Managing Breast Milk Oversupply: the MDR method

by Svea Boyda-Vikander on November 19, 2013

Breast milk is amazing. It provides everything a baby needs to grow into a chubby ball of cuteness. It fights disease. It’s nutritious. It’s delicious (yes!). It’s always on hand, it requires zero preparation, and it’s close to free.

But sometimes, it’s possible to have too much of a good thing.

Enter, OVERSUPPLY. Clad in stained pajamas, she runs to center stage shrieking hysterically. Smelling of regurgitated, rancid milk.

“THE MILK IS COMING, THE MILK IS COMING, WHERE THE F*** ARE THE TOWELS… OH, IT BURNS! IT BURNS!”  (Her bountiful bosoms peak as ten or more jets of milk shoot through her shirt. Specs of white milk fall upon the black wooden stage.)

Has Oversupply paid you a visit recently? She’s a regular at our house. Today I’ll share some of the strategies I’ve used to deal with her because, let’s face it, she tends to overstay her welcome. I call my approach MDR: Manage, Donate, Reduce, and I pronounce it ‘moder’ because that’s how they say ‘mother’ in Sweden. Those three tactics, in that order, have allowed me to get my life back. I can leave the house. My breasts are no longer painfully engorged every day. My baby is not a gassy, army-green pooping mess. And I can leisurely get out of the shower without scrambling for a towel because the cold air has triggered my milk ejection reflex and wow, I really don’t have time to wipe that off the floor. But before I begin, I should say this: I haven’t received any compensation for endorsement of the products discussed in this blog. And I am not a doctor, a nurse, or a lactation consultant. Just a mom with a lot of milk.

Manage:

You need to find something to absorb all that milk. Your first stop, of course, is your baby. But while she’s valiantly gulping down the river of liquid gold coming from your right breast, your left is holding its own wet T-shirt contest. You need to get yourself some nursing pads.

If you have hyperlactation, the terry cloth reusable nursing pads are a joke. They were soaked even before they reached my nipple. I splurged on the most expensive reusable bamboo cloth nursing pads, and they didn’t do jack, either. So: disposable. The bad news is that they don’t come cheap, and they go straight into the landfill. The good news is that disposable nursing pads are sold in most pharmacies. And they work.

I have tried all the disposable nursing pads on the market and in my experience, the Lansinoh brand is the best. There’s a lot I don’t like about them: they have the same super-absorbent chemicals as disposable diapers (sodium polyacrylate, yummy!); they come individually packaged (it takes a special kind of idiot to sell a nursing pad in a plastic bag that says ‘keep away from baby’); and they cost $7.50 USD per package of 60. At my peak, I was filling up several of these per breast per day. But if it works, it works, right?

disposable-nursing-pads-500_500_500

A disposable nursing pad won’t cut it over night. They’re unlikely to cover the nipple as your breast moves in its bra while you toss and turn. Some women have used super-absorbency menstrual pads for this purpose. We co-sleep and my practice was to put a folded cloth diaper (CLEAN, people!) in my bra on the breast that I wasn’t going to nurse off of. I slept in a fresh nursing bra and tank top every night, because they were damp with milk when I woke up. But damp is better than wet! And wet is better than soaked…

Which is what your mattress will be if you don’t protect it. I layered thin, flat receiving blankets under my nursing breast (the one that – sexy! – didn’t have a diaper on it) and put my baby to sleep with his head on top of them. He would spit-up in the night and I would leak while nursing him. This did something to protect the sheets. To cover the mattress, we got a waterproof mattress cover. Concerned about PVC off-gassing into my fresh little newborn baby’s lungs, I shelled out for an organic cotton canvas cover. I’m pretty sure you could just make one yourself from, you know, organic cotton canvas.

OK, so we’ve got the spray under control: you’re not leaking through your shirt because you have a stash of industrial-strength disposable nursing pads in your purse and a few in your bra. You’re not drenching your bedclothes because you have a clean cloth diaper to absorb the milk instead. And your mattress won’t smell like a pair of sweaty gym socks stuffed into a tennis ball canister and left on the dashboard of your car over the summer, because you’ve taken steps to protect it.

My next step was to donate.

I told my mom that I am donating breast milk to another family and she said, “That is such a beautiful, loving thing to do.” If you feel even slightly comfortable donating your breast milk, you should give it a try. It’s worth it. Mom says.

