Breastfeeding 101: What is the Let-Down Reflex

Breastfeeding 101: What is the Let-Down Reflex

Breastfeeding can be tricky, and the let-down reflex is there to make things a bit easier for you and your baby. We created a few visuals to help illustrate the process. Scroll below for more insights on how to pump more milk during each breastfeeding session. 

What is the let-down reflex?

The term “let down” means that the milk from your breast is being released. This is a normal reflex that happens when the nerves in your breasts are stimulated, usually when your baby is sucking your nipple. 

When “let down” happens, specific hormones are released into your bloodstream; in particular, prolactin to stimulate milk production and oxytocin (the cuddle hormone), which triggers the breast to let down the milk and makes the milk ducts widen so that it’s easier for the milk to flow. 

What are the signs of let-down?

In terms of timing, there’s really no one-size-fits-all answer. For some nursing moms, let down happens within a few seconds of their baby sucking; for others, it can take several minutes. Since every woman’s body is different, try resisting the urge to compare yourself to other moms. 

If you’re new to nursing, there are a few signs to watch out for…or, ‘feel’ out for. Some moms can feel their milk flowing from their ducts to their nipples, while others do not. Other possible signs include a feeling of fullness of the breast, milk leaking from the other breast or a tingling sensation. 

One thing to consider is that, even if you are nursing from one breast, let down typically happens to both breasts at the same time. Some women also feel their uterus contract during let down, and that is totally normal. 

How can you increase milk supply?

Milk supply is regulated through a series of processes known as lactogenesis, which is the process of secreting milk and involves the maturation of alveolar cells. 

Mammary glands, which are modified sweat glands surrounded by epithelial cells, contract and squeeze to drain milk toward the nipple through ducts called lactiferous ducts. Milk gets ejected through tiny holes all over the nipple called nipple pores. 

The dark, circular areas around the nipple are called areolae and they serve a couple of different functions. They contain small bumps called areola glands (sometimes called Montgomery glands) and they secrete lipoid fluid. Lipoid fluid is an oily fluid that works to moisturize the nipple so that it’s not dry or cracked during breastfeeding. 

The areolae’s dark color also works as a target for the baby, as it gives them a hint of where to go for milk. Remember, a baby’s vision is not the best so soon after birth. Some research shows that the lipoid fluid also has a specific smell that also attracts the baby to its food source. 

Neural pathways are also involved. When a baby suckles on a mom’s breast, receptors in the nipple called mechanoreceptor neurons are activated and send messages up the spinal cord and to the hypothalamus in the brain. 

The hypothalamus then sends ON signals to a set of oxytocin neurons in the posterior pituitary gland telling it to make oxytocin. It also sends an OFF signal to a neuron in the anterior pituitary that releases a prolactin prohibiting neuron, so more prolactin get released to start the process of milk production all over again. In short, this is why emptying the breast of milk really matters to continue to produce more milk!

Let down is hard for me. What can I do?

As best you can, try to relax. Try to get out of your head and into your body. Take slow and deep breaths or even do a short meditation if that resonates. Some moms find that drinking a warm beverage or listening to calm music helps them relax; others take a warm shower before starting to breastfeed. 

Another tactic is to gently massage your breasts. The Lilu Massage Bra aids with that, for times when you are pumping. Breastfeeding recommends stroking your breast toward the nipple with the flat of your hand or edge of a finger. Then roll your nipple between your fingers. 

Lastly, studies show that thinking of your baby or holding a picture of them while you pump, encourages let down. 

If you’re having emotional irregularities, speak to your doctor about Dysphoric Milk Ejection Reflex (D-MER). This is a sudden emotional “drop” that happens in some women right before milk release and can last a couple of minutes. While brief, your emotions can range from happy to self-loathing. 

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