Let Down Reflex

The Let Down Reflex Breastfeeding

Milk let down is a normal process, but sometimes it can cause a few breastfeeding problems when it becomes too forceful or too slow.

Most Moms experience a weird pins-and-needles feeling in their breasts when let down occurs.  Other Moms say that it is quite painful! There are also mothers who say they don't feel a let down reflex at all. 

What you need to remember is that your body is still getting accustomed to the needs of your baby and things should start improving within a few weeks; then your baby should also start drinking more aggressively, which will help normalize milk flow.

Below is an illustration of let down reflex and what actually happens.




oxytocin, breastfeeding illustration, illustration of breastfeeding The letdown reflex

Overactive Letdown Breastfeeding

Is your milk flow too fast?

What is a forceful let down?

It is when Mom’s milk is spraying out of the nipple too quickly, often causing Baby to become fussy or to choke at the breast.

A forceful letdown will have decreased before Baby turns 6 months, but usually by six weeks, when Mom's body has adjusted to the volume of milk needed.


What causes a forceful let down?

* This usually occurs when Mom has an oversupply of breast milk.

* Can be caused by a growth spurt period, which causes a baby to drink more often, therefore increasing a mother's milk supply.


Signs of a Forceful Let Down

* Gagging, coughing and/or choking while breastfeeding.

* Baby makes funny clicking sounds while breastfeeding.

* Baby is constantly trying to pull off the breast while breastfeeding.

* Baby spits up often and is very gassy (explosive frothy stools) caused by Baby drinking too much foremilk.

Read more about foremilk hindmilk imbalance.

* Refusal to breastfeed at times.


How to Handle an Overactive Ejection Reflex

* If an oversupply of milk is causing your forceful let down, you can start by giving your baby only one breast at a time (change breasts only every four hours).

If you start to feel discomfort in the full breast, you can express a little milk for comfort. This will also prevent hindmilk foremilk imbalance and decrease fussiness and colic symptoms.

* If you start to feel a letdown, 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.

You might need to do this a few times during a feed. Pumping milk before feeds is not a good idea as this will just increase milk supply even more.

* Make sure that your baby is calm before breastfeeding.

Read tips on how to calm a baby for breastfeeding.

* Try not to press on your breast with your fingers while breastfeeding as any pressure or massage can increase the flow of milk and cause a let down. 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 his/her throat. This prevents choking.

* Lie down while breastfeeding for the first few minutes. This will help because it allows any extra milk to flow out of Baby’s mouth.

* Keep yourself reclined at an angle with Baby lying on his/her tummy as shown in the illustration. This uses gravity to your advantage as milk is not forced down Baby’s throat.

* Another helpful breastfeeding position is when Mom allows Baby to straddle her leg and sits Baby upright whilst breastfeeding, holding his/her back and neck for support.

* Remember to burp your baby often, because your baby might be swallowing air which will make him/her even more uncomfortable.

* Do not introduce a bottle unless you decide to pump exclusively; Baby might prefer the flow of the bottle and then refuse to breastfeed afterward.


Under Active Let Down Breastfeeding


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


Slow Let Down Reflex

Sometimes your baby might become frustrated because the milk is not being pushed out fast enough!

This will cause Baby to fuss and Mom to stress, and stressing actually slows down milk flow even further.



What causes a Slow Milk Letdown?

* Low milk supply.

* Stress and PPD.

* Excessive alcohol intake during breastfeeding.

* Smoking while breastfeeding.

* Certain medications.


How to Increase Milk Ejection Reflex (get milk flowing faster)

* Breast compressions.

* Certain herbs like fennel may help increase milk flow.

* Relax while breastfeeding.

* Look at a picture of Baby (if pumping), touch your baby’s hair and sing a song to Baby. The hormone Oxytocin is released during affectionate feelings and this will stimulate milk flow.

* Pump for a few minutes before breastfeeding to get your milk flowing.


Example of an Overactive Let Down Reflex



Other pages on “breastfeeding problems” in connection with breastfeeding let down reflex

- Hindmilk formilk imbalance

- Oversupply (too much milk)

- Food sensitivities in a breastfed baby

- Overfeeding a breastfed infant

- Storing breast milk safely

- Nipple confusion

- Exclusive pumping

- Leaking breasts

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Site by BFeeding Mamma, Tracy Behr. Currently studying through Child birth International (CBC, CBD). Also an accomplished author and Mommy of two.

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