Updated February 23, 2015.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
What is Let-Down?
Let-down, also referred to as milk-ejection, is a reflex or natural involuntary reaction that occurs when your baby breastfeeds. The action of the infant suckling at your breast sends a message to your brain to release the hormones prolactin and oxytocin. While prolactin is responsible for making more breast milk, it's the oxytocin that lets your milk leave the milk ducts. This release of milk is the let-down reflex.
Let-down is the key to successful breastfeeding: it allows your milk supply to flow out of your breasts to your baby. Without a good let-down, your baby will only receive a small amount of foremilk, so he may not grow at a healthy pace — or he may become frustrated and refuse to breastfeed.
How Can You Tell if Your Milk is Letting Down
- You feel tingling, pins and needles, or a burning sensation in your breasts while your baby is breastfeeding.
- The breast that the baby is not nursing on is leaking or spraying milk.
- You can hear your baby gulping and swallowing.
- There is milk dripping out of your baby's mouth.
- You feel menstrual-type cramping in your uterus, especially in the early weeks following delivery.
- Your baby is gaining weight, having at least 6 to 8 wet diapers a day, and appears content after feedings.
You may also notice let-down at times other than when the baby is at the breast. It can come on quickly and unexpectedly when you hear your baby cry, when it's getting close to feeding time, when you take a warm shower, or during sexual activity.
What Does Let-Down Feel Like?
Let-down occurs many times during a feeding. The first release is usually the only one that is noticeable. It may feel like pins and needles, tingling, burning, or pressure, and it could be a little uncomfortable or even mildly painful. Some women feel the sensations very strongly, while others do not feel anything at all.
The hormone oxytocin is associated with love and bonding. It is released during childbirth, when you nurse your baby, and during sex. This hormone can bring about feelings of peace, calmness and relaxation. When let-down occurs, the oxytocin causes contractions in the uterus, so you may feel cramping: a good sign that breastfeeding is going well. Other effects of oxytocin that you may feel when you are nursing could include sleepiness, thirst, headache, nausea and vomiting, hot flashes, and night sweats.
If you do not feel any of these sensations, it doesn't necessarily mean that something is wrong. As long as you can see the signs that your baby is getting enough milk and growing well, you do not need to be concerned. But if you do not feel let-down, or you have stopped feeling it and you do not see any of the signs listed above, it could indicate that your milk supply is low.
Problems With Let-Down
The let-down reflex does not always work perfectly. It can be slow, difficult, painful or hyperactive. Problems with let-down can lead to feeding issues. It can also cause a decrease in your milk supply, because if only a small amount of milk is removed from your breasts at each feeding, your milk production will decline.
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Slow or Difficult Let-DownPainful Let-Down
Hyperactive Let-Down
Pumping and Let-Down