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What Experts Say^*

Many nursing moms worry whether their milk supply will be sufficient, but you have an entirely different concern. You feel like you have enough milk to feed all the babies in your neighborhood!

A very abundant milk supply is often combined with an overactive milk ejection reflex. As milk ejects, the flow can be quite forceful. Authors Jack Newman, M.D., and Teresa Pitman, of "The Ultimate Breastfeeding Book of Answers," write "The baby goes to the breast, and as the milk flows, he may choke, or the mother may take him off the breast to try to calm him or stop him choking. The baby will usually be hungry when he comes off the breast because he will have fed only a very short time. So he will try to latch on again, but the process may repeat itself."

Tip for Nursing with an Overabundant Milk Supply

You'd think it would be pretty easy to tell that you have too much milk. Surprisingly, many moms think just the opposite -- that they have too little. Your baby may sputter, choke, and pull on the breast as your milk ejects. This can be very frustrating to your baby (and you).

Fussiness and unhappiness at the breast is a hallmark of oversupply. Your baby may appear to dislike nursing, and may want to nurse only for food, not for comfort. You may have leaking, full breasts between feeds, and may be more prone to breast infections and plugged ducts. Your baby may have plentiful loose green or yellow stools, gassiness, and colicky behavior.

• Proper positioning and attachment can work wonders. When your baby is well positioned throughout the feed she has better control, so it's easier to handle a rapid milk flow or increase your flow as it slows. Sore nipples are common in moms with very abundant supplies. Babies may clamp down on the nipple to stop the flow or slide off the breast as a way of handling the rapid milk flow. If either of these happen, remove your baby from your breast by putting your finger in the corner of her mouth, and try again.
• Try a new position. Nurse your baby upright or lying down. To nurse upright you can adapt the classic nursing positions such as the cradle hold and clutch hold, keeping your baby in almost a sitting-up position with her head above your nipple. Nursing in the side-lying position, or even with you flat on your back and your baby lying across your body can help your little one more easily deal with your abundant milk supply. If your baby doesn't easily latch on while you're on your back you can sit on the edge of the bed, get your baby properly latched on and then lie back.
• Stick with one breast per feed. Switching breasts during a feed is not recommended for moms with too much milk. As the feed progresses, your milk gradually transitions from lower-fat foremilk to higher-fat hindmilk. If you switch breasts your baby will get a high-volume feed of mainly foremilk. Too much (high-lactose) foremilk can make your baby colicky, gassy, and irritable with frequent loose green stools. If your baby wants to nurse more frequently, offer the same breast in one time block, starting at two to three hours on one breast. (Express just enough milk from the unused breast to feel comfortable.) This time period can be increased if necessary to further reduce milk supply. Take it slow and reassess the situation to avoid reducing your supply too much.
• Let your baby "graze" at the breast. Though frequent breastfeeding may seem counterintuitive, your baby can more easily manage your milk flow and will suck less aggressively. Your let-down will also be less forceful when there is less time between feeds.
• Allow your baby to control the feed. Babies of moms with too much milk often come off the breast several times during the feed, usually as the milk ejects. This is perfectly fine. Just remember to offer the same breast.
• Go with the flow. As your milk ejects you can press into your breast tissue with the heel of your hand to help reduce flow. Change areas of pressure on your breast so you don't end up with a plugged duct. If your baby still has difficulty with your fast flow, remove her from the breast, catching your milk in a cup or diaper, and putting her back once it slows.
• Keep your cool. Cool compresses, applied to your breasts for 30 minutes at a time, remaining off at least 60 minutes, can help reduce your milk supply. Cool cabbage leaf compresses can also help. Tuck a few chilled cabbage leaves inside your bra and change every two hours, or when they wilt. Give it a try for one day and reassess your supply the following day.
• Burp your baby frequently. Though most breastfed babies do not need to be burped, babies of moms with very abundant milk supplies are often gassy. They may take in more air during a feed and may also be gassy from a high-lactose feed of foremilk.

Safety Note

• As you make breastfeeding changes, keep an eye on your baby's diapers and weight gain. A baby over 3 days old should wet five to six disposable diapers and have at least three to four (quarter-size) bowel movements a day. You will often see less frequent bowel movements after six weeks of age. Regular weight checks will reassure you that your baby is growing normally.
• Babies with these conditions may have trouble coping with even a normal milk flow: Reflux; pain from a birth injury; a short frenulum (tongue tie); low muscle tone; difficulty coordinating sucking, swallowing and breathing; respiratory problems; and sensory integration problems.