Overactive Letdown of milk while breastfeeding (also known as milk oversupply, overabundance of milk, or forceful milk ejection reflex) is a common occurrence in early breastfeeding. I've always been a little suspicious of the "diagnosis" of overactive letdown, as in "Oh, your baby is choking at the breast and milk is spraying everywhere – you have overactive letdown. This bothers me because it implies that the breastfeeding mom so diagnosed has some sort of "defect" or "problem," when in fact, I see overactive letdown as more of a stage of breastfeeding that affects many, if not most, breastfeeding mothers.
Overactive letdown is characterized by a milk ejection that is more forceful than the baby can handle. This typically occurs for some days, weeks or (occasionally) months after the milk comes in as the mother's body and the baby do nature's beautiful dance of establishing healthy milk supply and adjusting to each other's needs. Sure it can be a messy dance of spraying milk, soaked clothes, spit up and green poop – but many great things start out all over the place before coalescing into something wonderful.
So how can a breastfeeding mother try to avoid overactive letdown?
First, it's worth noting that apparently, overactive letdown doesn't occur in all cultures. In places like the United States, breastfeeding help and instruction more commonly comes from books or overworked and undersupported postpartum nurses, rather than from a community of experienced breastfeeding women. As a result, breastfeeding instruction becomes whittled down to a "formula" of so many minutes on each side in specific intervals in such-and-such a position. This is comforting to new moms.
However, in reality, healthy breastfeeding in the early days would more resemble feeding on cue, whenever the baby is hungry, with an eye towards allowing the baby to empty a breast until they switch because they need more than that breast is providing, and then switching sides based on which breast feels fuller at the next feeding. However, that would require new moms trusting their instincts and being supported by veteran moms who can be generally around, answer questions and offer tips. Starting this sort of pattern (or lack thereof) from the time milk comes in, or even before, might avoid many of the issues associated with overactive letdown. By nursing on cue, and draining the breasts before switching, milk adjusts to the baby's needs that much sooner. An artificial pattern can lead to oversupply, or worse, to undersupply.
If you are already struggling with overactive letdown, see my article on Correcting Overactive Letdown in the related links below.
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