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 the flow of milk becomes too forceful or too slow.

Most mothers experience a weird pins-and-needles feeling in their breasts, when let down occurs.  Other mothers say that it is quite painful! There are also those who say they do not 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 days; then your baby should also start drinking more aggressively, which will help to normalize the milk flow.

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

oxytocin, breastfeeding illustration, illustration of breastfeedingThe letdown reflex

Overactive Letdown Breastfeeding

Is your milk flow too fast? 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.

A forceful letdown will most certainly have decreased before the baby turns 6 months, but most of the time it will have decreased by six weeks, when a mother's body has adjusted to the volume of milk needed.

What causes a Forceful Let Down?

Signs of a Forceful Let Down

  • Gagging, coughing and/or choking while breastfeeding.
  • The 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 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.
  • Make sure that your baby is calm before breastfeeding. Read "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 the baby’s mouth.
breastfeeding reclining positionReclined position
  • Keep yourself reclined at an angle with your baby lying on his/her tummy, as shown in the illustration. This uses gravity to your advantage, as milk is not forced down your baby’s throat.
  • Another helpful breastfeeding position: Allow your baby to straddle your leg and sit him/her upright whilst breastfeeding, hold 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 before six weeks, unless you decide to pump exclusively; your 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?

A Slow Let Down Reflex

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

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 Letdown?

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 your baby (if pumping), touch your baby’s hair and sing a song to your 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


- Nipple confusion

- Exclusive pumping

- Leaking breasts

Storing breast milk safely

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What Other Moms Have Said

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No Let Down 
My milk stopped letting down completely and I can only feed him when I'm full or he's half asleep. And even then it takes a little while to start up. …

lactose intolerance 
When my daughter was 1 month old Zi was exclusively breast feeding and she had the green frothy poop. Dr said to supplement to see if that helped …

Wipe that babies face! Not rated yet
It might just be me but I feel bad for that poor baby who was practically choking on the milk. Why was the mother purposely spraying it all over the babies …

Painful letdown Not rated yet
After 7 weeks of having painful letdown at at least half of my son's feedings, I decided to do some research. I waited so long because I thought it …

Signs of Forcefull Let Down Not rated yet
Wow....I mean Wow. I wish every OB Gyn, and Pediatrician had your website, and La Leche Leage...I have been asking questions about my let down, and everyone …

fussiness in baby Not rated yet
Thank you so much. I now realise that my overactive let down is likely a huge part for my 6 week old being so fussy. The tips I have learned on these pages …

she cries and chokes, nose blocking and itchy eyes Not rated yet
I think my baby has these symptoms When I bottle feed her, she's crying and when I make her sleep on her stomach, she cries and chokes, nose blocking …

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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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