Women may experience under or oversupply of milk. Like “birth works,” breastfeeding too generally goes well. However, like with all aspects of our bodies, problems sometimes arise. Dr. Alison Stuebe has coined the term “lactastrophe” so referring to such problems. In addition to breast pain, conditions of concern include under or oversupply of milk.
Undersupply
It can be heartbreaking to be unable to produce as much milk as your baby takes in. In general, the most effective way to increase milk supply are frequent suckling at the breast and making sure that your baby is able to remove milk. Using an electric pump can also increase production, but babies are typically better at moving milk. If your baby is not removing milk well, it may help to work with a lactation specialist. Some women also try galactogogues, which are herbs or medications that may help increase milk production.
Sometimes, despite our strong desires and support, undersupply remains an issue. In these cases, mothers can consider using other women’s milk for baby feeding, through donor human milk banks or via peer-to-peer sharing. The Academy of Breastfeeding Medicine describes donors as lactating women who have surplus milk after feeding their own infant (oversupply), have milk they cannot provide to their infant due to infant illness, or who have experienced the loss of a baby. Milk banks screen donors and pasteurize milk. This pasteurized donor human milk (PDHM) is usually provided to sick babies in the hospital, and may also be available by prescription outside the hospital. In peer-to-peer milk sharing, women with extra milk provide to others on an informal basis. Wet-nursing (also known as cross-nursing), which is directly breastfeeding a nonbiological child, is another mode of informal milk sharing. According to the Academy of Breastfeeding Medicine, although informal breast milk sharing can benefit infants and families, it also carries potential risks, and families should take care to screen donors and handle milk safely. Internet-based breast milk sharing is not recommended under any circumstances.
Moms who experience low milk supply often ask whether they will have trouble making milk in a future pregnancy. Moms who have struggled with one baby are more likely to face challenges the next time around, but there are many factors that affect breastfeeding. It can be helpful to meet with a lactation consultant during your next pregnancy so that you have a plan in place.
Oversupply
Making too much milk can also cause challenges. Having overfull breasts can lead to plugged ducts or infections, and the very fast flow that some mothers have at the start of feeding can cause baby to cough, gasp, or bite down to control flow. It can help to use a “laid back” position, so that baby can lift his head away from the breast if the flow gets too fast. Women whose babies are more than 3-4 weeks old who want to decrease their milk supply may try “block feeding.” This is offering the baby the same breast over a 3-4 hour period. This allows the baby to completely drain one breast. After a 3-4 hour block, milk removal switches to the other side for the next 3-4 hours. Oversupply symptoms may take several days to improve.
Sometimes, oversupply develops when a mother is pumping multiple times a day, perhaps to stock up on milk before being separated from her baby, and ends up with far more milk each day than her baby needs. Gradually tapering the frequency and duration of pumping can align supply with baby’s needs.
References