The letdown reflex (or milk-ejection reflex) is what makes the milk in your breasts available to your baby.
Tiny nerve endings on your nipple and areola are stimulated by your baby suckling at your breast.
This causes the hormone oxytocin to be released from your brain, which makes muscles around the milk making tissue in your breast to contract.
In turn, this forces milk into your milk ducts and then out tiny openings in your nipple.
How Do You Know If Your Letdown Is Occurring?
Some mothers don’t feel their letdown reflex. They only way they may recognise their letdown is when their baby’s sucking changes from a quick shallow suck at the very start of the feed to a deeper more rhythmical suck when the letdown occurs. They may also notice milk leaking from the breast their baby is not feeding from (as the letdown occurs simultaneously on both breasts).
Other mothers who feel their letdown, may feel:
- A tingling sensation in their breasts
- A sudden feeling of breast fullness
- A slight pain in their breasts
- A sudden feeling of thirst
Some mothers who feel their letdown reflex in the early weeks may feel it less, or not at all, later on.
How To Tell If You Have An Overactive Letdown Reflex
Some mothers have an overactive letdown reflex (or a fast one). Does your baby do any of these things?
- Comes off your breast near the start of a feed gagging or coughing
- Makes big gulping sounds while breastfeeding (particularly at the start of a feed)
- Makes a clicking sounds while breastfeeding (particularly at the start of a feed)
- Spits up milk often
- Is very windy or unsettled
If the above sound familiar to you, you may have an overactive letdown. An overactive letdown commonly occurs with an oversupply. But it can also occur on its own.
Here are 6 tips to help deal with an overactive letdown:
Overactive Letdown Tip #1: Optimise Your Baby’s Attachment
When a baby is attached well to the breast, he is more likely to be better able to control the flow of milk. To help your baby attach well to your breast:
- Hold your baby in close so that his chest is touching yours
- Bring his nose directly opposite your nipple
- As he tips his head back, his top lip will brush over your nipple — this encourages him to open his mouth wide
- When his mouth is open wide, hug him to your breast, aiming for your nipple to be pointing towards the roof of his mouth.
Overactive Letdown Tip #2: It’s Not Real Estate, But Positioning Is Everything
Different breastfeeding positions work best for different mothers and their babies. Trying different positions can help you work out what works best for you and your baby.
Many mothers with an overactive letdown find the following positions helpful:
- A semi-reclined position. In this position, your baby is placed on your chest facing you. A reclining chair could be used or pillows can be placed behind you for support. In this position, your baby’s tongue is able to cup your breast better and this may help him to control a fast flow better.
- Side lying position. Lie down on your side and bring your baby in close with her facing towards your lower-most breast, supporting her with one hand behind her neck and shoulder blades. This position make it easier for your baby to take himself off the breast while the flow is fast and then go back on, and hence be more in control of the flow.
Overactive Letdown Tip #3: Burp Your Baby More Often
If your baby gulps, and comes on and off, during breastfeeds, he may take in more air. Seeing if your baby needs to burp (e.g. by putting him up over our shoulder) after he drinks from each breast (or when he comes off) may help him to digest what he drinks more easily.
Overactive Letdown Tip #4: Breastfeed More Often
Breastfeeding your baby more often helps to decrease the amount of milk your baby drinks at each feed. When there is less milk in a breast, the flow of milk is typically slower. Hence, feeding more often could make breastfeeds easier for your baby.
Overactive Letdown Tip #5: Catch The Fast Flow
If the above strategies don’t help enough, you may find it helpful to wait until your let-down occurs, then take your baby off the breast, while catching the fast flow milk in a towel for example. Then, once the flow slows, you can put your baby back on the breast. Beware – some babies dislike this greatly!
Overactive Letdown Tip #6: Express Off The Fast Flow
Only if the above strategies don’t help enough and your baby seems distressed by the fast flow (for example is refusing to breastfeed), you could try expressing off the fast flow of milk before putting your baby to the breast.
This is a last resort strategy because it stimulates your breasts to make more milk which is something you don’t want particularly if you already have an oversupply.
If you do this, try expressing a bit less milk each time, until you aren’t expressing before breastfeeding any more.
The good news is that many mothers find their overactive let-down reflex subsides at least by around 3 months.