Guest Author - Nicki Heskin
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. For general information on overactive letdown, discussion of a common cause and how to try and avoid this challenge, see my article on Overactive Letdown in the related links at the end of this page.
For those who are already struggling with overactive letdown, what's to be done?
A conventional answer to this question is often to pump milk at the beginning of feedings to siphon off the first letdown relieve the pressure of that first gush of milk. The problem with this is that it can compound the oversupply problem by removing more milk from the breasts than the baby is actually consuming. The concept of relieving the pressure for the baby is not a bad one, but a better solution is gently hand expressing milk, which doesn't provide the same sort of stimulation as a pump, or if you can't hand express, a simple hand pump used gently is somewhat better.
But to actually correct this issue, the general wisdom is to turn to single-side feeding. This does *not* mean to nurse only on one breast—it does mean to nurse on one breast for a specified period of time, allowing the other breast to fill and send messages to the body that less milk is needed during that interval of time. Then do the same thing on the other side. Two hours is probably good to start. If after a few days (4-7), if the breasts aren't responding by filling at all more slowly and the baby is not choking or sputtering less on the forceful letdown, increase that duration.
It is important to be careful about straddling the line between allowing the breasts to fill, but keeping an eye on plugged ducts (see the article on plugged ducts in related links below). And as the single-side feeding does, ironically, involve a schedule plan of the sort I mentioned might cause this problem to begin with—trust your body more than the clock as you go through this process. The goal is to reduce milk *gradually* by sending a signal to the body that that milk is not needed. Resist the urge to try to make it happen overnight and crashing your milk supply as a result.
The most important thing to remember is that overactive letdown does not represent any sort of failure or insurmountable problem on the part of the baby or the breastfeeding mother. It is not a diagnosis, so much as a description. Overactive letdown can be especially challenging when dealing with issues like sore nipples, poor latch, reflux, colic, exhaustion or more. It's worth knowing that overactive letdown can contribute to all of these issues by making it difficult for the baby to nurse, or the feeding pattern causing the overactive letdown may also be causing some of the other issues by delivering more lactose-containing foremilk than fat-containing hindmilk. The change in feeding pattern to correct overactive letdown may correct other issues as a result.
If you are having multiple issues, compounding breastfeeding difficulty, please find some support, both technical and emotional, to help get you through these early challenges (see the website section on finding and getting help in related links below) – when you come out the other side, and breastfeeding is established and settled in, you'll have the satisfaction of knowing you worked hard to maintain what is best for your baby and reap the rewards of the many benefits of breastfeeding.
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