Handling Forceful Letdown and Breast Milk Oversupply

Written by Donna Reese, MSN, RN, CSN
Medically reviewed by Kimberly Langdon, MD

Updated on July 29, 2022

• Choking, gagging, and breast milk running out of your baby’s mouth are signs of a forceful or overactive letdown.
• If not managed, a too-vigorous letdown can lead to feeding difficulties.
• You can manage overactive letdown by changing how you position your baby during feedings.
• Incorporating measures to control milk production can reduce milk oversupply and forceful letdown.
• A lactation consultant is a helpful resource if issues continue or if you want support with feeding difficulties and concerns.

Does your baby choke and gag while breastfeeding? Do you seem to produce too much breast milk? Although it is fortunate that you don’t need to worry about a dwindling supply of breast milk, you may be dealing with another breastfeeding concern – that of overabundant milk supply and forceful letdown.

Moms who plan to nurse their children have all kinds of concerns about breastfeeding. Most revolve around an undersupply of milk, sore nipples, and latching difficulties.  

There’s not as much discussion about too much breast milk and problems associated with a strong letdown. However, having your baby choke on your milk due to this issue can be quite frightening for a mom as well as distressing for your little one.

Although having a powerful flow of milk is a concern, there are ways to manage your milk flow and supply that will lead to a comfortable and happy feeding experience for you both.

What Is a Forceful Letdown?

When your baby first latches onto your breast, your milk should start flowing evenly with a steady and gentle stream. 

An initial overly powerful gush or stream of milk can choke infants as they struggle to handle more milk than they can swallow comfortably. This forceful letdown is called a milk ejection reflex. 

Does Forceful Letdown Mean Oversupply of Milk?

Moms with an overactive letdown often produce too much breast milk (hyperlactation).  

Your milk supply should increase during the first six weeks after birth. Nursing mothers need this time to produce adequate breast milk for their child’s particular needs. An oversupply of milk during this period is considered normal and, in most instances, a good sign of successful milk supply.

Once your body accommodates your child’s feeding needs, producing too much milk may lead to overactive letdown. Your need to release an overabundant milk supply will become great, causing an initial forceful flow that can gag and choke your baby.

Your baby may display the following signs if you produce too much milk:

• Excess gas
• Frequently fussy (colicky)
• Bowel movements that are mucousy, green, and explosive 
• Frequent spit-ups
• Pulling off the breast
• Excess weight gain
• Milk coming out of baby’s nose or mouth while feeding

Does Forceful Letdown Pose a Problem?

An overactive letdown that shoots milk forcefully out of the breast can negatively affect both baby and mom. Watching your little one gasping and choking while nursing is frightening for mothers. What should be a bonding and soothing experience becomes fraught with guilt and worry.

Babies cope with forceful milk flow by detaching from the breast. This negative feeding experience can eventually lead to breast refusal, poor feeding habits, and weight loss.

The Journal of the American Board of Medicine has this to say about the potentially detrimental effect of forceful letdown and breast milk oversupply, “Although breast milk oversupply occurs rarely and is often underreported, the damage it can cause to the breastfeeding relationship can be irreparable”.

Correcting this issue for moms intent on breastfeeding is worth the time and effort.

Signs of Forceful Letdown

You will want to know the signs of excessive milk flow to ensure that your baby’s health is not affected as a result of nursing issues.

If your baby is struggling with the following, you may be experiencing forceful letdown:

• Gasping, choking, and uncomfortable with nursing in general while on the breast
• Latching and unlatching frequently from the breast 
• Breast milk running out of your baby’s mouth while feeding
• Attempting to slow the flow by biting down on the nipple
• Refusing to nurse
• Spitting up frequently
• Excess gassiness as your child is gulping air and milk to keep up with the flow.

If your baby is exhibiting these signs of overactive letdown, there are ways to manage this concern. It’s a good idea to address the issue before it leads to further breastfeeding disruption.

