Your breast milk is so packed full of vitamins and nutrients that you won’t want to waste a single drop. Let-down — the process which makes milk flow from the breasts during feeding — is ultimately a good and necessary thing because it means your baby is getting the milk they need. It can happen in both breasts, which means the second breast can sometimes be left dripping while you feed. And every drop is worth saving.
What is milk let-down?
When you first begin breastfeeding or pumping, it might take a while before the milk flow begins. This is because the milk let-down reflex, also known as the milk-ejection reflex (MER), needs to occur before milk production properly begins.
When your baby latches to the breast, or once you start using your breast pump, this stimulates the nerves of the nipple, which sends a message to your brain to start releasing the hormones prolactin and oxytocin into the bloodstream.
Prolactin is the hormone responsible for triggering milk production within the body, while oxytocin causes the breast to actually release the milk — this is what’s known as ‘let-down’.
The let-down reflex varies from woman to woman. For some, it might take a matter of seconds, while for others, it might take minutes for let-down to begin. It can happen in both breasts simultaneously, or it might only happen in one breast at a time. Our bodies are all different, so it’s important not to compare yourself to others.
What does milk let-down feel like?
Lactation let-down might feel different for everyone. Some women might feel the let-down reflex quite intensely, while others might not feel anything. Some common sensations include:
A tingling sensation in the nipples.
Fullness in the breast.
Leaking milk flowing from the other breast.
Menstrual-like cramps from your uterus contracting.
A warm or burning sensation in the breasts.
For some women, the initial milk let-down and the sensation of breast milk flowing can feel quite uncomfortable, and may even be painful.
Signs of the milk let-down reflex that you might notice from your baby include:
A change in the baby’s sucking pattern, from short and fast to slower and longer once the milk has let down.
Exaggerated gulping and swallowing.
Overflow of milk from your baby’s mouth.
There’s no set timer for milk let-down. Sometimes milk let-down happens slowly. Other times it can occur much faster and milk flow might be stronger.
In some cases, you might not feel let-down at all. This doesn’t mean that it isn’t happening, or that anything is wrong; it’s simply that the sensations aren’t noticeable. If your baby is showing signs of healthy feeding and nutrition then there’s no need for concern. However, if you’re feeling worried, contact your doctor or a lactation consultant for advice.
Why does my milk let down randomly?
While the sucking sensation on the nipple stimulates milk let-down, it can also occur at other times — sometimes when you aren’t expecting it. It can also kick in a few seconds before you begin to breastfeed, so it’s worth having a cloth to hand to mop up any spills (or using the Elvie Catch to harvest any unexpected drops of milk).
You might experience symptoms of let-down when you hear your — or someone else’s — baby cry. It can also happen if you go for too long without breastfeeding or pumping.
Let-down can also be triggered if you’re experiencing strong emotions like anger, sadness or general stress. Your body may perceive these sensations as a sign to release milk. Once you get into a breastfeeding or pumping routine, these unexpected responses should become less frequent.
How to get milk to let-down
It’s normal to encounter hiccups on your breastfeeding or pumping journey. If you’re having problems with let-down there are ways to encourage it. Most of these techniques focus on relaxation and the mom-to-baby connection. Some tips include:
Trying a warm drink or listening to calming music.
Having a warm shower, or if there’s no time for that, placing a warm flannel on your breast for a few minutes before starting.
Gently massaging your breasts. Stroke your breast towards the nipple with the flat of your hand or the edge of a finger. Gently roll your nipple between your fingers.
Thinking about your baby or holding them close with skin-to-skin contact.
Being consistent with your routine before each feeding session.
Sometimes, pumping can be slower to stimulate the milk ejection reflex than nursing. If you are pumping, try to bring your baby to mind by:
Looking at a picture of them.
Smelling an item of their clothing.
Watching videos or listening to a recording of them.
Problems with the let-down reflex
Breastfeeding and, in particular, the breastfeeding let-down response isn’t always plain sailing. Sometimes you can experience difficulties, like a slow or painful let-down reflex, or even hyperactive let-down.
