What Triggers the Letdown Response in Breastfeeding

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Knowing what is let down is crucial for both breastfeeding and pumping mothers. In this article, I discussed all things related to let down so that you have better understanding about how your milk flows when you breastfeed or pump.

What is let down reflex?

Let down reflex, also known as milk ejection reflex, is a natural process that triggers breast to release breast milk. It typically happens at the beginning of breastfeeding. As your baby sucks, tiny nerves at breast are stimulated and send signal to brain to release two hormones.

The first hormone is prolactin, which is responsible in ramping up milk production. The second one is oxytocin, which allows breasts to release breast milk from the nipple.

How do you know if your milk has let down?

There are various signs of let down reflex that may occur and these may differ from one mom to another. Among them are:

• Tingling sensation, which feels like needle pricking sensation.
• The breasts suddenly feel full.
• You may also feel cramping in your uterus.
• If you breastfeed, you may notice the change in your baby's sucking pattern. He will have a stronger and slower sucking rhythm.
• You may notice your baby gulping sound, indicating that he receives the breast milk.
• The breast milk may drip or leak on the side of breast not used for nursing.
• When you pump, you will see that your milk starts spraying instead of slow drip.

Having said these, it is also entirely normal if a mom does not leak or feel the tingling/cramp/fuller sensation. Some moms can only know it from seeing the baby's gulping or watching the milk sprays (when pumping).

Do both breast let down at the same time?

Yes, both breast let down at the same time. A lot of moms use this opportunity to collect breast milk leakage on one side while the baby nurses on the other side. You can use a silicon pump like Haakaa to do this so that you can slowly build your breast milk stash.

This is also why it is recommended to use a double breast pump if you pump regularly. It saves a lot of time by triggering let down and collect milk from both breasts at the same time.

How long does it takes to get let down?

When it comes to how long to get let down, different moms may have different experience, but normally around two minutes of suckling/pumping. That's also why some breast pump brands  start in let down mode and automatically switch to expression mode after two minutes.

Some moms experience faster let down, around 1 minute mark and some have it later. As a general rule, the first let down is typically faster to get compared to the subsequent let downs.

How long does a let down last?

The duration of let down varies from mom to mom, around 5-10 minutes. Once the let down is over, milk flow slows down to drip or nothing. When this happen during nursing, the baby will automatically change the sucking pattern to initiate let down again so the milk will flow again. The cycle continues until the feeding finishes.

Typically you may get multiple let-downs per feeding session. The frequency varies from one person to another, from two to four let downs.

SEE ALSO: 10 Proven Tips To Pump Breast Milk Faster

Things inhibiting let down

Let down is triggered by hormonal process. There are several things that may inhibit the hormone release and thus hindering mother to experience let down. Among them are:

• Feeling of pain (including the feeling of pain due to sore nipple or pumping problem)
• Stress and anxiety
• Cold
• Excessive caffeine usage
• Certain medication

In some condition, the negative feeling trigger the release of adrenaline which inhibit oxytocin to work properly. As a result, your let down is being slowed down or repressed. This is why it is very important to stay calm and relax during feeding, as it may affect your milk flow.

How can I improve my let down?

When we are talking about improving let down, it may means to get let down faster. Alternatively, it may also be related to get a better milk flow.

In this case, you may focus on relaxing your mind or thinking about your baby by engaging your five senses.

For example:

• Looking at your baby pictures, listening to baby's babble, or smelling your baby's cloth helps you to think about your baby, triggering happiness feeling to stimulate let down.
• Warmth (whether in form of warm drink, shower or warm compress) and breast massage not only encourage faster let down but also better milk flow. You may use a handy tool like LaVie warming massager that allows combination of warmth and vibration to further aid your let down.
• Relax. Sometimes you focus too much on pumping and the amount of milk in the bottle so that you become anxious. In this case, distract yourself and relax. You may watch short video clips, listening to music, browsing your social media feed, or do anything that lets you forget about pumping and enjoy yourself.
• Conditioned cue. You may train your body by doing one specific thing before you start nursing / pumping, such as sipping a hot chocolate. Soon, your body will recognize it as a beginning of your feeding pattern and this will trigger the next step in feeding process, which is let down.

I discussed more detailed about this in my article about how to stimulate let down reflex while pumping. Some of the tips mentioned there are not only applicable while you pump, but also when you are latching directly.

Overactive Let Down

Now, let's talk about the opposite side. While there are mothers struggling to get let down, there are also mothers struggling with overactive let down.

Overactive let down is a condition whereby a mom is having a forceful let down, which is characterized by so much milk spraying out from the breast (even too fast such that it causes the baby to choke) and painful feeling experienced by the mom during let down.

The baby may exhibit colicky symptoms due to swallowing too much air. In extreme cases, the baby may have poor weight gain due to foremilk-hindmilk imbalance.

In this case, the mother is encouraged to express some milk first before nursing the baby. By doing this, the milk flow is more manageable and the fatty content increases to support healthy weight gain. You can click here to learn more about overactive let down and oversupply.

In Summary

It is crucial for breastfeeding mothers to understand the concept of let down during breastfeeding or pumping. Without knowing this, moms can be easily dejected when they see no milk coming out from the breast (which is actually because the let down has not occurred).

Understanding let down will also helps mother to do more effective pumping, switching back and forth between let down and expression mode to trigger better milk flow.

I hope this article helps you understand the concept of let down during breastfeeding and pumping. For more breastfeeding tips, do visit my blog post series here.

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Source: https://livingwithlowmilksupply.com/what-is-let-down-reflex

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