Some women find they seem to have too much milk and their babies have trouble coping with it. For most mothers, the swollen overfull breasts of engorgement are only temporary and can be resolved with appropriate help. It can take about six weeks for the breasts to adjust to producing the right amount of milk for this baby at each feed. Occasionally a mother may have continuing problems. There are several different ways you can have too much milk, so it's important to get a clear idea of what's really happening in your case.

In the first week or two, when you are both learning to breastfeed, your breasts may be hard and painful, and you may have a mild fever. This is engorgement, which can be eased by some practical management such as feeding baby more often, making sure you don't miss any feeds, giving night feeds or expressing in the night, cutting out any water, glucose water, or formula feeds, and letting your baby finish the first breast first. This means letting your baby have a good long thorough feed from the first breast before you offer the second one. Your baby should be having 8 - 12 feeds in 24 hours. For a comprehensive coverage of engorgement and its treatment and prevention, see the ABA booklet Too Much or contact an ABA breastfeeding counsellor. Booklets are available from Mothers Direct.

Signs of too much milk in the early months are

• rapidly filling breasts
• lumpiness, tightness usually disappearing with breastfeeding
• baby gags, gulps at start of feed, often will not take second breast
• baby may bring up quite a lot of milk at the end of the feed
• often a high weight gain, occasionally a poor gain
• baby may be extra fussy between feeds, especially in the evening
• often a bowel motion each feed, often green and frothy.

As your baby gets older, other signs can include milk dripping out of his nose or the corner of his mouth, pulling off during the let-down when milk will spray from the nipple openings, or lots of possetting. Perhaps you have a normal supply but a very fast flow. Your baby will probably ask for the second breast each feed, weight gains will be adequate, but your baby may be pulling off at the beginning of the feed when the milk is spraying (letting down).

There are lots of ways to tackle oversupply.

• Finish the first breast first, letting your baby set the length of the feed. He may not want both breasts at each feed.
• Ensure your baby is well positioned to suck effectively. When your baby is properly attached you will see that his tongue has come forward so that he takes a good bit of the areola as well as the nipple in his mouth. His head will be tipped back a bit so that his chin is touching or almost touching the breast, and his bottom lip will be turned out rather than sucked in. You should not feel any pain.
• Express only as much as necessary for your comfort or to help your baby to attach properly.
• These suggestions need to be tried for a few days before you notice any real change.

Too Much contains useful information about handling leaking, controlling a forceful let-down reflex, and tried and true ideas for soothing your uncomfortable baby. Some babies from a very early age show a preference for feeding from one side only at each feed. This is perfectly all right, and will help to stabilise your supply quite quickly. These babies will probably need to feed a bit more often, especially as they get older, and some eventually begin to take both breasts at a feed.