Maya Lott, IBCLC

Oversupply is such a controversial topic online these days, and so many moms are suffering with this unnecessarily.  It may come as a surprise that the pain and stress that come with oversupply are in most cases completely avoidable.  In this article, we’ll go into the surprising distinctions between oversupply and overactive letdown, how to avoid oversupply, and how to correct it if you find yourself struggling with it.

Oversupply vs. Overactive Letdown

While oversupply and overactive letdown do sometimes occur together, it’s important to know that they are not the same thing.  The definitions, symptoms, root causes, and treatments for each will be different, and treating the wrong one will be completely ineffective.

	Oversupply	Overactive letdown
What is it?	Producing a lot more milk than your baby needs (in a 24 hour period)	A milk flow that’s much too fast for your baby to handle
Symptoms in baby	• Frothy, green, explosive stools • Reflux, spit-up, gassiness • Very fast weight gain	• Pulling away and arching the back during a feeding • Coughing, sputtering, or choking • Shallow, “pinchy” latch
Symptoms in mom	• Feeling full even after feedings • Frequent mastitis	• Seeing milk spraying or leaking from the side baby is not feeding from

Dealing with Overactive Letdown

It’s not clear what causes overactive letdown, but that doesn’t mean we don’t have techniques for dealing with it.  Some things you can try:

• Nurse in the laid-back position, which helps the baby handle the milk flow better because it’s going against gravity
• Wear a silicone breast shell on the side you’re not feeding on to catch the letdown and avoid leaking (be sure to use one with ventilation holes in it and avoid ones that suction to the breast)
• Hand express a tiny amount to trigger a letdown before latching your baby
• Be reassured that many cases of overactive letdown balance out with your postpartum hormones and as your baby grows

Dealing with Oversupply

The good news about oversupply is that in most cases it is completely avoidable and reversible.  The key is that breastmilk production is a demand and supply relationship, so your body will only “supply” what you’re “demanding”.  Oversupply happens when more milk is being removed from the breast than your baby needs.  But here’s the thing: babies are physically incapable of removing too much milk from the breast, so the culprit of oversupply problems is pretty much always – you guessed it – the pump.  I have yet to see a case of oversupply that was not directly caused by pumping and solved by simply dropping the pumping.

Now if you’re thinking to yourself, “Hang on, I have/had an oversupply even though I never pumped,” here are my next questions:

1. Are you referring to the temporary engorgement in the very early weeks postpartum (6 weeks or so) while your hormones are going crazy?  If so, this is not what we’re talking about here.
2. Are you sure you don’t actually just have an overactive letdown (see above)?
3. Are you really not removing any milk other than what your baby is taking in?  This includes hand expression, a Haakaa, or anything else providing suction or stimulation to the breast.

In almost all cases, simply stopping pumping for a few days will be enough to get your body back to a happy medium with breastmilk production.  If stopping pumping entirely is not possible for you due to being separated from your baby, limit your pumping time to as long as it takes you to collect enough milk for just one feeding and avoid pumping beyond that.  Remember, the less milk you remove, the faster your oversupply will resolve.

If stopping pumping alone doesn’t take care of your oversupply, consult with an IBCLC (like me!) who may advise you to try a technique called block feeding under careful supervision.  Block feeding without supervision by an IBCLC may cause your supply to decrease too much, resulting in an undersupply.

Resolving your oversupply may cause you to develop mastitis, a condition characterized by inflammation of the breast tissue.  Mastitis is not dangerous, but you should monitor your symptoms closely.  For more information, check out my blog post here.

Summary

Oversupply and overactive letdown are not the same thing, and they should not be treated the same way.  Pay attention to your symptoms so you can tell which you’re dealing with, and if you have any questions, never hesitate to reach out!