How do I know if my baby has lactose overload?

Lactose overload is commonly seen in breastfed babies who consume large amounts of milk. When a mother has an oversupply in the early weeks, a baby can take in too much milk, too fast, resulting in an unsettled bub. Ironically, a mother may think that she has a low milk supply because her baby always seems hungry. So, how can you tell if it’s lactose overload, and what can be done to remedy it?

How do I know if my baby has lactose overload?

When babies consume a large volume of milk at each feed, the lactose reaching the lower bowel can produce excess gas, fluid build-up, and acidic poos. Here are some of the telltale signs that your baby has lactose overload:

  • Is your baby under 3 months of age?
  • Does your baby have a nappy rash?
  • Is your baby ‘acting hungry’, as in are they unsettled and want to suck?
  • Is your baby drawing their legs up at feeds, or screaming?
  • Does your baby have adequate to large weight gain?
  • Does your baby have many, often explosive, poos?
  • Is your baby’s nappy wetter than usual?
  • Is your baby doing green, frothy poos?

Aren’t green poos a sign that something is wrong?

Green poos can be normal for breastfed babies, and it usually means that the gut contents have passed through quickly. However, green frothy poos is also one of the signs of lactose intolerance, and the occasional dark green-coloured poo can mean insufficient milk intake.

My baby appears to choke on my milk. Does this mean I have an oversupply?

Even if you appear to have a very fast let-down, and your baby comes off the breast coughing and spluttering, it does not necessarily mean that you have an oversupply of milk. There also needs to be some of the other signs we’ve just mentioned, such as many wet and dirty nappies and good to high increases in weight, before taking further steps address the situation.

What can I do if I suspect I have lactose intolerance?

First of all, know that you’re doing an amazing job, and you’re not doing anything wrong. It’s common for a mum to make more milk than her baby needs as her supply adjusts, and it should only take a few days to resolve.

Speak to an Australian Breastfeeding Association counsellor or a lactation consultant. What they will most likely recommend is that you switch from on-demand feeding to block-feeding, but only for a few days, with the aim to slow the rate at which milk goes through the baby.

To block feed, you will feed your baby from one breast per feed. It doesn’t mean spacing feeds, but rather only feeding from one breast in one period, and this might be every 3-4 hours depending on your oversupply. So, for 4 hours (set a timer), every time your baby wants a feed, you use the same breast, and then the next 4 hours, you use the other breast, and so on.

Each time your baby goes back to the already used breast, he gets a lower-volume, higher fat feed that helps to slow the system down. Ensure that your unused breast doesn’t get overfull. If you feel a lump, feed or express it out.

How do I know if this change has been effective?

It will take 3-4 days to see an improvement, but your baby may start to be more settled, cry less, and the number of necessary nappy changes might have reduced. A normal number of nappies for young babies in 24 hours is 5 disposable (or 6 very wet cloth) nappies, and at least 3 dirty nappies.

As soon as the symptoms have been relieved, you can return to your baby’s normal on-demand feeding routine. If the symptoms persist, discuss with your lactation professional about why there is an oversupply of milk.

One possible reason is that a baby is unsettled due to something else physical going on (for example, they’re unwell, or suffering discomfort from a difficult birth), so they’re wanting to comfort-suck more, consequently increasing your supply. You might also consider consulting with a chiropractor and your GP to rule out anything medical.

Another possible cause of prolonged oversupply is that some mothers are anxious that they have a low supply, so they time feeds and switch sides after a set number of minutes, or offer more feeds than their baby needs, because they think their baby’s unsettledness is caused by hunger.

Finally, some mothers just have a natural tendency to oversupply. Everyone’s body is different, and yours just might be one that produces a lot of milk. Whilst this might sound like a gift to a mum who struggles with low milk supply, you might find it uncomfortable and unpleasant physically and emotionally. Please get the necessary support to find strategies that will help you to enjoy your breastfeeding journey.

Australian Breastfeeding Association

La Leche League International