What is the let-down reflex?
- When your baby suckles at your breast, tiny nerves in the nipple are triggered. This causes hormones to be released, and the hormone oxytocin causes the breast to push out or “let-down” the milk. Cells around the alveoli contract and squeeze out the milk, pushing it down the ducts towards the nipples.
Signs of a normal let-down reflex:
- Short sucking pattern that changes into a more drawn out sucking pattern
- The mother feels calm, relaxed, tired as the feeding starts.
- Strong thirst sensation (in mother)
- Baby exhibits frequent swallowing: a swallow sounds like a whoosh of air coming from the baby’s nose.
- Some mothers may feel a tingling sensation, fullness of breast, itching, headaches, nausea or sadness with letdown
Why might the milk struggle to let down?
- A slow let-down can happen both when pumping, as well as when nursing
- Possible causes include pain, anxiety, cold, stress, caffeine or alcohol use, exposure to smoke, and the use of some medications.
- Mothers who have had breast surgery may have nerve damage that can interfere with the let-down
- Sometimes a slow let-down creates a cycle of a baby becoming fussy at the breast due to slow let-down, causing the mom to get anxious, resulting in further disruption of the let-down
What can I do?
- Have a common routine that you use when nursing (i.e.: the same chair used, drink a glass of water, same music CD)
- Keep baby undressed to increase skin-to-skin contact
- Massage breasts and use nipple rolls with gentle tugging. Moist heat may help milk begin to move as well
- Look at a picture of your baby or smell a blanket that has been with baby if pumping while away from your infant
- Use relaxation technique s that work for you: deep breathing, eyes closed, quiet music, etc.
- Try singing/humming or listening to soothing music
- Visualize milk draining from your breasts
- Use a heating pad on shoulders and neck to relax your tense muscles
- Breast compression with thumbs or two fingers to help drive milk towards nipple.
- Try switching frequently between breasts until let down occurs
If you have further questions or concerns, please call to speak with someone on our lactation team.