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The Let Down Reflex
When you are lactating, milk is not just constantly flowing out of your breasts. There is a hormonal on and off switch controlled through breast stimulation. A baby or pump on your breast activates these hormones, which activates the let down reflex and tells your breasts to let down the milk. So, having a let down means that your milk has started to flow.
This let down reflex usually happens within about two minutes of your baby nursing or turning on your pump.
What does the milk let down reflex feel like?
Some women feel this let down reflex as tingling or warmth. Other women don’t feel their let down at all. Both are normal. If you don’t feel your let down reflex while breastfeeding, you will still know it’s happening because you will see a change in your baby’s sucking pattern. Babies start off using a quick suck to activate the let down reflex and then switch to a slower, longer suck when the milk flows, and they are drinking. If you are pumping with clear flanges, you will be able to see your milk flowing more quickly or even spraying as it lets down.
Expert Tip
“You may notice your let down reflex is activated if you hear your baby cry or hear any baby cry—like a baby who is a few rows away in the supermarket. To prevent yourself from leaking everywhere, firmly press your palms into your nipples for a few seconds and this should stop the milk flow. You can also cross your arms across your chest to be more discreet about it. In the beginning it is a good idea to wear nursing pads as a backup.”
Michelle P., WIC IBCLC
Multiple Let Downs
It is normal to have more than one let down during a breastfeeding or pumping session. You will likely see milk start to flow quickly within the first two minutes, and then a few minutes later this flow will slow down or stop altogether. If your baby is breastfeeding, they will change their sucking pattern back to a quicker suck to tell your breasts to let down more milk.
Within a few minutes, you should see the baby drinking again, as another let down happens and more milk flows. In a pumping session, you may notice your milk flowing more quickly at first and then slowing down or stopping altogether. If you continue pumping, you will likely see another let down of milk within a few minutes. When there is little or no milk flowing, switching your pump to its faster speed mode, often called stimulation or massage mode, may help you trigger another let down more quickly.
Although your breasts store milk in between feeds, they can also make milk on the spot. This means that your breasts are never truly empty. Therefore, if a baby keeps sucking at the breast, or you continue to pump, you will keep having let downs of milk.
Forceful or Overactive Let Down
If you notice your milk spraying forcefully in a way that is making your baby choke or sputter at the breast, you may have an overactive let down reflex. This may also be called a forceful let down or fast let down. Many mothers with an oversupply of milk notice this fast let down is strongest during the first few minutes of the feeding. Although an overactive let down is most common with oversupply, it is possible to have a normal milk supply and still notice a forceful let down reflex. If you feel that your baby is struggling with a forceful flow of milk, here are some tips to help:
Lean back.
In a laid back position, the baby is positioned on top of the breast, so gravity assists in making the let down less forceful. This allows your baby to manage the fast flow a little more easily.
Take a little milk out of the breast before latching.
You can trigger your let down reflex with your hands or your pump, and then catch the first fast spray of milk with a bottle. Once the milk is not spraying so forcefully, go ahead and latch your baby.
Avoid unnecessary pumping.
If you pump to drain your breasts after every feeding because you still feel full, you are telling your body to make more milk, and making the oversupply and overactive let down worse. It's ok to pump or hand express a little bit of milk out when you are engorged but only until you are comfortable.
How to Trigger the Let Down Reflex if You Are Having Trouble
If you are not seeing your milk flow within about two minutes of beginning to breastfeed or pump, you may be experiencing a delayed let down. While very rare, this can happen if you’re feeling stressed or are having pain with latch or pumping. Here are some tips on how to help your milk let down:
- If you are nursing, make sure your latch is comfortable. If you are pumping, make sure your flanges are fitting you well.
- Try your best to relax. Take some deep breaths and try to notice the tension leaving your body every time you exhale.
- Warming your breasts with heating pads or a warm washcloth before feeding or pumping can help your milk let down.
- If you are pumping at work, sometimes taking a true break from working and relaxing with your eyes closed can help your milk to flow.
- If you are separated from your baby, looking at a picture of her, smelling her clothing or blanket, or watching a video of her might help with your milk letting down.