Everything you need to know about an overactive let-down while breastfeeding
Are you and/or your baby struggling with breastfeeding? You hear your baby choke/gag, pulling away from breast and being extremely fussy while nursing? You may have an overactive let-down. Read this post to learn about the symptoms of an overactive let-down and find easy solutions that will make breastfeeding for you and your baby more enjoyable again.
All information provided in this post is only informational and NOT medical advice. If you have any concerns about your baby’s or your health, contact your medical provider or reach out to a certified lactation consultant in your area for breastfeeding related questions.
With both my children I struggled with an overactive let-down during the first few months after birth. When nursing, milk would come out faster than my babies could handle, causing them to choke and pull off the breast at the beginning of every nursing session.
Not only was it super frustrating for my babies, it was also a huge mess. Milk was getting EVERYWHERE and I was starting to get so frustrated, wondering if it was normal for milk to literally spray out of your breasts. So I started my search for answers and spend HOURS searching for helpful information.
In this post you will find everything you need to know about an overactive let-down and real-life approved solutions, so you don’t have to spend hours googling.
What happens during a let-down ?
The let-down reflex, also sometimes called milk ejection reflex, happens at the beginning of every nursing session. Usually, there are multiple let-downs during a breastfeeding session, but the initial let-down is often the strongest and most noticeable.
When your baby latches onto your breast, nerves in your nipples are stimulated which causes them to send signals to your brain. Your brain then releases hormones, prolactin and oxytocin, which initiate milk production and the release of milk from the milk ducts in your breasts.
The release and pushing out of the breast milk, from the milk ducts, is called the let-down reflex or milk ejection reflex.
Many breastfeeding mothers will feel a tingling sensation in their breast or pressure and mild discomfort at the beginning of a let-down. With both my children I also felt very tired very suddenly during a let-down.
What is an overactive let-down?
Having an overactive or also called strong or fast let-down means that the cells in your breast push out a large amount of breastmilk very quickly creating a very fast milk flow. While some babies do not have any issues with a fast let-down, some infants, especially newborns and very young babies may have difficulty handling the fast milk flow.
Having a fast let-down and excessive leaking can also indicate an oversupply.
How do you know if you have a fast let down?
If your milk is forcefully spraying out of your breast instead of gently flowing or dripping during your let-down, that may be the first sign that you have a strong milk ejection reflex.
Often you will notice excessive leaking from the side you are not currently nursing from.
You may also hear your baby choke and gag at the beginning of a nursing session when you have a strong let-down, since they can’t handle the volume of milk being pushed out.
Some infants will pull away and push off the breast a few minutes after the start of a nursing session. This is another sign that your milk is flowing faster than they can handle.
What can you do to help baby with a fast let-down?
Catch your let-down in a milk collector or burp cloth
What can help your baby drink better is to catch your initial let-down milk in either a milk collector or a burp cloth. If you have a large amount of milk being pushed out, you may want to try and collect the milk in a collector. That way you can add it to breast milk from other pumping sessions and use it for bottle feeding when needed.
If you do not pump or use bottles, you may just use a burp cloth to catch your milk. That is what I did with both my children, since it was easier to handle than trying to collect it. Also both my children HATED the bottle so there was that.
Start nursing your baby as normal. As soon as you feel that let-down coming, gently remove baby from your breast and cover your breast with a collector or burp cloth.
To unlatch your baby, take your pinky finger and gently push it in the corner of baby’s mouth, between their mouth and your breast. This will release the latch. Some babies pull off the breast on their own when the let-down is too strong so you may not even have to do anything to unlatch.
As soon as the milk flow has slowed down, guide baby back to breast and continue feeding.
Your baby may not like this technique very much, since they are hungry and impatient. Fortunately, the initial let-down should be fairly quick so baby can get back to feeding quickly.
Pump before nursing
Another way to help your baby with your strong let-down is to pump or hand express some milk before nursing your little one. You want to pump just enough to get that initial let-down going. After milk flow slows down, stop pumping and start nursing your baby.
I have found it to be easiest to use a manual hand held pump or a Haakaa pump to get that initial let-down going. Especially in the morning, the Haakaa worked great for me, since the little suction the Haakaa provides is all I needed to get the milk flow started.
Later in the evenings when your milk flow is most likely slower and your breasts are less ‘full’ you may need to use a proper milk pump. This totally depends on your body.
If you have never heard of a Haakaa pump, it is a silicone pump you can suction onto your breast to collect breast milk. Some women also use it on one breast while nursing on the other side to catch the let-down and not let it go to waste. For me that did not work since the suction removed too much milk from my breast and I ended up with a massive oversupply (I had a lot of milk already so that pushed it over the edge).
Take a look at my favorite breastfeeding and pumping essentials for more products that will help your breastfeeding journey.
Elevated nursing
Trying different nursing positions can help “slow down” your milk flow and make it easier for your small baby to nurse. Elevated nursing is one thing you can try when dealing with a strong let-down. When nursing your baby make sure their upper body and head are elevated. This can make it easier for them to swallow.
Reclined nursing
Reclined nursing is how I fed my babies for the first few weeks and it made a great difference. If you have a recliner in your nursery, that would be a great way to practice this nursing position. But it also works in a regular arm chair or on your couch.
When breastfeeding your baby you want to lean back, maybe prop a pillow behind your lower back, and recline your upper body. Nursing in this position will make it so your milk has to flow against gravity, slowing down the milk flow. Reclined nursing your newborn works well with the football hold, cradle and cross-cradle position.
It’s also great for c-section moms who are struggling to sit upright comfortably.
Laid-back nursing
Laid-back nursing is similar to reclined nursing. Instead of just reclining your upper body, you lay down on your back completely to make your milk flow against gravity to decrease the milk flow.
While laying down on your back you lay your baby on their tummy on top of you, “tummy to tummy”.
Hang in there, Mama! As your baby grows they will get better at handling the fast milk flow and it won’t be an issue anymore before you know it.
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Refrences:
Australian Breastfeeding Association (2022): The let-down reflex and your milk flow. URL: https://www.breastfeeding.asn.au/resources/let-down-reflex-and-your-milk-flow (last visited: 01/07/2024).
John Hopkins Medicine: Overactive Let-Down. URL: https://www.hopkinsmedicine.org/health/conditions-and-diseases/overactive-letdown (last visited: 01/07/2024).
La Leche League Canada (2022): Oversupply and Forceful Letdown (Milk Ejection Reflex). URL: https://www.lllc.ca/oversupply-and-forceful-letdown (last visited: 01/09/24).
Nationwide Children’s (2021): Overactive Let-Down. URL: https://www.nationwidechildrens.org/conditions/health-library/overactive-let-down (last visited: 01/09/2024).
