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If you have breastfed you’ve probably heard of a little something called the let down reflex.
A “let down” in breastfeeding is essentially your body releasing hormones that signal to the breasts to push out the milk.
It is important as a nursing mom to be aware of the let down reflex so you know what to expect and also how to deal with different breastfeeding issues.
Here’s what you need to know about let down reflex:
What is let down reflex?
When you are breastfeeding, your body is producing and storing milk in your breast tissues, ready to feed your baby. When there is breast milk let down, the milk basically travels from the tissues to your nipples before it gets to the baby’s mouth (or a pump if you are pumping).
How fast or how slow the milk flows depends on the let down reflex, making it a vital factor in the breastfeeding process.
The milk let down reflex is also known as the milk ejection reflex (MER). This is an automatic response in your body but there are ways that you can encourage and stimulate milk let down.
Let downs are important since they provide your baby with the watery foremilk in the beginning of the feeding and also the thicker and richer hindmilk, which has a higher fat content and calories.
What causes the let down reflex?
When your baby starts sucking on your breasts or when you are using a pump, the hormone called oxytocin (the love hormone as it is sometimes called) gets released from the brain and this causes the let down reflex.
If you are new at breastfeeding, it may take a few minutes until a let down happens but as you continue on breastfeeding, it can happen faster. It is possible to also experience many let downs during a breastfeeding session. Although you usually will only feel the first.
Signs of milk let down
There are many ways or signs that can signal that a let down is happening. You may only experience some of these or you might even experience all of them.
An important thing to take notice of is your baby’s feeding rhythm in order to tell if they are really receiving the milk. Faster sucking helps stimulate the nipples for the let down to start. Once they develop a slower more rhythmic sucking pattern that generally means the milk has come in.
Some of the other signs of let down are:
- You can feel a tingling, achy, pins-and-needles type feeling in your breasts.
- You can see milk leaking or even spraying from the other breast.
- Your breasts feel like they are suddenly full of milk.
- Your baby switches from short quick sucks to long and slow sucks while feeding.
- You can feel cramps in your uterus, kind of like menstrual pains. This is most common in the days immediately following birth and will be felt stronger if this isn’t your first baby.
- You can hear your baby gulp and swallow the milk.
- You can see breast milk dripping from baby’s mouth.
- You feel a warm sensation.
- You feel relaxed and sleepy.
- If you are pumping, you can see the milk flowing into the breast pump.
Even if you aren’t breastfeeding or pumping, you may feel a let down when you hear your baby cry, look at a photo of your baby, are taking a warm shower, or during sexual activity.
There are also some signs that let down is slow or delayed:
- Baby is rapidly sucking but not swallowing.
- Baby gets upset or frustrated after feeding for a few minutes.
- Your baby will beat your breast or pull away.
- You have a tense or stressed feeling.
At the same time, it is also important to recognize the causes of a slow let down reflex in order to address them right away.
Here are some reasons you may be experiencing slow let down:
Sore nipples/breasts –
If you are feeling uncomfortable or tense before feeding due to painful and sore nipples or breasts, you are causing your body to prevent the release of oxytocin, which helps in causing this let down reflex.
In order to treat and prevent sore nipples you can try the following:
- Make sure baby gets a proper latch. Seek help from a lactation consultant to assist you with this if you are having a hard time.
- Expressing milk out using your hand or a breast pump.
- Using nipple cream to treat sore nipples and act like a barrier to protect them.
- Nipple shields can be used while your nipple is still healing.
- If your breasts are feeling engorged, try a warm compress and use your hand to express a bit of milk out to get rid of the discomfort and feel more relaxed to encourage a let down.
If you are feeling anxious or are experiencing stress or emotional issues, this could lead to a hindrance of a let down reflex. By being more happy and relaxed, you can help with a let down.
This is where emotional support from friends, relatives and family is important to help you get through stress and obstacles during this time. You can also talk to other moms, charities, supports groups, and others who are experiencing a similar thing.
If you are taking any medications, it is best to consult your doctor if these are okay to have while breastfeeding and if they will not interfere with a let down.
Health issues –
If you have a hormone or thyroid imbalance, you may need to talk to your physician on how you can address this is and treat it without affecting your let down.
Try to reduce amount of caffeine you are taking in while breastfeeding since this can affect your let down if you are taking excessive amounts.
Breast surgery –
If you have undergone any surgical procedure on your breasts, it could affect your let down reflex so make sure you talk with your surgeon about this.
