The Letdown reflex

This happens when your baby sucks at your breast, nerves are stimulated and hormones are released. The hormone prolactin stimulates milk production and the hormone oxytocin causes your breast to release or “let down” milk. Some women may feel it as a tingling in the breast, a sudden fullness/warmth in the breast. some may feel nothing.

Did you know?

When the let down starts on one breast, it will also start on the other. In the early days having a muslin cloth to catch this, a breast pad or a silicone pump/passive milk collector can be helpful. You will be aware a letdown has happened when you see changes in your babies sucking pattern, as the milk flows there will be long deep sucks and swallowing of milk.

The let-down reflex occurs:

• in response to your baby sucking at the breast.

• hearing, seeing or thinking about your baby.

• using a breast pump, hand expressing or touching your breasts or nipples.

• looking at a picture of your baby.

• hearing your baby (or another baby) cry

• It can be affected by stress, pain and tiredness but once feeding is established, it requires little or no thought.

• the let-down reflex generally occurs 2 or 3 times a feed.

Letdown can be fast

If too much milk flows quickly out of your breast, it can cause pain during the release. Additionally, it can causes issues as your baby will struggle to swallow it all.

Try these tricks to slow down the flow:

• Use your hand to express some milk and catch the first letdown in a cloth before you settle down to breastfeed.

• Work with gravity. Recline or layback and put your baby on your chest to feed. Your milk flow will be slower with your baby sucking against gravity.

• Alternate breasts at each feeding.

Letdown can also be slow.

Some causes include:

• caffeine.

• anxiety.

• History of breast surgery or injury.

• smoking/alcohol.

• pain.

Dysmorphic Milk Ejection Reflex (D-MER)

When breastfeeding triggers emotions of dysphoria, as let down occurs you may be flooded by intense feelings of sadness, dread or anxiety. These feelings happen at letdown and can last for up to 10 minutes after. It is estimated to happen to about 9% of breastfeeding mothers. There is ongoing research into D-MER but it is thought to be caused by the drop in dopamine that happens when the milk is let down.

Some techniques helpful to cope with D-MER include:

• Deep breathing.

• doing skin to skin with your baby in between feeds.

• listening to relaxing music while breastfeeding

Parents report D-MER improves after the early months of breastfeeding, others say it improves when their babies are not exclusively breastfeeding anymore.