while supply adjusts, and mild oversupply often settles on its own within a few months. A fast, forceful letdown often comes with it.

Signs

In you:

• Breasts that stay very full, or leak a lot.
• Blocked ducts, mastitis or nipple blebs that keep coming back.
• Breast or nipple pain.

In your baby:

• Coughing, choking or pulling off during feeds.
• Clamping down on the nipple, fussing at the breast, or refusing it.
• Short feeds, lots of gas or spit-up, or green, explosive poop.
• Gaining a lot of weight.

A full-term baby drinks about 450 to 1,200 ml a day (15 to 40 oz), and making a lot more than that may be oversupply. Fullness in the first 1 to 2 weeks is usually engorgement. See the engorgement guide.

Slowing a fast letdown

• Laid-back feeding slows the flow. Recline with your baby lying on your front. See the latch guide.
• If you need to express for comfort, the ABM suggests hand expression over a pump.

Bringing supply down

• Pump only what your baby needs. Pumping on top of feeds is a common cause. If you pump in place of feeds, pump about as often as your baby drinks.
• Stop supply boosters. That includes teas, herbs and medicines taken to raise supply, and foods like fenugreek or moringa. Check with your doctor first if one was prescribed.
• Size your stash to your needs, for example for going back to work.
• Block feeding means feeding from one breast only for a block of time, such as 3 hours, then switching. It can help within 24 to 48 hours, but it can also drop supply too far or cause blocked ducts. The ABM advises doing it only with close support from a doctor who knows breastfeeding.
• Skip cabbage leaves and binding. There's no evidence they help with oversupply.
• Medicines to lower supply are a last resort and need a doctor.

When to get help

Talk to your doctor or an IBCLC (lactation consultant) if:

• Blocked ducts or mastitis keep coming back. See the blocked ducts and mastitis guide.
• Your baby struggles at the breast or refuses it.
• You want to try block feeding or any medicine to lower supply.
• You have a fever, or a red, hot, painful area on the breast.