Let-Down Reflex – What You Need to Know About Your Milk Flow

What is a Let-down Reflex?

When your baby starts to suckle at your breast, tiny nerves in your nipple get activated. This sends signals that tell your body to release two important hormones: Prolactin and Oxytocin. Prolactin helps make more milk, while Oxytocin triggers the let-down reflex by opening the milk ducts and squeezing milk out. This makes it easier for your baby to get milk. You usually start to feel the let-down reflex once your mature milk comes in, which happens between days 3 and 6 after birth.

The let-down reflex usually happens around two minutes into nursing and can occur more than once during a feeding. It mostly happens in both breasts at the same time. Sometimes, just hearing or seeing your baby can trigger the let-down reflex, even if the baby is not nursing. This reflex is natural, but a very fast or very slow milk flow can cause feeding struggles. Keep in mind that it can take about six weeks for your body and baby to settle into a smooth feeding pattern with the let-down reflex.

What Does a Let-down Feel Like?

Most moms describe the let-down reflex as a tingling or pins-and-needles feeling in their breasts. Some even feel a little pain, but that usually goes away after a couple of weeks as your body adjusts.

If you feel upset or worried during let-down, you might be experiencing a condition called dysphoric milk ejection reflex. – Kellymom

If you don’t feel the let-down reflex at all, don’t worry. As long as your baby is happy, gaining weight, and having enough wet diapers, everything is fine. These signs show that your baby is getting enough milk even if you can’t feel the let-down.

Let-down Reflex Signs

• A tingling or pins-and-needles feeling in your breasts
• Sudden fullness or heaviness in the breasts
• A burning sensation or pressure
• Milk dripping or spraying from the breast you’re not nursing on
• Your baby sucking and swallowing rhythmically
• Some moms feel mild cramping, like menstrual cramps, because Oxytocin also helps your uterus shrink back to its normal size after birth

Some moms have what is called an overactive or forceful let-down. This means milk sprays out too fast, which can make your baby cough, choke, or fuss. If this happens, you might also leak milk or spray your baby’s face. A forceful let-down often comes with having an oversupply of milk. When milk flows too fast, your baby might swallow extra air, which causes gas and fussiness. Sometimes, your baby’s stools might be very runny or green, indicating too much foremilk (the thinner milk at the start of feeding) and not enough hindmilk (the richer milk that comes later). If you fix the oversupply, these problems usually get better. But try not to reduce your milk supply until your baby is at least six weeks old, as your body is still adjusting to your baby’s needs.

How to Handle a Fast Let-Down Reflex

• When you feel let-down, gently take your baby off the breast for a moment and let some milk flow out to slow the flow. Then put your baby back on.
• Make sure your baby is calm before feeding.
• Don’t press too hard on your breast to stop the flow, as this can cause blockages.
• Help your baby latch so the nipple points to the roof of their mouth, which helps prevent choking.
• Burp your baby often during and after feeding to release swallowed air.
• Consider block feeding if you have an oversupply: feed from one breast for about six hours, then switch to the other breast for the next six hours. Pump if needed to relieve pressure. (Not recommended before your baby is 6 weeks old)
• Use cold compresses between feedings to reduce milk flow without harming supply.
• Avoid extra breast stimulation like pumping or hot showers, as these can increase milk production.

How to Encourage a Let-Down When it’s Slow

If your milk flow is slow or the let-down reflex feels weak, your baby could get frustrated and fussy. A slow let-down might make a baby bite or refuse to nurse sometimes. Stress and anxiety can make this worse by blocking the let-down reflex. Some reasons for a slow let-down include smoking, drinking alcohol, certain medications, being very tired, pain, or previous breast surgery. Moms who pump instead of breastfeeding might also find let-down harder. How to increase your let-down:

• Try hand expressing a little milk before nursing to help the flow start.
• Keep distractions low during feedings so you can relax.
• If pumping, look at photos of your baby or listen to their sounds.
• Gently massage your breasts from the outer breast toward the nipple. Rolling your nipple between your fingers can help too.
• Take a warm shower or use warm compresses to increase milk flow.
• Some moms find meditation, deep breathing, or imagining milk flowing like a waterfall helps trigger let-down.
• Listening to music while breastfeeding or pumping has been shown to increase milk supply and milk quality.
• Skin-to-skin contact with your baby strongly encourages let-down and offers extra benefits.
• Check your baby’s latch carefully as a shallow latch won’t stimulate good milk flow.
• Use breast compressions during feeding to help milk flow.
• If using a Haakaa pump, put it on your breast and massage gently while using a warm compress for 5–10 minutes to get let-down easier and possibly multiple let-downs.

A Let-down While Not Breastfeeding

Sometimes you might feel a “phantom let-down,” a sensation of milk flow even when you are no longer breastfeeding. This is normal and nothing to worry about. But if you start producing milk months or years after weaning, you should talk to your doctor as it could indicate a hormone issue.

The let-down reflex can also happen in moms who aren’t breastfeeding anymore or who just had a baby, because Oxytocin stays in the body for some time after birth. If you experience let-down and are not breastfeeding or recently postpartum, it’s a good idea to check with your doctor.

Resources and References

• La Leche League – International breastfeeding support
• NHS – How to breastfeed – latching on
• NCBI – The physiology of breastfeeding