As mentioned in my article "Lopsided Breasts or Uneven Milk Supply," about two weeks after the birth of my second daughter I had the experience of successfully correcting lopsided breast size and supply issues. I began simply, by just beginning to start each feeding on the side with less milk, which gives the first side more vigorous stimulation. This might be sufficient for some; however, in my case, the speedy decline of the supply on the smaller side and increase on the larger was apparently too set in motion to be arrested by this method alone.
So I grabbed my pump
Early in nursing, milk supply is incredibly responsive. I continued starting all my feedings on the smaller side, switching to the larger side only when the baby detached on her own and still needed more milk. But after the feeding, I also began pumping the smaller side until completely emptied and then continued pumping for about 10 minutes after the milk stopped coming out. This is what tells that breast to start producing more milk. By doing this for about 4 days, I brought the supply on the smaller side back up until it was producing at its former, regular amount.
To increase the supply, I used a Medela Lactina, a multi-user pump rented from a nearby hospital. Note that a manual hand pump will not be sufficient for increasing supply a hospital grade rental pump is the best option if one is available and affordable for you. However, a Medela Pump-In-Style or other equivalent personal-use pump you already may have on hand may be sufficient (it may take slightly longer or require slightly longer pumping times after milk flow stops).
After rescuing the supply on the smaller side, I continued starting all feedings there, again switching only when the baby self-detached and wanted more. Because the smaller side was producing better, the larger side was not emptied after feedings. When that side became engorged in between feedings, I hand expressed only enough to be comfortable, while watching VERY carefully to avoid plugged ducts. A small manual handheld pump, would also be appropriate for this if you are not successful at hand expression, although care should be taken not empty the breast absolutely any more than necessary to maintain comfort and breast health.
It took about another 4 days for the supply in the fuller side to drop back to normal levels. Be aware that a drop in supply can happen more quickly as well, so take care not to simply reverse the lopsided problem by letting it drop too much! After a more even supply returned to both breasts, I began adding back alternating the starting breast occasionally, and eventually again, every other feed, until I knew everything was back to status quo.
Now this may all sound complicated, but it's really just a matter or temporarily managing milk supply using pumping for increase and hand expression for decrease in a systematic way. I share this because I don't think it is necessary to live with the inconvenience of severely lopsided breasts. More importantly, if there is a potential for women's self-consciousness over this situation to lead to earlier weaning than might otherwise occur, then I want to share my experience so that women know that uneven breasts are possible to correct.
I believe that it is important to raise supply on the smaller side *before* reducing supply on the larger side. While it would theoretically make it faster to do these things simultaneously, the most important thing is to protect milk supply for the baby during the process. By raising the supply on one side first, my body naturally told me when it was time to start dealing with the oversupply on the larger side because I was always feeding first on the smaller side as the baby was more satisfied as supply increased, the larger breast retained more supply and naturally transitioned me into dealing with the second side.
Note that it is absolutely critical to be paying careful attention to the baby's wet and dirty diapers any time you are addressing supply issues, to ensure that the baby is continuing to get adequate nutrition and hydration. If you have uneven breasts and decide to tackle this problem, and you have any concerns or note any changes in the baby's elimination patterns or behavior during the process (especially in the early weeks when lopsidedness would be more likely to occur), consult the baby's pediatrician or other health professional immediately.
For more information and additional tips on increasing supply as well as ensuring the baby's health the following articles in the archives of this site may be helpful to you. Links to "Is My Newborn Getting Enough?," "Increasing Low Milk Supply" and "Dehydration and Breastfeeding" can all be found in the related links at the bottom of the this page.
Examples of the pumps mentioned in this article for increasing or reducing supply
For increasing supply, use a hospital grade rental pump, or at least a Medela Pump-In-Style or equivalent:
For reducing supply, hand expression is preferred, or a handpump like the Medela Harmony or Avent Isis would be appropriate if carefully used:
Disclaimer: All material on the BellaOnline.com Breastfeeding website is provided for educational purposes only and does not constitute medical advice. Although every effort is made to provide accurate and up-to-date information as of the date of publication, the author is neither a medical doctor, health practitioner, nor a Certified Lactation Consultant. If you are concerned about your health, or that of your child, consult with your health care provider regarding the advisability of any opinions or recommendations with respect to your individual situation. Information obtained from the Internet can never take the place of a personal consultation with a licensed health care provider, and neither the author nor BellaOnline.com assume any legal responsibility to update the information contained on this site or for any inaccurate or incorrect information contained on this site, and do not accept any responsibility for any decisions you may make as a result of the information contained on this site or in any referenced or linked materials written by others.