What is overactive letdown reflex/too much milk? 

  • Quick milk flow when at the breast – your baby may become fussy and appear “colicky”
  • As your baby starts nursing, he/she may also cough, choke, or struggle
  • If your baby comes off of the breast, milk may continue spraying from the breast
  • Your baby may return to the breast and repeat the same pattern
  • Your baby may become fussy and impatient when the milk flow slows down
  • Mothers often think the baby is not getting enough milk as they are so fussy at the breast

Management:

  • Often, the first spray is forceful and then slows down as the feeding continues. If the first sprays of milk are too much for the baby to swallow, allow the milk to collect in a towel or container. Put your baby to breast once the spray has slowed down to drips.
  • Lying back so you are almost flat on your back with the baby on its stomach can help to slow the flow of milk down
  • Some babies want the flow to stay fast so after a time mom needs to sit back up to make the milk flow faster again
  • Sometimes breast compressions are needed to increase the flow of milk towards the end of the feed. For a video on how to do breast compression click here.
  • Make sure the baby’s head is tilted well back to make swallowing easier
  • Burp your baby often during a feeding
  • Express breastmilk when necessary to ease discomfort from over full breasts
  • Feeding may be easier if your baby is breastfed more often, reducing the amount of milk that collects in the breast, making feeding easier
  • Breastfeed your baby as soon as possible—even before he/she is fully awake; your baby may suck more gently in a relaxed state, making the flow of milk slower

 Different positions may help:

  • Hold your baby so that the baby is straddling your leg, in an upright position, directly facing the breast, with head tilted back, well supported
  • Lean back as described previously
  • Lying on your side may also help. Use a towel to catch any dripping milk.

 Additional tips: See which of these options work best for you and your baby

Switch Feeding:

  • Baby feeds from one breast very briefly for first burst of swallowing, once baby pauses switch to other side
  • Continue to switch back and forth until feed is finished
  • This allows some milk removal from each breast and helps reduce the chance of plugged ducts and mastitis

One breast per feed:

  • Baby feeds from one breast per feed as long as baby continues to swallow. If baby wants to return to breast within an hour or so, return to the same breast. Switch only if baby is no longer swallowing.
  • This method tells mother’s body to make less milk, but can increase the risk of plugged ducts and mastitis
  • Start with the fullest breast first at the next feed