There are three ways you can do this, with varying levels of intimacy. The first is through wet-nursing, which used to be a respectable working-class profession (one in twenty babies born in Paris in 1780 was nursed exclusively by their own mother) and remains common in some parts of the world. Most American moms don’t wet-nurse or have their babies wet-nursed, but I personally think it’s great. If you want to do this, you might casually mention it to your close family and friends – not, “Can I nurse your baby?” but, “I love the idea of wet-nursing – I just have so much extra milk.” Only young babies will take to the breast of a woman who has not nursed them before. When our friend offered her breast to my one year-old son, he smiled, nodded his head, and backed away. It was hilarious.

The second is through local milk-sharing. Check out the Facebook groups Eats on Feets and Human Milk For Human Babies. You can post a bit about yourself and the milk you have to share (is it frozen? are you willing to donate on an ongoing basis? about how much do you produce in a day?) and parents will contact you to arrange a shipment or pick-up. Be honest about your intake of alcohol, nicotine, caffeine, and any other medications and supplements you take. To collect the milk you can use a breast pump – but if you have hyperlactation, you probably won’t need to. I just put my little Medela hand-held pump over my nipple and think about breast feeding. My milk lets down and sprays into the nozzle, down through the flange and into the bottle (could it be any easier?). Add a little bit of pumping at the end to get the engorgement down and it is heaven.

While you pump/moan in relief, you can use an O-cal-ette cup on the other nipple.* 377735214O-cal-ette cups have been around forever and are about a quarter as expensive as Milkies/Milk-Savers. They’re little plastic cups which go into your bra and collect milk when it lets down. They have a vent hole at the top (which is great for airing out those nips and preventing thrush) but with the amount of milk I produce, I have to put a piece of tape over it to prevent leakage. Depending on your arrangement with your recipient family, you might store the milk in breast milk freezer bags or in sterile jars in the fridge.

*In fact, these may be a good option for use around the house.

Lastly, you can consider donating to an established milk bank. Because I don’t like it when people try to get me to donate my bodily fluids for free so they can sell it at a large profit, I avoid banks like Prolacta. You can find your nearest non-profit milk bank through the Human Milk Bank Association of North America. To qualify as a milk donor, you will have to complete a short phone interview and a home blood test, which they pay for.

Reduce:

Before you take steps to reduce your milk supply, make sure that breastfeeding is established and that you truly do have more milk than your baby needs. It’s harder to increase your supply than to decrease it, so proceed with caution.

The first thing you should know is that, because low milk production is the number one cause of early weaning in the United States, nearly all of the breastfeeding advice out there is aimed at increasing supply. So you, O Madonna of the Moo, can forget about nursing from both breasts during each feeding, pumping extra milk to store, and waking your baby up to nurse (unless your baby is very small and needs it). Instead…

  • Block feed. Nurse on cue, but nurse from one breast only. Do this for 3-4 hours at a time and then switch (and hold your baby at bay for the first few minutes of that let-down; your unnursed boob is going to rival the space shuttle Atlantis in its, uh, lift-off). output_snPRadBlock feeding is the most effective way to decrease your milk supply. But it also increases your risk of blocked milk ducts. Blocked milk ducts can lead to mastitis. So pay careful attention to your breasts, noticing if they develop any painful, hard, hot lumps. If so, immediately nurse from that breast, aligning baby’s nose with the lump. (If you are also nursing a toddler, get them to do it. Bonus points for nursing a toddler!) You may have to place baby on the floor and dangle your breast into his/her mouth to do this (breastfeeding! It’s glamorous!). You can also place hot compresses on the lump. If it does not go away within 24 hours or you develop a fever, head in to your healthcare provider, stat.
  • Stop pumping. Did you hear what I said? Stop pumping. JUST STAHP. Pumping mimics the sensation of suckling which is precisely what gets the milk production process started. Some people will tell you to pump for the first few minutes of your let-down to capture the foremilk so the baby can get some hindmilk. This well-meaning advice has ruined countless tank tops. Babies need fatty milk, but the distinction between fore- and hind-milk is not clear-cut. If you let your initial let-down spray into an unused diaper (CLEAN, PEOPLE), and then let your baby latch on once it’s reduced to a steady drip, you should be fine.
  • Side-nurse. If you nurse lying on your side or with your babe lying on top of you, your ejection reflex won’t be nearly so active. I pretty much only nurse my baby lying down on the bed (or grass, or sand, or carpet…). When I decide to nurse her in the Beco, I de-latch her as soon as the let-down comes, pinching my nipple in two fingers before I can cover it with the nursing pad. Then I let it spray for at least a minute while she wails like the wronged creature she is.
  • Drink a cup o’sage. I’ve never tried this, but apparently sage decreases blood estrogen levels. So if you drink a cup of sage tea in the evening, it will decrease your milk supply. Try it and tell me how it works out.

And now, a survey: raise your hand if your milk let down while reading this post.

Mmm-hmmm. I thought so.

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