Table of contents

• What is milk let down?
• When you can't feel a let down.
• The signs of a breastfeeding let down.
• What is an overactive let down?
• What to do when you have a fast MER (milk ejection reflex)
• Breastfeeding positions to reduce gas.
• Slow let down - baby frustrated.
• Breast milk let down stimulation.
• A phantom let down.

What Is a Milk Let-Down?

When your baby suckles at the breast, the tiny nerves in your nipple are triggered; these nerve impulses will cause Prolactin and Oxytocin to be released (the hormones that stimulate milk production). The Prolactin will increase production while the Oxytocin helps push the milk out, assisting with the flow. Oxytocin does this by widening the milk ducts, making it much easier for the milk to flow through them. It also causes the alveoli to contract and squeeze the milk out. The release of breastfeeding Oxytocin may also cause headaches, nausea, lethargy, and thirst.

You will only start to feel a milk ejection reflex once your mature milk has come in between days 3 and 6.

What does letdown feel like?

Most mothers experience a weird pins-and-needles feeling in their breasts when let down occurs.  Other mothers say that they experience a painful letdown! Letdown pain should only last a couple of weeks while your body regulates your supply.  

If you are feeling negative emotions during a let-down, you might be experiencing a dysphoric ejection reflex.

Most mothers will feel a breastfeeding letdown reflex after two minutes of nursing. A milk ejection reflex can occur more than once during a feeding and will usually occur in both breasts simultaneously. Most mothers will only notice let-downs during the first few weeks after birth.

It is not uncommon for a mother to have a milk let down when she hears or sees her baby, especially when her baby cries. Yes, milk will start to flow, even though her baby is not at the breast.

A milk let down reflex is a natural function, but sometimes it can cause a few breastfeeding problems when the milk flow becomes too fast or too slow.

You need to remember that before six weeks postpartum, your body is getting accustomed to the needs of your baby, and things should start improving; then, your baby should also begin to drink more aggressively, which will help to normalize the milk flow.

What If You Have No Let-Down Reflex?

Some say they do not feel a milk ejection reflex at all. As long as your baby is happy, gains weight, and produces enough wet diapers, you don't need to worry.

The signs that your baby is getting enough breast milk.

The Signs of a Let-Down

• A tingling feeling (pins and needles feeling)
• A sudden feeling of fullness of the breasts.
• A burning sensation or pressure.
• Milk may start dripping or spraying from the left breast if nursing from the right breast and vice versa.
• Rhythmic sucking and swallowing.
• You may feel menstrual-like cramping during the first few weeks when a let down occurs. Oxytocin is released during a let down, and this hormone is responsible for the contraction of the uterus; this will help your uterus return to its original size.

Overactive Let-down and Breastfeeding

What is a forceful let down?

It is when a mother’s milk is spraying out of the nipple too quickly, often causing her baby to become fussy or to choke at the breast. Your baby may struggle to stay on the breast. You may leak as well as spray your baby in the face. Mothers with forceful let-downs often have an oversupply too.

Your baby may swallow a lot of air while nursing, which can lead to excessive gassiness and fussing. Your baby may also gain weight quicker than most. If your baby has runny, explosive, green stools and is showing colic symptoms, a foremilk/hindmilk imbalance may be to blame; this is when your baby takes in too much lactose. Once the oversupply issue has been fixed, all these other problems should come to an end, also.

NB- Do not try to reduce your supply if your baby is younger than six weeks. It is normal for babies younger than this to have temporary issues and for your milk supply to be increasing rapidly. You need to give your body a chance to regulate the amount of milk required.

A forceful letdown will most certainly have reduced before the baby turns six months.

Ways to Handle an Overactive Ejection Reflex May Include the Following:

• If you start to feel a let-down, you can gently remove your baby from the breast and allow some of the milk to flow out into a cup or cloth until the flow subsides, then put your baby back on the breast.
• Make sure that your baby is calm before breastfeeding.
• Do not try to stop the flow with pressure, as this could cause a blockage.
• Make sure your nipple is facing the roof of your baby's mouth instead of the back of their throat. This prevents choking.
• Burp your baby often during feeding and after a feeding to help release any air that may cause bloating and pain.
• If you have an oversupply, you can try block feeding. You can do this by breastfeeding from only one side for 6 hours, then breastfeed from the other breast for six hours. Pump to relieve some pressure if need be. The idea is to decrease demand, which will reduce supply. Do not limit the time your baby spends on the breast. Breastfeed on demand but from that one breast during that specific time period.
• Cold compression between feedings can reduce blood flow and, therefore, milk production too.
• Avoid extra breast stimulation such as pumping, compressing your breasts while nursing, hot showers, or wearing breast shells.
  

Breastfeeding Positions to Reduce Gas    

The laid-back nursing position or side-lying position will make it easier for your baby to nurse. Gravity is acting against the flow of milk; therefore, the baby is less likely to struggle with the fast flow.

Another helpful breastfeeding position for older babies would be to allow your baby to straddle your leg and sit them upright while breastfeeding, holding their back and neck for support.

