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When it comes to breastfeeding there are a lot of challenges a mom can face along the way. We hear a lot about women who cannot produce enough milk for their babies but we don’t often hear about the reverse problem, those who produce too much milk or who have a letdown that is so forceful it causes problems for both mom and baby.  You would think having too much milk, or milk that comes out too fast wouldn’t be much a problem, but for those of us who suffer from overactive letdown or oversupply we know just how much of a challenge it can be.

Overactive letdown, also referred to as forceful letdown, is when the milk forcefully sprays out of the breast during letdown. It can occur only with the first letdown per feeding, or multiple times per feeding.  Often the mother will have pain, or at the very least discomfort, in her breasts during the letdown. A baby nursing from a mother overactive letdown often has difficulty managing the flow and will choke, gag, and pull away from the breast. As a result these babies often end up with a lot of extra air in their tummies causing them to be gassy and fussy.  Since so much milk is coming out so quickly babies often fill up on the lighter, sugary foremilk and doesn’t get enough of the rich hindmilk. This lactose imbalance can result in gassiness, green, runny stools, discomfort and a lot of spitting up.

Moms with overactive letdown often end up being told their babies are lactose intolerant or that the baby is reacting to something in the mother’s diet, or that their babies are just coliky. This often results in the end of the breastfeeding relationship.

Although you can’t control your letdown there are a few things you can do to help make the flow a little more manageable for baby. These include:

  • Nurse the baby in a position so that the baby is “uphill”, modified cradle hold so that baby is tummy is lower than her head, football hold, or laying down so the baby’s head of above the breast.
  • Remove the baby from the breast during the letdown and let the milk spray into a clean cloth placing the baby back on the breast when the flow has slowed down.
  • Pump through the first letdown and then begin breastfeeding when the flow slows down.
  • Remove the baby from the breast often during breastfeeding to burp him or her to help prevent too much air build up.
  • Nurse the baby on one breast only per feeding. This will allow the baby to get the richer hindmilk.
  • If the baby wants to nurse again within 2 hours return to the same breast.
  • If you flow is incredibly forceful and you have too much supply nurse the baby on the same breast for a 2-4 hour block, switching only after that time frame is up.
  • Some women find it helpful to pump to empty first thing in the morning as it can help keep the flow slower during the day.
  • Nurse the baby when he or she is drowsy as their sucking with be less intense and will help keep the flow of milk a little slower.

It may take a while but eventually your baby should see some relief from the discomfort of the overactive letdown. Some babies, when faced with overactive letdown continuously, will begin to refuse the breast, or get angry when nursing. Try to work through it by following some of the helpful tips above, eventually the baby should return to nursing.

I’ve suffered from overactive letdown with both of my daughters. Thanks to the 19 months of breastfeeding experience I had under my belt I recognized what was going on immediately this go around. Anna and I are still trying to work through this challenge. I’ve been nursing her on one breast per feeding for several weeks and have started letting my initial letdown spray into a cloth. Slowly, I am beginning to see some improvement in her tummy troubles.

It can be frustrating dealing with a problem that others don’t necessarily see as a problem. Be sure to seek support from a lactation consultant or your local La Leche League if you are suffering from oversupply or overactive letdown. Having support to work through the challenge and to help come up with ways to manage the related issues will make it so much easier to continue your breastfeeding relationship with your baby.

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