Let Down Reflex (Milk Ejection Reflex) – Causes and Symptoms


The process of breastfeeding is rather complex, everything from the proximity to your baby to hormonal changes facilitating breast milk production and release, factor in for successful breastfeeding. In this article, we will look closely at the letdown reflex and the various factors that influence it.

What is Let Down Reflex?

Let down reflex is the process by which a mother’s body releases milk for a hungry baby. When a baby sucks at her mother’s breast, sensitive nerves of the nipple are triggered to release hormones into the bloodstream. Two such hormones, prolactin and oxytocin are directly responsible to assist with breastfeeding. Prolactin triggers the production of milk in the breast while oxytocin causes the breast to let down or allow the milk to flow. Oxytocin not only pushes the milk out by contracting the cells around the alveoli but also widens the milk ducts to allow the milk to flow more easily. This process makes the breast milk available for the baby to feed.

Let down reflex while breastfeeding allows the baby to feed as he sucks on the mother’s nipples and plays a vital role in the nourishment of the child.

How Does Let Down Reflex Feel?

During let down reflex, you may feel a few sensations going on in your body. Here are some things that you may feel at this time.

  • A tingling feeling in the breasts.
  • Cramps in the uterus mostly in the first few days post delivery.
  • A feeling of fullness in the breasts.
  • Milk dripping from the breast.
  • The baby’s feeding action changing from sucking to swallowing.

What is an Overactive Letdown?

An overactive or forceful let down is when the milk from a mother’s breast is flowing too quickly and in larger quantities. An overactive let down usually is the result of an oversupply of milk or the fact that the mother’s body has not adjusted to the babies feeding needs and pattern.

Causes of a Forceful Let Down

A forceful letdown may occur due to the following reasons.

  • An oversupply of milk.
  • A sudden increase in the baby’s feeding requirements.
  • Excessive milk production on account of a temporary increase in the baby’s feeding pattern. If a baby starts feeding too often, the breast will get full quicker.

Symptoms of Overactive Letdown and Reflex

Most symptoms of an overactive let down can be identified by observing the feeding baby. If a baby is pulling away from the breasts or is gagging and coughing this could indicate an overactive letdown. If a baby is making clicking sounds while feeding or is refusing to be breastfed this could also indicate an overactive letdown.


Is Overactive Let Down Painful?

An overactive let down can have different effects on women; some women complain of an intense pins-and-needle feeling, some complain of intense pain while some mothers barely notice it. By and large, an overactive let down can fill the breasts with excessive milk and they can feel swollen causing pain.

How to Deal with Overactive Letdown?

Here are a few ways you could control or deal with an overactive letdown.

  1. Increase the frequency of breastfeeding, you should be breastfeeding the baby every two and a half to three-hour intervals.
  2. Allow sufficient time for the baby to feed on each breast.
  3. Offer only one breast to the baby per feeding.
  4. Feeding the baby in a laid back position should make it easier.
  5. Squeeze the areola, this will allow the baby to feed at a controlled rate.
  6. Expressing some milk before breastfeeding should slow the rate of flow while breastfeeding.
  7. Massaging the breasts before feeding should also prove useful.

What is a Slow Letdown?

The opposite of an overactive let down is a slow letdown. A slow letdown can cause difficulties with the flow of the milk; the milk will flow slowly and may even be painful. A slow let down can also affect a baby adversely; it is difficult for a hungry baby to cope with slow letdown when he wants to feed. A baby may often get frustrated cry more often on account of hunger or bite on the breast to try and get more milk.

Causes of a Slow Let Down

The primary causes of slow let down identified so far are

Let Down Reflex Pain

Let down reflex can cause pain and discomfort particularly in the first two weeks after childbirth. Shooting pain in the breasts and painful contractions of the uterine muscles may be experienced. Let down reflex may also result in cracked nipples and cause the breasts to become hard and swollen. Such painful experiences may interfere with the breastfeeding and necessary bonding sessions between mother and child. In case of severe complications, expert help and medical advice should be sought.


Dealing with Slow Let Down

Here are some ways you can deal with a slow letdown.

  1. Anxiety and stress can further complicate slow let down, it is crucial that the mother maintains a relaxed composure before and during breastfeeding.
  2. Breast compressions can be useful in assisting the flow of milk.
  3. Touching the baby lovingly or expressing affection can aid in the release of oxytocin which will assist with the flow of milk.
  4. Pumping before breastfeeding should also prove helpful.
  5. The intake of certain herbs like fennel can also be helpful with milk let-down reflex.

Let down reflex is crucial for breastfeeding, but as seen above there may be complications in some instances. The two most common complications are one an overactive letdown and two a slow let down. For the most part, both these complications can be remedied, it is important for the mother to maintain her composure and relax. In case of severe complications, medical assistance and expert consultation should fix the problem. Breastfeeding is essential for the bonding between a mother and her baby, it is a natural process and difficulties faced on the onset may sort out on their own.

Also Read: Common Neonatal Reflexes