Pat writes:

<I have a mom coming to my BF moms' support group that has gobs of milk.
Baby is 7 weeks and has been gaining a pound a week. She said she has a
microadenoma on her pituitary and had to take bromocriptine early in her
pregnancy to save this baby. She had previously had several miscarriages
within the first few weeks of pregnancy. After baby has nursed she can
still pump 3-6 oz. Is this just "regular" oversupply--if there is any
such thing as "regular oversupply"--and she's a milk goddess or is the
pituitary an issue?

After baby has nursed . . . . she can???? or feels uncomfortable unless she does . . . . pump 3-6 oz.??? And just how often does she do that in the average 24 hour day? On just one side? or is the total from both? Are the baby's stools green? Are there any other indications of secondary lactose overload in the baby??


Whatever her prolactin lab levels might be, if taken before and if I remember vaguely, about 45 minutes after nursing, certainly, removing more milk by pump after nursing has to be contributing to oversupply because nature doesn't know that it's not going into that ... or another ... (twin, triplet . . .) baby!! Or a milk bank! She's thereby not getting the full "tamping" value of FIL!


Oversupply is a tricky issue. I think the term "milk goddess" is a convenient label for the "needing further histological and perhaps radiological research" file. I am convinced that beyond any direct hormonal aspect, there are women who are actually genetically gifted with the previously labeled "normal" full component of lobes (15-20) in one or both breasts. OTOH, I believe there are many other women who for one reason or another, perhaps environmental contamination of foods, during the appropriate embryonic and fetal periods, did not have as many secondary buds or branching's and/or completion of the process of apoptosis within branches that forms the canalization within the ducts. 


I believe that many of our "routines" and suppositions about management are based on these women, not those with their full complement of ducts, and therefore, as a result, more lobes, lobules and alveoli. Thus, we may actually induce oversupply in some moms with standard instructions of "Soften the first breast first, then offer the second breast, and if little or nothing is taken, start with that second breast the next feeding."


It sometimes takes time to tamp down oversupply, even if done carefully under the knowledgeable supervision of a well-informed lactation consultant. I know of one mother on another continent who apparently "could not hear" past her "common sense", fears and previous understanding, who was helped by keeping a written diary of baby symptoms, times and number of nursings on which breast. She herself prolonged the process by still sometimes giving in to temptqtion to"pump for relief". The supply balanced nicely once she was finally persuaded to restrain herself from removing milk too often, under the combined guidance of an experienced midwife, myself and Gonneke van Veldhuisen!!

I highly recommend Gonneke's article in the Int BF Journal, and feel sure that she would be glad to have you contact her personally if you feel her guidance would help you and the mother. I hope my vote of confidence doesn't overload her, but Gonneke gets my vote as the "go-to LC" on problematic oversupply! She understands this subject inside and out!

Overabundant milk supply: an alternative way to intervene by full drainage and block feeding
Caroline GA van Veldhuizen-Staas
International Breastfeeding Journal 2007 2:11 

This article is published under open access, meaning that you can read the full text without a subscription:

K. Jean Cotterman RNC-E, IBCLC
WIC Volunteer LC, Dayton OH

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