These issues can be overwhelming and cause frustration, or even lead to other breastfeeding challenges — but whatever the reason for your let-down issue, there are ways to help.
Underactive or slow let-down
Slow let-down, or a delay in the let-down reflex response, can be caused by any number of things including stress, temperature, pain, and alcohol or caffeine consumption.
Try to massage the breast before feeding or pumping to help stimulate let-down. If you can pump or express milk by hand before putting your baby to your breast, it may help to create a smoother transition. Make sure you drink lots of fluids to stay hydrated but try to avoid tea, coffee or alcohol.
Some women experience a hyperactive let-down. This is when the milk let-down reflex is so powerful that it causes an oversupply of milk to flow too quickly out of the breast. When this happens, your baby might start to cough or splutter or pull away from your breast.
A hyperactive let-down can cause your baby to gulp and swallow a lot of air, or your baby might bite down on the nipple to try and stop the flow of milk. This can lead to gas, sore nipples, and general frustration for you and your baby. To help with a hyperactive let-down, try the following:
Keeping a cloth to hand to catch your milk when it first lets down, and putting your baby to the breast after the first let-down eases.
Pumping first to release some breast milk before your baby sucks and latches onto the nipple.
Feeding in a laid-back position to let gravity slow the flow of breast milk.
Milk let-down can be painful for women. This is because milk ducts need to constrict to force milk out of your nipple. Common symptoms include swollen breasts, sore nipples, thrush, and clogged milk ducts.
As your body becomes used to breastfeeding, pain should ease. While these symptoms are common, if pain persists, or if you’re worried, talk to your doctor or a lactation consultant.
Sometimes pain can signal another condition such as mastitis. Mastitis is a breast infection that often requires antibiotics. If you notice intense pain and a fever or flu-like symptoms, seek medical advice from your doctor.
Dysphoric Milk Ejection Reflex (D-MER)
If you find that you’re experiencing an abrupt emotional ‘drop’ just before or during the release of milk, this is known as Dysphoric Milk Ejection Reflex. D-MER can be particularly difficult to deal with (especially if you’re new to breastfeeding) and may include feelings of anxiety, sadness, anger, or hopelessness.
Despite being a condition that affects many breastfeeding women, D-MER wasn’t widely recognized by medical science until recently. Some experts believe that it may be caused by a brief drop in dopamine; a neurotransmitter that plays a role in regulating emotions and motivation.
Symptoms of D-MER include:
Anger or rage
Agitation or irritability
Shame and guilt
In some cases, physical symptoms may also arise, such as tension in the breasts or stomach.
If you’re struggling with D-MER, just remember — it’s not a permanent disorder, and it is treatable. Don’t ever suffer in silence. Speak with a lactation consultant or talk to your doctor — they should be able to provide guidance and support. For more information, visit D-MER.org.
Making the most of let-down milk
Let-down often occurs in both breasts, meaning that your other breast might leak milk while feeding with the other. But don’t let it go to waste.
Breast milk is actually pretty resilient and can be stored well, so you might as well store up any milk that’s produced during your letdown. That means during moments when you don’t have enough time to breastfeed, you can instead use some stored milk that you caught from your other breast.
We made Elvie Catch to help mamas stay leak-free and save their milk. It holds up to 1 oz / 30ml of milk in each cup, so you’ll have no more wasted milk during feeding.
Storing your breast milk
Breast milk can be stored in the refrigerator for up to 8 days, or in the freezer for up to 6 months in a sterilised container or special breast milk storage bags.
In general, the accepted guidelines for storing breast milk are:
In the refrigerator: Up to 8 days at 4°C or lower (you can buy fridge thermometers online) — if you're not sure of the temperature of your fridge, or it is higher than 4°C, use it within 3 days.
In the ice compartment of your fridge: Up to two weeks.
In the freezer: Up to 6 months (if the temperature is -18°C or lower).
For more information, visit our guide on how to store and reheat breast milk.
Don’t waste a single drop
At Elvie, we’re all about the things that make life easier for moms, and being able to catch your letdown and store your excess milk can be a lifeline during early rough patches or just long nights. Make the most of every last drop, mama!