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<html lang="en" class="hexml-course s2e"><!--[if lt IE 8]> <html class="oldie"> <![endif]--><!--Generated at Wed, 12 Oct 2022 23:23:13 +0000--><head><meta name="author" content='["Carole Dobrich"]'><meta name="course" content="MA03"><meta name="topic" content="6.2"><meta http-equiv="content-type" content="text/html; charset=utf-8"><meta name="copyright" content="2022 Health e-Learning"><meta name="robots" content="NONE,NOARCHIVE"><meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=0"><link rel="stylesheet" href="//static.health-e-learning.com/jigsaw/design/hexml.pack.css?v=1665616993" type="text/css"><script type="text/javascript" charset="utf-8" src="//static.health-e-learning.com/jigsaw/design/hexml.pack.js?v=1665616993"></script><title>MA03: Hyperlactation</title></head><body class="loading"><div class="ajax-modal Fixed"></div><div class="watermark"><span>Health e-Learning</span></div><div id="access"><a href="#access" accesskey="a">Access Keys</a><a href="#menu" accesskey="m">Skip to Menu</a><a href="#content" accesskey="c">Skip to Content</a><a href="#footer" accesskey="f">Skip to Footer</a></div><div id="nav"><span class="nav-menu">Maintaining BFHI Education for Nurses and Midwives - Series 2</span><a id="hamburger" href="#"><span class="hamburger hamburger--collapse"><span class="hamburger-box"><span class="hamburger-inner"></span></span></span></a><div class="progress-container"><div id="myBar" class="progress-bar"></div></div></div><nav id="menu"><ol><li><a href="topic_1-0.html"><span class="menu-item-icon">1.0 </span><span class="menu-item-title">Introduction</span></a></li><li><a href="topic_2-0.html"><span class="menu-item-icon">2.0 </span><span class="menu-item-title">Protection of Breastfeeding [Domain 1]</span></a><ol><li><a href="topic_2-1.html"><span class="menu-item-icon">2.1 </span><span class="menu-item-title">A Code History Timeline</span></a></li><li><a href="topic_2-2.html"><span class="menu-item-icon">2.2 </span><span class="menu-item-title">Marketing - the role of the International Code</span></a></li></ol></li><li><a href="topic_3-0.html"><span class="menu-item-icon">3.0 </span><span class="menu-item-title">Understanding the importance of skin-to-skin</span></a><ol><li><a href="topic_3-1.html"><span class="menu-item-icon">3.1 </span><span class="menu-item-title">Infant innate behaviours</span></a></li><li><a href="topic_3-2.html"><span class="menu-item-icon">3.2 </span><span class="menu-item-title">Skin-to-skin and the role of the Health Worker</span></a></li><li><a href="topic_3-3.html"><span class="menu-item-icon">3.3 </span><span class="menu-item-title">Addressing barriers to skin-to-skin</span></a></li><li><a href="topic_3-4.html"><span class="menu-item-icon">3.4 </span><span class="menu-item-title">The loving relationship</span></a></li></ol></li><li><a href="topic_4-0.html"><span class="menu-item-icon">4.0 </span><span class="menu-item-title">Postnatal Interventions</span></a><ol><li><a href="topic_4-1.html"><span class="menu-item-icon">4.1 </span><span class="menu-item-title">The chemistry of feeding</span></a></li></ol></li><li><a href="topic_5-0.html"><span class="menu-item-icon">5.0 </span><span class="menu-item-title">Special needs and infant challenges [Domain 6]</span></a><ol><li><a href="topic_5-1.html"><span class="menu-item-icon">5.1 </span><span class="menu-item-title">The 'late preterm' 'early term' baby</span></a></li><li><a href="topic_5-2.html"><span class="menu-item-icon">5.2 </span><span class="menu-item-title">Ankyloglossia</span></a></li></ol></li><li><a href="topic_6-0.html"><span class="menu-item-icon">6.0 </span><span class="menu-item-title">Managing common difficulties</span></a><ol><li><a href="topic_6-1.html"><span class="menu-item-icon">6.1 </span><span class="menu-item-title">Engorgement</span></a></li><li class="current mm-selected"><a href="topic_6-2.html"><span class="menu-item-icon">6.2 <i class="fa fa-caret-right" aria-hidden="true"></i></span><span class="menu-item-title">Hyperlactation</span></a></li></ol></li><li><a href="topic_7-0.html"><span class="menu-item-icon">7.0 </span><span class="menu-item-title">Supplementation</span></a><ol><li><a href="topic_7-1.html"><span class="menu-item-icon">7.1 </span><span class="menu-item-title">Feeding-line device at the breast or chest</span></a></li><li><a href="topic_7-2.html"><span class="menu-item-icon">7.2 </span><span class="menu-item-title">Cup feeding</span></a></li><li><a href="topic_7-3.html"><span class="menu-item-icon">7.3 </span><span class="menu-item-title">Finger Feeding</span></a></li></ol></li><li><a href="topic_8-0.html"><span class="menu-item-icon">8.0 </span><span class="menu-item-title">Closing session</span></a><hr></li><li class="appendix"><a href="references.html"><span class="menu-item-icon no-topic"><i aria-hidden="true" class="fa fa-book i-topic"></i></span><span class="menu-item-title">List of references</span></a></li><li class="appendix"><a href="contents.html"><span class="menu-item-icon no-topic"><i aria-hidden="true" class="fa fa-file-text-o i-topic"></i></span><span class="menu-item-title">Course contents</span></a></li><li class="appendix"><a href="full.html"><span class="menu-item-icon no-topic"><i aria-hidden="true" class="fa fa-print i-topic"></i></span><span class="menu-item-title">Print version</span></a></li></ol></nav><div id="content"><h1 id="top">6.2 Hyperlactation</h1><section class="section" id="Hyperlactation"><h2>Hyperlactation</h2> <section class="section" id="Oversupply_-_too_much_milk_"><h3>Oversupply - too much milk!</h3> <div class="content-node"> <p>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.</p> </div> <blockquote> <div class="content-node"> <p>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.</p> </div> </blockquote> <div class="content-node"> <p>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.</p> <p>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.</p> </div> </section> </section><section class="section" id="Signs_and_Symptoms_of_Hyperlactation"><h2>Signs and Symptoms of Hyperlactation</h2> <div class="content-node"> <p>Signs and Symptoms of Hyperlactation that may be experienced by the breastfeeding/chestfeeding dyad.</p> </div> <div class="columns"><div class="column" style="width: 50%"> <div class="content-node"> <h3>Mother/lactation parent</h3> <p>Excessive breast growth during pregnancy &gt;2 cup sizes<br> Persistent or frequent breast fullness<br> Breast and/or nipple pain<br> Copious milk leakage<br> Recurrent plugged ducts<br> Recurrent mastitis<br> Nipple blebs<br> Vasospasm</p> </div> </div><div class="column" style="width: 50%"> <div class="content-node"> <h3>Infant</h3> <p>Excessive weight gain<br>
Difficulty achieving a sustained, deep latch<br>
Fussiness at the breast<br>
Choking, coughing, or unlatching during feeds<br>
Breast refusal<br>
Clamping down on the nipple/areola<br>
Short feedings<br>
Gastrointestinal symptoms (e.g., spitting up, gas, reflux, or explosive green stools)</p> </div> </div></div><br style="clear: both"> </section><div class="captionBox"><img width="601" height="451" data-src="images/lb.jpg" src="//static.health-e-learning.com/jigsaw/design/lazy_image.gif" alt="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."><p>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.</p></div><section class="section" id="Clinical_management"><h2>Clinical management</h2> <div class="content-node"> <p>Management of hyperlactation.</p> <ul> <li>Block feeding for 24-48 hours under close supervision by experienced lactation support professional.</li> <li>Herbal remedies may include sage, jasmine flowers, and chasteberry to reduce milk production.</li> <li>Prescription medications may include pseudoephedrine and oral contraceptives (oestrogen) under medical supervision.