Handling Forceful Letdowns

Most breastfeeding moms and babies have their favorite feeding positions for comfort and ease while nursing. When experiencing an overly powerful flow of milk, you may need to experiment with feeding positions to help your infant nurse comfortably.

Some breastfeeding positions that may help to manage overactive letdown are:

1. Side lying position. This adjustment will allow excess milk to flow from the baby’s mouth.
2. Laid back nursing position. With mom reclining (propped on pillows), position baby with his belly on your abdomen with baby’s head and mouth near your breast. In this placement, milk flow slows as baby is feeding against gravity.
3. Baby sitting up and facing mom. Once your baby is a little older, you can try this feeding position to reduce the flow of milk.

You may also want to hand express a small amount of breast milk before each feeding to decrease the pressure of overly full breasts.

Remember to burp your baby frequently to help relieve gas and spit-ups.

Managing Overabundant Milk Supply

Changing your nursing schedule and routine may help to reduce your milk supply.

A few ideas to successfully manage extra milk production are:

1. Apply cool compresses. To soothe breast discomfort and control milk supply, apply cool compresses to breasts for 30 minutes per one-hour intervals.
2. Sleepy baby nursing. Babies tend to suck more gently when they are not wide awake, which leads to decreased milk production.
3. Nurse frequently. By decreasing the time between feedings, your milk supply will adjust by producing less milk.
4. Switching Sides. During the same feed, switch breasts several times. When babies nurse on the same side too long, that breast will respond by producing more milk.
5. Block Feeding. Block feeding may be a little tricky, so you may want to consult your provider or a lactation consultant for direction and support. 

Block Feeding Can Help With Too Much Milk

Block feeding is another option to try. This technique aids in decreasing breast milk production by “tricking” your body into thinking it has enough milk. 

Here’s how it works.

1. One hour before feeding, hand express or pump both breasts for a short period to soften your breasts.
2. Feed your baby on one side only.
3. Allow your baby to nurse on the same breast as needed, if hungry, within the next six-hour block of time.
4. After six hours, allow your baby to nurse from the opposite breast in the same manner as above (remember to pump briefly first).

You may need to work up to the six-hour schedule in the beginning. Your lactation consultant may recommend that you start with three-hour time intervals so that your breasts may not get too uncomfortable while using this technique.

You may experience leakage from one breast during block feeding. If so, briefly expressing or pumping the “unused breast” just enough to relieve the drip and breast pressure helps. Most moms use nursing pads or breast milk collection cups when experiencing this issue.

What to Do With Too Much Breast Milk

When you have an overabundance of breast milk, it is a shame to throw it away. Most moms hate to waste a drop of this precious life fluid. But when you are overloaded with mom milk, what can a mother do with all of it?

Most mothers prefer to freeze breast milk, with some even purchasing a portable mini-fridge to ensure that their supply stays fresh and safe for their baby in the future.

Another altruistic idea is to donate your breast milk. The Breast Milk Foundation lists how and where to donate milk.  Numerous local and state agencies also accept breast milk.

A Few Final Words About Breast Milk Supply

Breastfeeding is a special time of bonding between mother and baby. However, many moms experience issues and concerns about the nursing process that may cause anxiety and guilt. 

In the early weeks of motherhood, many adjustments need to be made. Dealing with an overabundant milk supply and a baby who gags and chokes will naturally compound an anxious mom’s distress.

During this time, be gentle with yourself and realize that most mothers encounter challenges of some kind while breastfeeding.

A lactation consultant can be a great help for any mom who is committed to nursing her baby.  

Don’t be embarrassed or timid about contacting your local breastfeeding professional for assistance on any aspect of breastfeeding.  Once you have answers to your questions and your baby is nursing contentedly, you will be glad that you reached out.

The information WonderBaby provides is not intended to be, and does not constitute, medical or other health advice or diagnosis and should not be used as such. Always consult with a qualified medical professional about your specific circumstances.