Rapid Letdown, Oversupply, & Lactose Overload
Although most breastfeeding parents worry that they don’t have enough milk, some have too much milk, which can lead to complications for both the nursing parent and the baby; for some, their “letdown” (a.k.a. milk ejection reflex) is so rapid or forceful that it interferes with effective feeding.
A parent with a rapid or forceful letdownmay notice their baby gagging, coming on and off the breast, clamping down on the nipple (to try to slow the flow), spitting up during nursing, swallowing excessive air, and/or having short feeds.
Strategies for helping with rapid or forceful letdown:
Adjust your positioning. Positions to try include laid-back nursing and side lying. Also try positions that have baby’s head higher than her bottom, and positions that have her more upright, such as the koala hold.
Express milk briefly until you see the flow slow down; then put baby on the breast.
During letdown, gently and firmly press down on the breast with your hand to reduce flow.
Give your baby frequent burping breaks.
Give it time—you will likely find that your baby gets better at handling the fast flow as he gets older.
Parents who have an oversupply of milk are making more milk than their babies need. This can lead to discomfort for the breastfeeding parent and the baby. If you have an oversupply, your breasts may feel engorged and painful. You may notice your baby demonstrating many of the same struggles as with rapid letdown. Your baby may seem fussy and gassy and may have consistently green poops.
Feeds may be short, too. Babies who consistently have short feeds might ingest more “foremilk,” which is higher in lactose, than “hindmilk,” which is higher in fat. These babies can experience lactose overload, which can result in a gassy baby with green poop.
NOTE: Lactose overload is not the same as lactose intolerance. Lactose is the primary carbohydrate in human milk, and human babies are almost never lactose intolerant!
Strategies for helping with oversupply:
Try “block nursing” – nurse on the same side for two feeds in a row before switching to the other side.
Avoid pumping longer than needed, just to keep yourself comfortable if your breasts are full between feeds.
Avoid pumping after nursing, or pumping more than you need for times away from baby.
Use gentle edema massage and cool compresses to help manage breast discomfort.
Please contact us with questions or for individualized help.
DISCLAIMER: We know when you surf the web for information, you can get conflicting results, and it’s not easy to know whether you are finding evidence-based, high quality recommendations. That’s part of our job here at Kodiak KINDNESS; we are here to support your informed decisions about infant feeding through your baby’s first year. We’ve done some background work, and to the best of our knowledge, this post reflects current best practices. However, the information contained in this post and any links contained herein is for your informational use only; it is not a substitute for professional advice, diagnosis, or treatment. Furthermore, Kodiak KINDNESS is not responsible for the accuracy of any information contained in this post or links contained herein; it is for you to review at your own risk and discuss, as needed, with your health care professional in order to make a plan that suits your individual circumstances.