What to do if there is a lot of milk when breastfeeding?

Breastfeeding is a blessing and the best food for a baby, because with mother's milk he will receive everything necessary for his development and growth, it will fully satisfy the need for liquid. Mother's milk is well absorbed by the immature digestive system of the baby and, unlike animal or milk formulas, does not cause intestinal disorders, allergies, colic. It is a big problem if a woman has little of it, but abundance becomes no less a test. In the first days after childbirth, the breast fills, swells and hardens. The child is often unable to suck out a sufficient amount of milk due to the tight areola. Sometimes this is caused by the incorrect position of the baby during feeding, and painful cracks are formed - an easy way for infection to penetrate the mammary gland through the lymphatic vessels. As a result, there is stagnation in the breast and a real threat of mastitis. According to statistics, from 3% to 5% of women after childbirth face this. Treatment for the disease often makes it impossible to return to breastfeeding.

Every breastfeeding mother will have problems with excess milk supply, or hypergalactia, beyond the first few weeks after birth. Very little research has been done to identify, explain, or help solve this problem. Lactation experts have identified several problems for women with hypergalactia. [ 1 ]

Hypergalactia is also called hyperlactation, oversupply, and engorgement. The International Classification of Diseases (ICD) 10 uses the terms hypergalactia, hyperlactation, and increased lactation. The term most commonly found in dictionaries to describe excess milk is hypergalactia.

The generally accepted definition is the condition of producing excessive amounts of milk, which causes discomfort and may force the nursing mother to express and store milk beyond what the baby takes in. Mothers with hypergalactia are at increased risk of developing acute mastitis, [ 2 ] plugged ducts, [ 3 ] chronic breast pain, [ 4 ] early weaning.

Many women induce hypergalactia on their own in a variety of ways. Many herbal supplements are used to increase milk supply, such as alfalfa, fenugreek, goat's root, fennel, milk thistle, saw palmetto, and shatavari. New mothers are often instructed to feed their babies on a clock, such as 15 to 20 minutes on each breast, rather than breastfeeding according to baby feeding tips. This causes some mothers to breastfeed longer than the baby needs, which further increases prolactin levels. [ 5 ]

So what should a nursing mother do if she has a lot of milk?

How to reduce milk supply while breastfeeding?

As a rule, by 3-4 months of a child's life, the process of milk production is established on its own and the problems associated with it disappear. Before this period, a woman needs to learn to cope with its abundance herself. [ 6 ] Hyperlactation most often occurs due to the individual characteristics of the mother, genetic predisposition, improper organization of feeding, pumping. To reduce the amount of milk during breastfeeding, you need to take the following measures:

• before feeding, express a little from the breast, which will make it softer and more pliable for the baby, and feeding more effective. This is the "front" milk of low fat content, the subsequent milk - fatty - is more important for the baby's body;
• During feeding, let only one breast be emptied and do not limit the process in time. If the child gets tired of sucking and falls asleep, after a short pause, massage the breast and squeeze the milk directly into the mouth, doing everything to continue sucking (shake the nose). It is recommended to give the same breast for 3-5 hours;
• the second breast should be expressed only a little (full expression will lead to even more milk production), for relief you can use a breast pump. After that, apply a cold compress for a few minutes;
• put the baby to the breast as often as possible;
• sometimes the baby chokes due to the abundance of milk, he is not able to absorb so much liquid. In this case, you can resort to relaxed feeding: the mother is half-lying with her head raised, her shoulders and arms supporting the baby on her. This position allows you to latch on to the breast deeper, and the tongue to move better. Many women prefer feeding in a sling, noting its effectiveness;
• folk methods that women resorted to in the old days suggest compresses of cabbage leaves on swollen breasts, decoctions of sage, [ 7 ] oak bark taken internally (reduces the amount of milk), mint [ 8 ] and parsley root (removes fluid from the body);
• a nursing mother should limit the amount of liquid she consumes;
• take a warm shower, during which milk will flow from the breast itself.

Pharmaceuticals for reducing lactation

1. Pseudoephedrine is a commonly used decongestant that has been found to decrease milk supply. One study found that a 60 mg dose of pseudoephedrine was associated with a 24% decrease in milk production. It is unclear whether the effect is due to a decrease in prolactin levels.[ 9 ] Pseudoephedrine can be given at 30 mg initially, monitoring for side effects of nervousness, irritability, and insomnia. If the 30 mg dose does not decrease supply within 8 to 12 hours and is well tolerated, the mother can increase the dose to 60 mg. Once the mother notices that her milk supply has dropped, she can use it every 12 hours as needed to maintain her supply at an acceptable level. It is important not to give this for a set period of time, such as twice daily for 3 days, as this may cause the supply to drop. By using it as needed, the mother can more accurately determine her body's response to the drug.
2. Estrogen has a negative effect on lactation, decreasing milk supply. [ 10 ] Estrogen can be given as a combination contraceptive pill once daily for a week and then stopped. The mother should see a decrease in milk supply by days 5–7. If her supply increases over time, she can be put back on short-term treatment with the combination contraceptive pill. Estrogen treatment increases the risk of thromboembolism in the mother, especially if given before 4 weeks postpartum.
3. If none of the previous treatments reduce milk supply, the final step would be to use antiprolactin drugs such as bromocriptine or cabergoline. Both are effective in reducing milk supply in the early postpartum period. Cabergoline has been shown to have fewer side effects than bromocriptine. [ 11 ] However, very little is known about the transfer of cabergoline into breast milk, whereas very little bromocriptine is transferred into breast milk.
4. There are no published reports on the effectiveness of any of these drugs in the treatment of hypergalactia in late lactation.

All the inconveniences and difficulties of the feeding period will be rewarded with good immunity of the child, protecting him from infections, frequent colds, as well as appetite, weight gain and proper development.