What to Know About Breastfeeding and the Letdown Reflex
If you're breastfeeding, the letdown reflex can feel tingly and warm. For some, it can feel uncomfortable. Learn the signs and how to manage this milk-ejection reflex.Medically reviewed by Katie Drakeford, MA, RD, CSP, LD, CLCMedically reviewed by Katie Drakeford, MA, RD, CSP, LD, CLCThe breastfeeding letdown reflex, which is also called the milk-ejection reflex or the oxytocin reflex, is an automatic natural reaction that happens in your body as your baby breastfeeds. When your baby successfully latches onto your breast and begins to suck, nerves are activated that send a message to your brain to release the hormones associated with pregnancy and postpartumprolactin and oxytocin. These hormones cause milk to be produced and released, triggering the letdown reflex.This one of the many hormonal changes that comes with pregnancy and lactation. In this case, prolactin is responsible for making more breast milk, and oxytocin causes the letdown or release of your breast milk. Learn more about the signs of letdown, how it feels, tips for stimulating the flow of breast milk, and how to deal with a slow or painful letdown.
Parents / Alison Czinkota
Signs of the Letdown ReflexWhen you're breastfeeding, the sensations are very strong for some, while others don't feel anything at all.Tingling: You may feel pins and needles, or a warm sensation in your breasts.Leaking: You may see breast milk leaking or spraying out of the breast that your baby is not breastfeeding on.Pressure: You may feel a heaviness or pressure in your breasts.Burning: Some people feel a heat or warmth in their breasts during letdown.Gulping: You may hear your baby gulping and swallowing milk.Dripping: You may see breast milk dripping out of your baby's mouth.Cramping: You may feel menstrual-like cramping in your uterus, especially in the early weeks following childbirth.Gaining: Your baby is gaining weight, has at least six to eight wet diapers a day and appears content after breastfeeding.You may also notice the signs of milk letdown when you are not breastfeeding or pumping. Letdown can come on quickly and unexpectedly at feeding time, when you hear your child cry, during a warm shower, or during sexual activity.Tips To Stimulate LetdownWhen the letdown reflex is working well, your baby can get enough breast milk to feel satisfied, gain weight, and grow at a healthy pace. The following are some tips to help encourage and stimulate the breast milk letdown reflex:Take a warm shower or apply a moist, warm towel to your breasts before you breastfeed.Massage your breasts gently for a few minutes before you begin feeding and continue as you nurse.Sit or lie down and get comfortable in a quiet area away from distractions.Relax your body and your mind, so you are feeling calm and free of stress.Take Tylenol (acetaminophen) or Motrin (ibuprofen) about 30 minutes to an hour before feeding time, if you are still in pain from childbirth.Place your baby on your chest in direct skin-to-skin contact.Look at, touch, and smell your baby.Keep the same routine before each feeding session; milk letdown is a reflex that you can condition or teach your body to do at a specific time.Be consistent so your body can recognize the signals that mean you are getting ready to breastfeed.Not Feeling Milk LetdownIf you do not feel your milk letting down, it doesn't necessarily mean that something is wrong. You may never notice it or you may feel it in the first few weeks then less over time. As long as you can see the signs your baby is getting enough breast milk and growing well, you don't have to worry.Of course, if you don't feel your milk letting down or you have stopped feeling it, and you do not see any of the signs listed above, it could indicate that your supply of breast milk is low.In that case, you should contact your health care provider or a lactation consultant for assistance for maintaining your supply. You should also bring your baby to the pediatrician to be sure they're gaining weight.Oxytocin and LetdownThe hormone oxytocin is associated with love and bonding. Your body releases it during childbirth, when you breastfeed your baby, and during sex. This hormone can bring about feelings of peace, calmness, and relaxation.Oxytocin also causes muscle contractions that help shrink your uterus back down to its normal size after childbirth. It's the reason you may feel uterine cramping as your milk lets down in the early weeks postpartum. These uterine cramps are a good sign that breastfeeding is going well. Other effects of oxytocin that you may experience while you are nursing could include:HeadachesHot flashesNausea and vomitingNight sweatsSleepinessThirstPossible Letdown ProblemsThe breastfeeding letdown reflex does not always work perfectly. It can be slow, difficult, painful, or hyperactive. Difficulties with the letdown reflex can lead to breastfeeding issues.They can also cause a decrease in your breast milk supply because if your child can only remove a small amount of milk from your breasts at each feeding, your production of breast milk will go down.Slow or difficult letdownMany reasons might lead to a delay in the letdown of breast milk.Possible causesAlcohol useCold temperaturesExhaustionEmbarrassmentPainPrevious breast surgerySmokingStressWhen your breast milk is slow to release, it can be frustrating to a hungry child. Your newborn may cry, bite down on your breast, or refuse the breast altogether. Here are some tips to combat a slow or difficult milk letdown:Pump or hand express a little bit of breast milk before each feeding to help stimulate your letdown reflex.Put the baby to your breast