(I had to have a benign tumor removed from one of my breasts before I had my babies and it hasn’t affected my breastfeeding at all. So don’t give up if you’ve had to have a breast surgery!)
Pumping techniques –
It may take a while to master the pumping technique but you’ll get the hang of it as time goes by. If you are using a breast pump, adjust the settings to mimic a baby sucking on your breast so go from short and fast pumps to long and slow pumps when your milk is already flowing.
Tips to increase or stimulate let down reflex:
Nipple stimulation –
Try to gently pull, stroke, and roll your nipple using your hands in order to stimulate a let down. If you are using a pump on one breast, you can also stimulate your other nipple at the same time to achieve a faster let down.
Think about your baby –
You can look at photos or watch videos to help motivate and inspire a let down reflex. You can also try to smell their clothes or toys that smell like them. You can also physically touch your baby or look at them directly to encourage the release of oxytocin.
Warm beverage –
You can try drinking warm nursing tea in order to promote a let down. A warm drink can also help in getting you to relax and therefore triggering the oxytocin hormone.
Warm compress and massage –
The combination of a breast massage and warm compress (you can also apply a warm towel) will stimulate the milk ducts and not to mention, the warm temperature is relaxing and great for activating a let down. While breastfeeding you can also massage your breasts at the same time.
Do something you enjoy –
Sometimes if you get to watch your favorite show, browse your social media, or read a good book, it can help you to relieve stress and just feel better generally. This will help ease the tension and stress and can help to encourage a let down.
Relaxation techniques –
You can do different things in order to relax. Deep breathing is an effective way of finding your calm and reducing stress. Meditation, yoga, and even prayer are other ways you can practice to help you relax.
Sometimes you can also just find a place where there are no distractions and sit/lay down and get comfortable. It is important to find the balance and calm for both your mind and body.
Warm shower –
This might not be possible to do all the time, but try taking a warm shower before a pumping or feeding session and you can see it will stimulate the let down reflex. You can also take a warm bath in the tub with your baby.
Practicing let down cues –
There are many ways you can let milk down and by practicing a routine before you breastfeed or pump, this can train your body that once these cues are present, a let down will occur. This takes time and practice for your body to get used to so be consistent!
Take a break from pumping –
If after a while you still haven’t achieved a let down, it is better to stop and take a break rather than continue but only get drips. Sometimes a quick restart can help to trigger the let down reflex.
Related: The Right Way To Store Breastmilk
Placing baby skin-to-skin on your chest.
Comfortable position –
You can use tools like a nursing pillow, breastfeeding chair or footstool in order to be at the optimum position and feel the most comfortable while breastfeeding or pumping. This will increase your chances of achieving a let down.
Make sure you are always hydrated and maintain a healthy diet.
On the other end of the spectrum, there are also times when you have an overactive or forceful let down. This is when your let down comes too fast and strong.
This is not good for baby since it can cause gas and baby will struggle to swallow quickly. It may also cause your baby to refuse to eat – which is obviously a big problem!
Although overtime, your baby may learn to adjust to your quick let down,
Here are some signs that you are experiencing a quick let down:
- Your baby gags, coughs, or chokes as you start to feed.
- Baby is fussing and pulling away from the nipple.
- Baby is sometimes refusing to breastfeed.
- Baby is suffering from colic or gas pains.
- Baby could be spitting up frequently.
- Baby clamps down on your nipple.
- Baby has green stools because of the imbalance of foremilk and hindmilk.
- Your milk sprays.
- There’s a lot of leaking.
- You may experience a painful let down.
In order to counter a fast let down reflex, you can do the following:
Laid-Back Breastfeeding –
Try a laid-back breastfeeding position since this will allow baby to gain more control when feeding. Your tummy will be against his/her tummy while the head is over the breast. This will also mean that the milk will have to go in an “upstream” direction which will help to slow down the flow.
After baby stimulates the let down, you can take him/her off the breast and catch the initial flow and letting baby re-latch once the flow starts to slow down.
Burp Often –
Burp baby often so that excess air will be released.
Let your nipple face the roof of your baby’s mouth instead of the throat in order to prevent choking and gagging.
Wait to Introduce Bottles –
Stay away from bottles since your baby might prefer it compared to your breast.
Do blockfeeding, which means you would need to empty out one breast so baby can receive the hindmilk. You would then feed the other breast during the next feeding.
If all these techniques are still not working for you and you can’t have a proper let down, you should always consult your doctor and seek professional help.
Experiencing a let down is a natural process that the body will go through and more often than not, it will come naturally. This is just another process that is part of the beauty of breastfeeding.