Definition: Making more milk than your baby/babies need(s) on a daily basis.
Problems which may be related to overproduction:
- Breast engorgement, fullness, hardness, discomfort during the day and/or night.
- Recurrent blockages or mastitis.
- Unwanted leaking.
- Fussy or gassy baby.
Before you diagnose yourself with overproduction, you need to make sure that your baby is actually getting all the milk he/she needs from you and is gaining weight well. I say this because sometimes, a women senses that her breasts are full, but this may be because the baby is not transferring the milk. If this is allowed to go on, two things will happen: your baby will not gain weight well and your milk production will decrease. If your baby is not gaining weight well, you will need to pump your milk and give it to the baby via bottle or supplemental nursing system, until you know your baby is feeding effectively. Feed the baby and preserve the supply.
Ways to deal with overproduction:
The easiest way to control production is to pump completely dry after the morning feed (somewhere around 6 or 7 AM). If you do this, the breasts will never fill up to the degree that they usually do for the early morning feed. The next feed after you pump dry, the baby will get a lower volume of milk (also creamier because the breast is emptier). The rest of the day, your breasts will feel more comfortable. The next day, again pump dry after the morning feed and the breasts will decrease the amount of milk produced. After one week, if your breasts have been feeling comfortable during the day, you may slowly start to cut back on the pumping. Do this by cutting the pumping time by two minutes per day until you are no longer pumping. Example, pump for 13 minutes one day, 11 minutes the next day, then 9 minutes, etc. to zero.
One sided feeds
If you don’t want to pump or feel like the pumping didn’t work, you can try nursing on one side per nursing session. Transitioning from two-sided to one-sided feeds can be tricky and if done abruptly, can lead to mastitis. If you start one-sided feeds, make sure that the breast that is “waiting” to be drained is not overly full. If it is, you may need to pump or hand express a little milk out(1 ounce or less) so the breast can feel comfortable while it “waits.” After two days of pumping to comfort on the “other” breast, you should not feel the need to pump for comfort. Women with significant overproduction may need to feed on the same breast for two feedings in a row (R,R, L,L,R,R,L,L). Be careful that your production does not decrease too much if you do this.
****If you are doing one-sided feeds, I encourage you to restart offering the second side once the baby is 4 weeks old. If the baby refuses the second side, that’s fine. Continue to offer the second side in the weeks to follow. I recommend this because the hormones of milk making start to calm down after 4-6 weeks post-partum. At the same time, babies start to sleep longer at night. The combination of the hormones decreasing, the longer nights sleep and the one sided feeds may cause the supply to decrease too much and some women could end up with low production.****
Cabbage leaves have been used to decrease engorgement and milk production. Separate leaves and freeze. Some recommend crushing the main vein of the cabbage with a hammer before putting them on the breast. Cover entire breast with leaves and change frequently or when they warm or wilt. I do not recommend using cabbage for more than one or two days because the milk production can go down dramatically.
Sage has been used to decrease milk production. You can eat the leaves, buy sage tea bags or brew your own tea. Be careful not to drink more than one or two cups daily at first because you can’t predict how much it will lower your production. If two cups does not affect your production, you can increase to 3-5 cups daily.
Peppermint tea may also decrease milk production.
Medications to decrease milk production
Diphenhydramine (Benadryl), pseudophedrine, cabergoline (Dostinex), and estrogen containing oral contraceptives and vaginal creams have been used to decrease production. Discuss with your doctor before taking any medications to decrease milk production.