6.2 Hyperlactation
Hyperlactation
Oversupply - too much milk!
In everyday language, the issue of "too much milk" may be referred to as overproduction, overproduction syndrome, or an overabundant milk supply. In lactation literature, overactive production by the milk-producing glands during lactation may also be called hyperlactation or hyperlactation syndrome.
Hyperlactation, also termed hypergalactia or ‘‘oversupply,’’ is the production of breast milk in excess of the volume required for growth of healthy infant(s) based on international standards.
Parents with oversupply are usually very uncomfortable with large, swollen breasts, leaking milk, and an abundant milk supply. The baby may appear to gulp milk during feeding or develop poor breastfeeding technique, slipping off the nipple in an attempt to not have to consume so much.
But why does it happen? Breastfeeding mismanagement can contribute to why this might occur. It can be self-induced by the mother/parent concerned about possibly not enough milk and therefore stimulates the breasts and/or takes herbal galactagogues to produce more milk than the infant requires. It can also occur when health care professionals through their recommendations contribute to an excessive milk production. Recommending pumping in addition to breastfeeding, and galactagogues may be appropriate in certain situations yet without close follow-up and guidance about cessation, this if not closely monitored can lead to iatrogenic hyperlactation. Idiopathic hyperlactation refers to a mother/parent with a high rate of milk production with no clear etiology. With guidance, health professionals can help with prevention by using good counselling skills about breastfeeding and encouraging breastfeeding self-efficacy.
Signs and Symptoms of Hyperlactation
Signs and Symptoms of Hyperlactation that may be experienced by the breastfeeding/chestfeeding dyad.
Mother/lactation parent
Excessive breast growth during pregnancy >2 cup sizes
Persistent or frequent breast fullness
Breast and/or nipple pain
Copious milk leakage
Recurrent plugged ducts
Recurrent mastitis
Nipple blebs
Vasospasm
Infant
Excessive weight gain
Difficulty achieving a sustained, deep latch
Fussiness at the breast
Choking, coughing, or unlatching during feeds
Breast refusal
Clamping down on the nipple/areola
Short feedings
Gastrointestinal symptoms (e.g., spitting up, gas, reflux, or explosive green stools)

Leaning back in the laid back position such as in this image (using gravity) may help the infant cope better with the milk flow and volume.
Clinical management
Management of hyperlactation.
- Block feeding for 24-48 hours under close supervision by experienced lactation support professional.
- Herbal remedies may include sage, jasmine flowers, and chasteberry to reduce milk production.
- Prescription medications may include pseudoephedrine and oral contraceptives (oestrogen) under medical supervision.
- Dopamine agonists such as bromocriptine or cabergoline can possibly be utilized under medical supervision if hyperlactation persists despite all other interventions.
- CAUTION as these medications have a long half-life, there are concerns about the side effects, and can lead to suppression of lactation.
What is Block Feeding?
Block feeding is to restrict breastfeeding to one breast for a set number of feedings or a set amount of hours and then change to the other breast for a set number of feedings or a set amount of hours.
"Close monitoring on an individualized daily or weekly basis can help ensure adequate infant growth and reduce maternal complications. Block feeding must be discontinued in the event that milk production falls below the infant’s needs."
van Veldhuizen-Staas described the full drainage and block feeding method (FDBF) in the publication called Overabundant milk supply: An alternative way to intervene by full drainage and block feeding. Take the opportunity to review this article.
Herbal therapies
There are a number of herbal therapies suggested for decreasing milk production. Many are anecdotal without readily available published research. Research has found that jasmine flowers used topically were an effective and inexpensive method of suppressing puerperal lactation and could be used as an alternative in situations where cost and nonavailability restrict the use of dopamine agonists.It is important to remember there are also traditional or cultural treatment or practices families might use.
Take the opportunity to read, print out or save the PDF - ABM Clinical Protocol #32:Management of Hyperlactation and keep it for future reference. It is for the medical profession yet has lots of helpful information.

What you should remember
- Hyperlactation can be self-induced, iatrogenic, or idiopathic.
- Prevention is the first step when possible
- Block feeding with close supervision
- Dopamine agonists should be reserved for cases that do not resolve with other treatments and used with caution and close suppervision.