Oversupply and a fast let-down, too much milk and how to manage it

Oversupply is one of those problems that sounds lucky and really does not feel it, and I see how much it can knock a parent's confidence, especially the leaking. Having too much milk might sound like the easy problem to have, but oversupply and a fast, forceful let-down can be genuinely hard. It can leave you sore and leaking, and it can make feeds a struggle for your baby. The good news is that it usually settles as your supply regulates, and there is a great deal that helps in the meantime.

What oversupply and a fast let-down are

Oversupply means your body is making more milk than your baby needs. It is common in the early weeks while your supply is still settling, and for some it carries on for longer. A fast or forceful let-down is when your milk releases quickly and sprays out strongly. The two often go together, though you can have a strong let down without a big oversupply. It all comes back to how supply and demand works, which you can read about in How your baby and your body work together.

Signs of oversupply for you

• Your breasts feel very full and firm, and leak a lot.
• Milk sprays out when your baby comes off the breast.
• You get engorged often, or keep getting blocked ducts or mastitis.
• Your breasts rarely feel properly comfortable or soft.

How it affects your baby

A fast, plentiful flow can be a lot for a small baby to manage, so you may notice your baby:

• Gulping, spluttering, coughing or choking at the breast.
• Pulling off, clamping down or fussing soon after latching.
• Clicking as they feed, or dribbling milk from the corners of their mouth.
• Being very windy, hiccuping a lot, or bringing milk back up.
• Passing green, frothy or explosive nappies, from taking a lot of the first thirst quenching milk and less of the richer, fattier milk.
• Gaining weight quickly but seeming gassy, uncomfortable or unsettled.

It can look and feel like colic. It helps to know that your baby is usually still feeding and growing well through all of this, and that it is manageable.

Helping your baby cope

The aim is to slow and soften the flow so your baby can keep up.

• Feed in a laid back position, with your baby lying on top of you and their head above the breast, so the milk works against gravity and flows more gently.
• When your let down comes, take your baby off for a moment and let the first strong spray go into a muslin, then latch them back on once it settles.
• Let your baby take breaks, sit them upright, and wind them often through the feed.
• Make sure your baby has a deep latch with their chin free, so they can handle the flow and breathe easily.
• Try offering one breast per feed rather than both, so your baby gets the fuller, richer milk and you are not stimulating even more supply.

Feeding from one side at a time can help, but fully draining one breast and holding your baby off the other for long stretches, sometimes called block feeding, should only be done with guidance. Done too enthusiastically it can cause blocked ducts and mastitis, or drop your supply too far.

Easing oversupply for you

• Feed responsively, and try not to add extra pumping sessions, as pumping to empty tells your body to make even more.
• If you are uncomfortable, express or hand express just enough to feel comfortable, not to empty the breast.
• Use cold compresses between feeds for comfort.
• Watch closely for blocked ducts and mastitis, and act gently and early. You can read more in Engorgement and mastitis.
• Be patient. For most women oversupply settles by itself as your body learns how much milk your baby actually needs.

Breast pads and looking after your skin

With oversupply you will leak, and how you manage that matters for your skin and your breast health. A breast pad that is damp with milk and sitting warm against your skin is a perfect place for bacteria to grow, and that bacteria can get into a cracked or sore nipple and contribute to problems like mastitis or thrush.

• Change your breast pads as soon as they feel damp, and change them often through the day.
• Let your nipples air dry for a moment before you put a fresh pad on.
• Choose breathable pads, and avoid ones with a plastic backing that traps moisture against your skin.
• If you use washable pads, wash them well and make sure they are fully dry before you wear them again.
• Keep the skin of your nipples clean and dry between feeds. There is more on breast care in Looking after yourself while breastfeeding.

Leaking in public and how you feel about it

Leaking in front of other people is something many women find embarrassing, and sadly some stop breastfeeding altogether because of it. Please know that leaking is normal, it does not mean anything is wrong, and for most women it settles as your supply regulates. It is not a reason you have to stop.

A few things make it easier when you are out:

• Wear absorbent breast pads and carry spares to change into.
• Patterned or darker tops hide any marks far better than plain, pale ones.
• When you feel a let down coming and cannot feed, press the heel of your hand or your forearm firmly against your nipple for a moment to stem the flow.
• Keep a spare top, a scarf or a muslin in your bag, just in case.
• Feed or hand express a little before you go out if you will be a while.

If leaking or the feeling of being on show is making you think about stopping, please talk to someone first. It is such a manageable thing, and it would be a shame to stop for a reason that passes.

How a consultation helps

Oversupply and a fast let-down are very manageable with the right approach, but the wrong approach can make them worse. When I see you I watch how your baby is coping with the flow, get your positioning working for you, help protect you from blocked ducts and mastitis, and guide you on gently bringing your supply into balance without losing it.