What's a "let-down?"
“I don’t feel my let-down.”
“My let-down is so strong my baby sometimes coughs and sputters.”
“I only feel one let down during each feed – is that a problem?”
“I only feel my let-down while pumping”
Chances are, if you are breastfeeding, you’ve heard about a "let-down" or "let-down reflex," or someone has asked you if you feel yours. This can be especially puzzling and confusing, so in today’s post I’m going to break it down a little… We’ll examine the physiology behind a let down and what it has to do with breastfeeding.
Time to put on our biology hats for a moment. Two key hormones involved in breastfeeding are prolactin and oxytocin, both which come from the pituitary gland. You’ve probably heard of oxytocin before. Many call it the “love hormone” – it’s responsible for that gushy feeling you see something adorable, of think of someone you love. If you gave birth in the United States, you may have received it in a synthetic intravenous form (Pitocin) during labor or postpartum, as it also stimulates uterine contractions.
The stimulation of a suckling baby (or pump) sends a signal to the pituitary to release oxytocin, which is responsible for what is known as the milk-ejection reflex. Tiny little muscles surrounding the microscopic milk-making cells within the breast contract and send milk out of the pores in the nipple. A fascinating aspect of this phenomenon is that it’s an involuntary reflex, but certain things can trigger it or inhibit it. You may have experienced being in line at the grocery store, hearing a stranger’s baby crying, and feeling your milk start to leak out. On the other hand, if you are stressed and rushed in between meetings, trying to squeeze in a pump session, it may be hard for the milk to start flowing.
If you find yourself in the category of having trouble letting down in certain situations, one of my first recommendations is some quality self-care.
Take a few deep breaths
Are you physically comfortable?
Is your body well-supported?
Are you hungry or thirsty?
Is the latch/pump comfortable? Check pump suction and settings!
If you are expressing milk when away from your baby, there are things you can do to help give yourself that surge of oxytocin
Sniff one of baby’s worn t-shirts or a well-loved lovey/blanket
Look at cute pictures or videos of your baby
Read something you find relaxing and enjoyable
Listen to a podcast you enjoy
For some people, distraction works well. For others, sitting quietly for a few minutes of mindfulness is more effective. Experiment to see what is right for you!
If you find yourself staring at your milk collection containers, try throwing a lightweight blanket or sheet over everything to stop focusing on it
Different lactating people describe the let-down differently. Some may feel it more on one side than the other, or on the opposite side than the one they are feeding from. Some may feel it only while pumping. Some may feel many let downs during a feed; some may feel only one. Some may only notice it because of the change of baby’s sucking pattern when the milk begins to flow more freely.
Another common side effect of that oxytocin surge? Thirst! This is why it’s helpful to keep water jugs all over the house near all of your favorite nursing/pumping spots.
For some additional information and resources, check out:
The Womanly Art of Breastfeeding, 8th edition (Wiessinger, West, & Pitman) pp. 23-24
Kellymom’s article on letdown
If you have any concerns about your let-down, or your baby’s reaction to it, please follow up with an IBCLC to discuss and troubleshoot. Click here to learn about my services and book a consult with me.