Let Down Reflex

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 happens.

oxytocin, breastfeeding illustration, illustration of breastfeedingThe let-down reflex

Overactive Let-down and 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 let-down will most certainly have reduced before the baby turns six 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 choking while breastfeeding.The baby makes funny clicking sounds while breastfeeding.
  • Baby is continually 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
  • 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 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. 
  • 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 while 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.

cute baby, pretty baby, baby in arms, baby in dads arms

What causes a Slow Milk Let-down?

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

  • Use breast compressions to get the milk flowing.
  • Certain herbs like fennel may help increase milk flow.
  • It is important to 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 tender feelings, and this will stimulate milk flow.
  • Pump for a few minutes before breastfeeding to get your milk flowing.

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