once your milk begins to flow.Place a warm compress on your breasts for a few minutes before feeding time.Massage your breasts gently before and during each feeding.Breastfeed or pump in a quiet place away from distractions.Get into a comfortable position. Use a nursing pillow and a breastfeeding footstool, try to relax, take some deep breaths, and concentrate on your baby.Ask your health care provider if you can take a pain reliever such as Tylenol (acetaminophen) or Motrin (ibuprofen) if you're in any pain.Try a nursing supplementer device.Refrain from overdoing it on the coffee and soda. Drink enough fluids to stay hydrated, and eat a balanced diet.Avoid alcohol and don't smoke.Be sure to breastfeed long enough at each feeding, because it may take a few minutes for your milk to let down.Painful Letdown ReflexSometimes the milk-ejection reflex is painful. Hard, swollen breasts, sore nipples, an overabundant breast milk supply, and thrush are common breastfeeding problems that are known to cause pain during letdown. Other pain could be related to uterine contractions which can be intense and very uncomfortable, especially in the first week or so after your baby is born. A painful letdown can make breastfeeding unpleasant and it might also force parents to breastfeed less, which in turn can lead to low breast milk supply, or early weaning. Here's what you can do if you have a painful letdown:Treat sore nipples, breast swelling and engorgement, and clogged milk ducts. Pump or hand express for just a couple of minutes to relieve pain from engorgement. Aim to remove the smallest amount of milk possible to achieve relief. Removing too much milk will have the opposite desired effect and increase milk production.Call your health care provider if you think you have developed thrush or mastitis.Ask your health care provider if you can take a pain reliever such as acetaminophen or ibuprofen.Strong or Hyperactive ReflexA strong or overactive letdown reflex causes too much breast milk to flow quickly out of the breast. You may notice your baby pulling off your breast and gagging. You may also see milk spraying or leaking heavily out of your breast.Parents with a forceful letdown reflex and fast flow of breast milk often have an overabundant milk supply as well.Taking in all that air can lead to gassiness and fussiness. The baby may also gain weight very quickly and show signs of colic. To help slow the flow you can:Express some of your breast milk before you begin to breastfeed.Put your baby to the breast after the first letdown passes and the milk flow slows down.Try the laid-back nursing position. Lie back and place the baby on top of you so that the baby is sucking against gravity. This breastfeeding position may help slow the flow of breast milk and make it easier for your child to breastfeed.Burp your baby during and after each feeding to help bring up any air that he may swallow.Try breastfeeding from only one side each feeding.Take your baby off the breast if your little one begins to choke or gag.Remove some more breast milk with a pump or through a hand expression technique, then try breastfeeding again.Letdown and PumpingMany people pump their breast milk. You may want to pump for an occasional bottle or to build up a stockpile of milk in your freezer. It may be that you have to return to work, or you have a child in the hospital. Whatever the reason, you might find that it is more difficult to stimulate the letdown if you're using a breast pump.How to stimulate the letdown reflex while pumpingWhen you're pumping, some of the things that can interfere with letdown and your breast milk supply are feeling rushed, pumping in an uncomfortable environment, and the stress of having a sick or premature infant. To help you relax and get your breast milk flowing, here are some tips:Go to a quiet, private area to pump.Try to get comfortable and relax.Look at a picture or watch a video of your baby while you pump.Listen to a recording of your baby cooing or crying.Hold and smell a piece of your child's clothing.For moms of preemies or hospitalized children, studies show that spending time engaged in kangaroo care (skin-to-skin contact) with your little one can help you pump more breast milk.Stopping LetdownWhen you're breastfeeding your child or pumping, you want to see the signs of the letdown reflex. But, there may be times when you don't want your milk to let down such as when you're dressed up for a night out or in a meeting at work.You can wear breast pads to protect yourself and your clothes from sudden embarrassing leaks, but you can also try to stop the milk from letting down. If you can, put direct pressure on your nipples. If you are in front of other people and cannot do that discreetly, you can try putting pressure on your breasts by crossing your arms tightly over your chest.Phantom LetdownPhantom letdown is the sensation of the letdown reflex that continues after breastfeeding has ended. People who have breastfed, but are no longer nursing, sometimes feel that familiar tingling in their breasts when they around infants or hear a baby cry. It is usually in both breasts and only lasts for a moment.It may feel like breast milk is about to leak out, but there is no milk in the breast.The phantom sensation of letdown can occur long after weaning, and it's typically nothing to worry over. However, if the production of breast milk has ended and all of a sudden there is fluid coming from the nipple, you should see your health care provider for an exam. For more Parents news, make sure to sign up for our newsletter! Read the original article on Parents.
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