If you are currently breastfeeding, you may have heard of the terms: “let down,” “milk let down,” “milk ejection,” or “milk ejection reflex”. All of these terms refer to the same thing: the milk ejection reflex. Understanding what the milk ejection reflex is and how to effectively trigger it can make a big difference in your breastfeeding journey. In this post, we’ll dive into what the milk let down reflex is, why it’s so important, and share some practical tips to help you trigger it more easily.
What is Milk Let Down?
Milk let down is a vital part of the breastfeeding process. If we imagine having an “on/off” switch for milk to start flowing, the milk let down is the “on” switch for milk release. It begins when the nipple is stretched and pulled during nursing or pumping, stimulating tiny nerves that send a signal to the brain which triggers the release of two hormones into the bloodstream: prolactin and oxytocin. Prolactin is responsible for producing more milk, while oxytocin is responsible for milk let down, which allows milk to flow from the breast.
When oxytocin levels surge, your milk ducts widen, and the tiny muscles around your milk-producing glands contract, pushing the milk out. This is why the technical term for milk let down is milk ejection— as your body is literally pushing milk out through your nipple pores!
Additionally, your milk let down can be stimulated by thinking about your baby or hearing a baby cry. These familiar sensations prompt your brain to release oxytocin, resulting in a milk release.
Signs of Milk Let Down
Some people experience a physical sensation during their milk let down and others don’t feel their let down at all! Both experiences are completely normal and whether or not you feel your milk let down, you should notice a change in your baby’s behavior while nursing or milk output while pumping. Sensations typically used to describe the feeling of a milk let down include:
- No sensation
- Tingly
- Warm
- Pins and needles
- Squeeze and release
- Stinging
- Increase in pressure
- Muscle spasm
- Pinching
If you’re directly nursing your baby, you should notice a change in your baby’s sucking pattern when you have a milk let down. Your baby will begin nursing by sucking in short quick bursts. Once your milk lets down, your baby will switch to long, strong, rhythmic sucking. As your milk lets down while your baby is nursing on one side, you may also notice sensations of a milk let down in your opposite breast which may result in milk flow and “leaking” from that side.
If you are using a breast pump, you'll find a setting labeled "stimulation mode," "let down mode," or "massage mode." This setting provides quick, gentle suction that mimics what your baby would do while nursing directly at the breast. Most people experience their milk let down within the first couple of minutes of pumping. When your milk lets down, you’ll notice an increase in milk flow, often appearing as if your milk is spraying out.
Common Challenges with Milk Let Down
If you’re having trouble triggering a milk let down or feel like it’s taking longer than usual, here are some common reasons why:
- Engorgement makes it difficult to drain fluids from the breast
- Stress hormones interfere with oxytocin release
- Pain
- Feeling uncomfortable, distracted, or overwhelmed
- Pumping: change in nipple diameter requiring a smaller flange size
- Pumping: it may be time to replace your silicone pump parts (valves, membranes, diaphragms, etc)
Techniques to Help with Milk Let Down
Difficulty triggering a milk let down can be very frustrating, but there are several techniques that can help make this process smoother and more efficient. Next we’ll explore these various strategies you can try to enhance your breastfeeding or pumping experience.
Relaxation
If you’re under a lot of stress, one of the most effective ways to help trigger a milk let down is through relaxation. Engaging in deep breathing exercises such as box breathing can help calm your nervous system. Visualizing a peaceful and calming scene, your milk spraying, or even water flowing, can also be incredibly helpful. You could also try listening to relaxing music, meditation, or watching a show you enjoy that can provide a pleasant distraction and help create a more calming environment for releasing milk.
Comfort
To promote muscle relaxation and stimulate milk flow you can try taking a warm shower before nursing or pumping. Some people find it soothing to enjoy a warm drink or apply heat directly to the breast. Additionally, finding a comfortable spot where you feel relaxed and at ease can create an optimal environment for breastfeeding or pumping.
Distraction
Sometimes, focusing too much on your milk let down or milk output can actually hinder the process. Try to distract yourself by not thinking about the milk let down or how much milk you're producing. Talking to a supportive family member or friend can provide a welcome distraction and help you relax. If you're pumping, covering the bottles with your baby's socks can prevent you from constantly monitoring the milk levels, allowing you to focus on other things and facilitate a faster let down.
Focus on your baby
Undressing your baby for more skin-to-skin contact can enhance bonding and stimulate milk flow. Look at your baby, touch them, and take in their scent to strengthen your emotional connection. If you’re pumping, carry an article of your baby’s clothing or a blanket to smell, look at a photo or video of your baby, or visualize your baby getting ready to nurse. These actions can help evoke the natural responses in your body that facilitate milk let down.
Massage
Gently massaging around your breast before nursing or pumping can prepare your body for milk flow. While nursing or pumping, use your hands to gently compress and release your breast, and gently stroke your breast with your hand flat toward the nipple. You can also ask your breastfeeding support person to massage your shoulders, applying pressure between your shoulder blades. These techniques can enhance circulation, promote relaxation, and facilitate a quicker milk let down.
Pumping
Throughout your breastfeeding journey, you may notice your nipples becoming smaller. For those who pump, I strongly advise measuring your nipple diameter every few months after childbirth or whenever you experience changes in comfort, milk let down, or milk output. This helps ensure you're using the correct flange size for optimal pumping efficiency and comfort.
Measuring your nipple diameter:
You should also check the user guide that came with your breast pump to determine how often you should be replacing your silicone parts. As you use your pump and wash and sanitize the pump parts, the silicone pieces stretch and wear out over time which can make the pump less effective. Most people replace their parts every 4-8 weeks depending on how often you use your pump.
Support
If you are experiencing significant stress, reaching out to your healthcare provider or a mental health professional is essential for appropriate management. Your lactation consultant can also be a valuable resource, helping you work through pumping and nursing issues that may be causing stress. They will also create a personalized plan tailored to your needs.
Final Thoughts
Understanding the milk ejection reflex and how to effectively trigger a milk let down can be helpful when learning about your baby’s feeding patterns while breastfeeding as well as what is happening while you’re pumping. It’s important to know there may be things that come up along the way that can inhibit your milk let down, but hopefully you can implement some of the strategies discussed in this article right away to optimize your milk let down and milk output. Don’t hesitate to reach out to your lactation consultant for personalized support and guidance.
This site is intended for informational purposes only and does not provide medical advice. Please consult your physician or other health-care professional.