</li> <li>Dopamine agonists such as bromocriptine or cabergoline can possibly be utilized under medical supervision if hyperlactation persists despite all other interventions.<ul><li>CAUTION as these medications have a long half-life, there are concerns about the side effects, and can lead to suppression of lactation.</li></ul></li> </ul> </div> </section><section class="section" id="What_is_Block_Feeding_"><h2>What is Block Feeding?</h2> <div class="content-node"> <p>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.</p> <p>"<em>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</em>.<em>"</em></p> </div> </section><div class="box"><div class="box-title"><a href="https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/1746-4358-2-11" target="_blank"><img src="//static.health-e-learning.com/jigsaw/design/article.png" class="icon" alt=""></a><h3><a href="https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/1746-4358-2-11" target="_blank">Full drainage and block feeding method (FDBF)</a></h3></div> <div class="content-node"> <p>van Veldhuizen-Staas described the full drainage and block feeding method (FDBF) in the publication called <img alt="External" src="//static.health-e-learning.com/jigsaw/design/external.gif"><a href="https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/1746-4358-2-11" title="External link" target="_blank">Overabundant milk supply: An alternative way to intervene by full drainage and block feeding</a>. Take the opportunity to review this article.</p> </div> </div><section class="section" id="Herbal_therapies"><h2>Herbal therapies</h2> <div class="content-node"> <p>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.</p> </div> <div class="box"><div class="box-title"><a href="https://www.bfmed.org/assets/DOCUMENTS/PROTOCOLS/Protocol%20%2332%20-%20English%20Translation.pdf" target="_blank"><img src="//static.health-e-learning.com/jigsaw/design/books.png" class="icon" alt=""></a><h3><a href="https://www.bfmed.org/assets/DOCUMENTS/PROTOCOLS/Protocol%20%2332%20-%20English%20Translation.pdf" target="_blank">ABM Clinical Protocol #32: Management of Hyperlactation</a></h3></div> <div class="content-node"> <p>Take the opportunity to read, print out or save the PDF - <img alt="PDF" src="//static.health-e-learning.com/jigsaw/design/page_white_acrobat.png"><a href="https://www.bfmed.org/assets/DOCUMENTS/PROTOCOLS/Protocol%20%2332%20-%20English%20Translation.pdf">ABM Clinical Protocol #32:Management of Hyperlactation</a> and keep it for future reference. It is for the medical profession yet has lots of helpful information.</p> </div> </div> </section><div class="box"><div class="box-title"><img src="//static.health-e-learning.com/jigsaw/design/remember.png" class="icon" alt=""><h3>What you should remember</h3></div> <div class="content-node"> <ul> <li>Hyperlactation can be self-induced, iatrogenic, or idiopathic.</li> <li>Prevention is the first step when possible</li> <li>Block feeding with close supervision</li> <li>Dopamine agonists should be reserved for cases that do not resolve with other treatments and used with caution and close suppervision. </li> </ul> </div> </div><div id="footer"><a href="topic_6-1.html" rel="prev" class="prev">&laquo; Prev</a><a href="topic_7-0.html" rel="next" class="next">Next &raquo;</a><br style="clear: both"><div class="floating-menu"><button class="theme-toggle" title="Toggle colors (dark or light)"><i class="fa fa-moon-o"></i></button><button class="gotoTop" title="Back to top"><i class="fa fa-chevron-up"></i></button></div><a href="javascript:%20window.print()" id="printLink">Print this page</a><span class="noPrint"> | </span>&copy; 2022 Health e-Learning<p class="printOnly">COPYRIGHT: You are permitted to print ONE (1) copy for your personal use only. No graphics, tables, quizzes, videos, etc, may be used in any form without express written consent. Author: ["Carole Dobrich"]</p><p class="dateUpdated">Updated on Wed, 12 Oct 2022 23:23:13 +0000</p></div></div></body></html>
