This morning I talked with a breastfeeding mother whose story is becoming all too common. Her 1-month-old third baby was having trouble coping with her fast milk flow. At many feedings, she coughed, sputtered, and sometimes pulled off the breast crying. This mom assumed from this behavior that she had an overactive let-down (OALD) and started a strategy called “block feeding.”
What is Block Feeding?
Block feeding involves restricting baby to one breast for 3-hour or longer blocks of time before giving the other breast. It is very effective at bringing down milk production when a mother is making way too much milk. Allowing the breasts to stay full for a set period of time sends the signal to slow milk production.
Block Feeding Dos
This strategy can be a lifesaver in some cases, as oversupply (aka “hyperlactation” or “overabundant milk production”) can decrease quality of life for both mother and baby. For a mother, the drawbacks include regularly full and uncomfortable breasts and recurring plugged ducts. For the baby, oversupply can cause a very fast milk flow that can be hard to manage. In this case, block feeding used for no longer than 1 week can be a boon for both mother and baby.
Block Feeding Don’ts
What seems to be more and more common, though, is the assumption that any struggle with milk flow is due to OALD or oversupply, when there is usually another cause. As a result, some mothers bring down their milk production with block feeding when their supply is actually at a healthy level, leading to other problems, such as slow weight gain.
As I told the mother this morning, during the early weeks, most newborns cough and sputter during breastfeeding some of the time. It takes practice and maturity for babies to learn to coordinate sucking, swallowing, and breathing during breastfeeding. Some episodes of milk flow struggles and pulling away are completely normal and are not necessarily signs of OALD or oversupply.
How to Know If Block Feeding Will Help
The most reliable gauge of whether block feeding may be helpful is baby’s weight gain. If breastfeeding is going well, during the first 3 months, most babies gain on average about 2 lb/mo. (0.90 kg/mo.). If baby’s weight gain is double this or more, block feeding for no longer than 1 week makes sense. If baby’s weight gain isn’t this high, it is likely that block feeding will cause more problems than it solves.
Alternatives When Baby Struggles with Milk Flow
What can you do if your baby’s weight gain is average but she is struggling with milk flow during breastfeeding? The best strategy is using feeding positions that give baby more control over flow. The most difficult feeding positions for babies from a milk-flow standpoint are those in which milk is flowing downhill into their throats, such as all those in which mothers sit upright.
In the feeding position shown at left, however, milk flows uphill into baby’s mouth, giving her more control. See this post to read more about these types of feeding positions and their advantages.
If baby continues to have consistent problems with milk flow, it's time to see a lactation professional to check for anatomy, swallowing, and breathing issues. To find a lactation consultant near you, go to this website, click on the "Find a Lactation Consultant" link, and enter your zip or postal code.
Caroline, G.A. & van Veldhuizen-Staas, C. G. Overabundant milk supply: An alternative way to intervene by full drainage and block feeding. International Breastfeeding Journal 2007; 2:11.