Can you overfeed a breastfed baby?


Can you overfeed a baby? The answer is absolutely yes. You have a tiny human with a tiny human stomach. All of our stomachs can stretch to hold more capacity than what we actually need to take. The question is, is over eating a problem? We’ll take a look at this and strategies to understanding if whether your baby is over feeding and if it’s a problem or not.

Now we all know that it is very easy to overfeed from a bottle. Bottles have a hole in them that are instant and constant and absolutely yes, many bottle fed babies are over fed. Many times parents are watching the volume in the bottle instead of watching the baby for baby’s cues that they are ready stop. It also takes 20 minutes for the stomach to tell the brain that it’s full, so it is very easy for babies to take the large volume in a short amount of time and eat more than their stomach needs to, before the brain knows that it’s full. The mouth can still be hungry while the stomach is full so babies may show cues that they are still wanting to suck which parents interpret as cues that Baby wants to continue to feed, and because the stomach can stretch and hold more than it needs to, parents often overfeed from a bottle.

The big question is, can babies overfeed at the breast? The breast works different than a bottle. The breast needs to be stimulated to release milk and milk is released in multiple waves that take time to be triggered. Most young babies will take 15 to 30 minutes at the breast, which allows their tummy time to tell the brain that it’s full. As they age and become more efficient; they learn to listen to their stomach to help guide when to stop feeding.

It is still possible to overfeed at the breast. We usually see this for two reasons: either from the mother side or from the baby side.

On the mother side, the most common reason for overfeeding is the mother has an over supply of milk. There are several reasons for having an oversupply. First, it may be caused by using a Haakaa or a breast pump and overstimulating the breast to make more milk than it needs. This also drives up the letdown response, which makes milk flow faster than if the baby were just feeding at the breast without the over supply. In this case, baby takes too much milk too fast. Mother may also have an oversupply being driven by certain medications. The most common medication I see driving over supply is Zoloft. There are also different medical conditions that can be the reason for an oversupply such as a prolactinoma, which is a pituitary gland tumor, or uncontrolled thyroid disorders.  This would be diagnosed by a physician after bloodwork and other medical imaging. Lastly, some new parents who don’t have as much experience with babies may also interpret every cue as a hunger cue. Some babies are totally willing to keep eating even if they are full. If you offer me a cheesecake, I will totally eat the cheesecake even if I don’t need it. Some babies are also like this, they will always latch when offered the breast. Every time baby is put down to sleep in the crib, they cry. Or they sleep for 10 minutes and cry to be picked up. But these cues get misinterpreted as the baby is still hungry and the baby is put back to breast. Some babies are very willing to go back to breast and keep feeding.

Overfeeding  could also be on the baby side. Certain tongue ties will stimulate the breast into an over supply. These babies often use a quick suckle pattern which initiates the let down reflex from how the nipple is stimulated. These cases are complicated in that the tongue may be restricted in a way that the mother doesn’t have much nipple pain or damage, but her body is compensating for the baby not having full range of motion of the tongue. Babies with reflux may also over feed at the breast. They often want to nurse more to keep swallowing, which helps keep milk in the stomach. Breastmilk is a pain reliever and many babies with reflux learn that they would rather be swallowing milk down than bringing it back up as reflux. So frequently feeding helps them swallow more often, but it becomes a vicious cycle.

When does overfeeding actually become a problem? If baby is having a lot of negative symptoms related to feeding, and over feeding is determined to be part of the root, addressing the reason WHY there is overfeeding would be appropriate.

If the baby has digestive discomfort, and has a lot of reflux/excessive spit up/projectile vomiting with pain, severe gas or digestive pain, we would want to address over supply or other issues, causing this discomfort. If the baby is having green, frothy/foamy or watery poops, this is also a sign of too much milk too fast. These kinds of watery or green poops may be a sign of lactose overload, where baby is accessible too much foremilk due to an oversupply.

Another symptom to watch for that would lead us to believe overfeeding is a problem would be baby coughing, choking, or leaking milk during the feeding. If the baby just physically cannot keep up and is constantly struggling during the feeding, there would be a reason why we would want to reduce milk supply to help baby feel more comfortable at the breast. Although this may also be a symptom pointing back to a tongue tie driving the over supply, so just bringing supply down would not necessarily be the best answer in this case. We would want to determine if the oversupply is causing the coughing and choking or if an inefficient tongue is contributing to baby not being able to swallow efficiently.

Babies gaining weight too quickly or faster than expected can also be a symptom that baby is being overfed, however, this is my symptom of least concerned. If the baby is gaining happily with no digestive discomfort, poops are a normal color and consistency, and is not leaking, coughing, or choking during feedings, fast weight gain alone would not be a concern. Many typically feeding babies with mothers with a normal supply can gain weight quicker than anticipated and then level off in weight once they become more active or distracted.

Yes, it is occasionally possible for breastfed babies to overfeed. If there there are symptoms happening (recurrent plugged ducts and mastitis for mother from an over supply, nipple pain and damage, coughing/choking baby, digestive discomfort or concerns with poop), working with an IBCLC lactation consultant can help determine what the root is (excessive pumping, medications, tongue tie, reflux, etc) to help balance the dyad for happier feeding.