Management of hyperlactation

Patient Guideline Summary

Publication Date: March 9, 2020
Last Updated: March 3, 2023

Objective

Objective

This patient summary means to discuss key recommendations from the Academy of Breastfeeding Medicine for management of hyperlactation.

Overview

Overview

  • Hyperlactation is producing more breast milk than an infant needs.
  • Some of the most common causes of hyperlactation are:
    • Self- or health professional-induced
      • Excess pumping or expressing of milk
      • Milk-stimulating herbs or medications
        • Herbs, curry with fenugreek, moringa
        • Domperidone, metoclopramide
    • Unrecognized causes
  • This patient summary focuses on reducing the overproduction of breast milk.

Diagnosis

Diagnosis

  • Maternal symptoms include:
    • Excessive breast growth during pregnancy
    • Breast fullness
    • Milk leakage
    • Plugged milk ducts
  • Infant symptoms include:
    • Excess weight gain
    • Refusal to breastfeed or fussing when feeding
    • Milk leakage
    • Short feedings
    • Digestive symptoms
  • Breastfeeding observed by an expert can help specify the problem and evaluate the effect of treatment.

Treatment

Treatment

  • Breastfeeding for 3 hours from one breast, then switching to the other breast for the next 3 hours (“block feeding”) may reduce milk production.
  • Herbs and medicines that suppress milk production are the next treatment option.
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Herbs Medicines
  • Peppermint
  • Sage
  • Jasmine flowers
  • Chasteberry
  • Pseudoephedrine
  • Estrogen – as in low-dose oral contraceptives only after the first 6 weeks
  • Cabergoline
  • Bromocriptine
  • Dopamine also reduces milk production but can have serious side effects and therefore is reserved for the worst cases.

Source Citation

Helen M. Johnson, Anne Eglash, Katrina B. Mitchell, Kathy Leeper, Christina M. Smillie, Lindsay Moore-Ostby, Nadine Manson, Liliana Simon, the Academy of Breastfeeding Medicine, Michal Young, Larry Noble, Melissa Bartick, Sarah Calhoun, Megan Elliott-Rudder, Lori Feldman-Winter, Laura Rachael Kair, Susan Lappin, Ilse Larson, Ruth A. Lawrence, Yvonne Lefort, Kathleen A. Marinelli, Nicole Marshall, Katrina Mitchell, Catherine Murak, Eliza Myers, Sarah Reece-Stremtan, Casey Rosen-Carole, Susan Rothenberg, Tricia Schmidt, Tomoko Seo, Natasha Sriraman, Elizabeth K. Stehel, Nancy Wight, and Adora Wonodi.Breastfeeding Medicine.Mar 2020.129-134.http://doi.org/10.1089/bfm.2019.29141.hmj

Disclaimer

The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.