Under Active Let-Down Breastfeeding

Is your milk flow too slow? Do you feel like you have no let down reflex?

Your baby may seem extremely frustrated, fussy and may cry when your milk takes too long to start flowing. A baby may begin to reject the breast or bite while nursing.

This will cause a baby to fuss and a mother to stress, and anxiety will decrease milk flow even further.

What causes a slow milk let-down reflex?

• Is your milk supply dropping?
• Excessive alcohol intake during breastfeeding.
• Smoking while breastfeeding.
• Certain medications.
• Being anxious or upset. Any emotions that promote the release of adrenaline into the system may hinder a let down reflex.
• Being overly tired.
• Being in pain.
• Not having your baby directly at the breast. Mothers who are pumping exclusively or pumping at work may struggle.
• Previous breast surgery.
• Fatigue.

How to Encourage a Let Down

• Express some milk, and once your milk begins to flow, you can put your baby at the breast.
• Keep distraction to a minimum while nursing.
• If you are pumping, look at pictures of your baby to encourage a let down or listen to a recording of your baby's voice.
• Gentle breast massage is a great way to stimulate a let down and ensure that you drain the breast well. Stroke your breasts from the outer edges of the breast towards the nipple with a flat hand. Rolling your nipple between your fingers may also help.
• Take a warm shower or apply a warm compress or warm face cloth to increase milk flow.
• Some mothers have found that meditation can help them relax just before a feeding or pumping session. Visualizations (imagine that your milk is flowing like a waterfall) and deep breathing may help.
• A study proves that listening to music while breastfeeding or pumping can significantly increase milk supply and increase the fat content of milk. (1)
• Skin to skin contact will lead to a let down and has many other fantastic benefits.
• Ensure that your baby is latched on well; a shallow latch will not stimulate a let down and will not allow for optimum milk removal.
• Use breast compressions while nursing.
• How to stimulate let down with a Haakaa - Put the pump suction on, then gently start massaging the top half of your breast. A warm compress can increase the effectiveness of this procedure. Do this for 5 to 10 minutes. This can also help you get multiple letdowns while pumping.
  

Get help if you need to. A lactation consultant can assess the situation and advise accordingly.

A Phantom Let-Down

This is when the sensation of a let down occurs even after the breastfeeding relationship has ended. It is nothing to worry about. However, if you suddenly start producing milk months or years after weaning, you will want to contact your doctor about it.

A Let Down Reflex When Not Breastfeeding

Mothers can experience the let-down reflex postpartum, whether breastfeeding or not. The hormone that causes a mother to let-down, namely Oxytocin, is still coursing through her veins and may take a couple of weeks to drop back to normal levels after giving birth.

If you, however, have a let down and you have not recently given birth or are not in the process of relactation, it could indicate hormonal issues. You will need to see your doctor about this.  

Comments

Question
A better let-down while pumping?
by Tiffany
(Grovetown, GA, US.)

"When I pump, it takes me like 3 mins to get a letdown, and with each let-down I get. 5 ounces - I get maybe four let-downs in 15 minutes on just one side.

I've been pumping like this for three days now and can't seem to get more - only a couple of ounces from the left breast. This is an hour after I feed my daughter.

How can I increase how much I'm getting when I pump?"

Answer
by Lyssa

"On average, a baby eats an ounce to an ounce and a half every hour between feedings. Usually, when a mom is exclusively breastfeeding, she makes precisely enough for what her baby needs.

Getting "only" an ounce after baby eats is excellent! The people you hear pumping 3+ oz are usually the ones pumping exclusively every three hours or pumping while away from their babies.

Some women are just unable to pump effectively. Some women find it easier to hand express; you can find videos on Youtube of proper techniques.

You can also try "power pumping." You pump 20 mins on and 20 mins off for an hour on, an hour off (for a few hours at the same time every day for a few days), which can sometimes increase supply.

I really would not worry about your supply."

This Was so Very Helpful
by Anonymous

"My baby is two months old. I am a 40-year-old first-time mom. I have been struggling with breastfeeding since day one. I have seen lactation consultants, doctors, and of course, grandmas, along with other moms. So far, this has been the most helpful information. Thank you! I thought for a while I was the only one experiencing these things. Good to know there are others and ways to help me. Thanks so much! :)"

It Is like You Have a Camera Here!
by Jessie
(Miami, FL)

"Wow...I mean, Wow. I wish every OB-Gyn and Pediatrician had your website and La Leche League. I have been asking questions about my let down, and everyone only said it would get better with time. This is so much better.

My baby has all the above symptoms. When my milk comes down, It is like majorly spraying everything. She is sprayed every time she releases. She chokes, she clicks.

It is like you have a camera here!! Thank you. I am going to keep looking at the other things on this website...I just didn't want to leave without leaving a comment."

Reference

1. www.ncbi.nlm.nih.gov

The effect of music-based listening interventions on the volume, fat content, and caloric content of breast milk produced by mothers of premature and critically ill infants.

Header photo by Luiza Braun on Unsplash