We all love to stash our milk. The HaaKaa breast pump-milk collector-storage device- doohickey is making breast storage super easy now. And when you are exclusively pumping for whatever reason, you have all rights to marvel at your frozen masterpiece. You have spent thousands of hours of your life pumping that liquid gold – hours that you will never get back. However, some moms end up with the uncomfortable condition of hypergalactia, where she makes an excessive amount of milk.

From Zero to Hero

Sometimes it starts off with a delayed onset on lactogenesis II – when your body starts making copious amounts of milk instead of colostrum. You persevere through the blistered nipples and sleepy sessions (and hopefully got some quality breastfeeding help!). With increased breast stimulation and perhaps some domperidone or other galactagogues to boost your supply – your milk comes in at full force. Worried that your milk may dwindle again, you begin pumping as much as your tired body will allow.

Maybe your baby latched on – most babies do within the first 6 weeks if they don’t develop a flow preference (pssst – paced bottle feeding, finger feeding, at-breast supplementing). Once you begin pumping more than a few ounces over what your baby is taking in each day on a regular basis, you are at increased risk of developing an oversupply of milk – termed hypergalactia.

With Great Milk Supply Comes Great Responsibility

Once hypergalactia sets in, you may notice that you begin having a lot of uncomfortable side effects:

• Engorged
• Breast leaking
• Plugged ducts
• Mastitis
• Abscesses
• Blebs
• Cracks/blisters from the pump
• Clicking or losing suction at the breast
• Fussy baby
• Watery green stool in the diaper
• Inability to wean

Constantly having engorged, leaky breasts with frequent bouts of plugged ducts/mastitis thrown in is definitely not a fun way to spend your time as a new mom. All of these symptoms may make it really hard to enjoy motherhood, especially if you find out later on that your baby won’t take any of your frozen milk. :'(

Hypergalactia: Fight Fire with Fire

If this sounds like something you or a friend of yours is dealing with, there are a couple of important steps to follow. You can look at this list as a progression – start with the least invasive measures and work your way downward. Of course, these cases are perfect examples of when you really need someone on your side. I provide home, office and virtual consults.

1. Check the latch, milk transfer, weight gain, and diaper output. It is VERY important that you triple check that this is indeed an issue with hypergalactia and not actually insufficient milk supply or tongue tie (FYI babies who are tongue-tied often cannot handle flow well). If you proceed without getting a good assessment, you may just shoot yourself in the foot. Your first step in any breastfeeding issue is perfecting the latch.
2. If you are able to do so without getting plugged ducts, you can block feed for up to 2-4 hours. This means to feed or pump on only one breast for that set amount of time, then switch sides and do the same. Results are typically seen within 12-24 hours – you will need to closely monitor this as you can easily go too far.
3. If you’re unable to block feed or it doesn’t work for you – which may be the case if you have taken herbal or medication galactagogues such as domperidone – you may need to use a medication or herb to reduce your supply – some commonly used substances include sage leaves, peppermint, pseudoephedrine (Sudafed), estrogen (combination birth control), cabergoline, bromocriptine.(1)

Every Mom is Different – Make a Plan with Someone You Trust!

Of course, this is all just information. You will need to discuss these options with someone skilled in breastfeeding medicine and you will need to consider the potential benefits versus the risks.

You should also think about what your end goal is. A care plan for a mom who is 6 weeks postpartum and wants to continue breastfeeding until 18 months will look a lot different than a care plan for a mom who has been exclusively pumping for 10 months (saint) and has exceeded her goal and wants to wean.

References

1. Eglash, A. (2014). Treatment of maternal hypergalactia. Breastfeeding Medicine, 9(9), 423-425.