What is a Let-Down Reflex while Breastfeeding?

The let-down reflex, or the milk ejection reflex, is an automatic chain reaction of hormones that occurs while breastfeeding. Here's how it goes down in the reaction:

Your pituitary gland emits the hormone oxytocin in response to various stimuli, such as when your baby begins suckling your nipple, when you hear, see, or think of your baby, when you touch your breasts, or when hand-expressing or pumping milk.
Oxytocin instructs your alveoli (little grape-shaped sacs in your breast) to contract (tighten).
Your alveoli push your breast milk into your breast ducts (pipes that lead to your nipples).
Milk comes out of your nipple.

"Without oxytocin release, most of your milk remains in your breast," says Dr. Szugye. "As soon as oxytocin begins to move, your breast milk will follow."

How does it feel, the let-down?

The let-down reflex is different for everyone. Some find it painful or tingling, and others feel nothing at all. All of these are totally normal.

"Your let-down will be different from someone else's and that's just fine," assures Dr. Szugye. "It can change over time as your milk supply shifts too."

So, how do you know whether your milk is "letting down"?

Observe your baby while feeding.

"Your baby will begin to swallow more forcefully and strongly," says Dr. Szugye. "You might also find milk drip or even spray from the other breast during nursing."

Breast milk let-down tips

If your let-down is difficult to achieve, no worries. These tips will help make it easier to get your milk going:

1. Try relaxation techniques

Stress is one of the largest causes of a delayed or absent let-down.

"Oxytocin is referred to as 'the love hormone' since your pituitary gland releases it when you're feeling closeness," says Dr. Szugye. "Stress can stop your oxytocin release, so it can be beneficial to look for ways to handle stress."

Sometimes, it's just not easy to forget the thing that's stressing you out. That's also okay. Prior to breastfeeding, you can get your body out of "stress mode" with:

Deep breathing exercises such as pursed lip breathing or diaphragmatic breathing.
Guided imagery strategies.
Music that relaxes you or a podcast you like.

2. Get comfortable

It’s Getting into a breastfeeding rhythm is difficult if you're hunched over on a hard park bench or metal folding chair. If you can, sit in a place with support for your back and arms so you won't be cramped or tense.

"Most nursing people have a go-to breastfeeding position that is comfortable for them and baby," says Dr. Szugye. "A good position feels good to the person being nursed and makes it easy for the baby to reach the breast, so everyone wins. And going into the same position every time can signal your brain to release the let-down reflex."

3. Pay attention to your baby

Now that you're as relaxed and comfortable as possible, focus on your baby. Your oxytocin release and let-down reflex rely upon multiple senses. Use your sight, hearing, smell and touch to coax it along.

"Look at your baby, stroke their back, listen to their coos, and smell their head," suggests Dr. Szugye. Skin-to-skin contact can also help, so try undressing your baby and putting them up to your chest."

What if you're pumping and your baby is not present? You can still use your senses to induce your let-down reflex if you:

Carry something your baby once wore around with you and sniff it before pumping.
Close your eyes and think about your baby being present with you, preparing to nurse.
Gaze at a picture of your baby.
Watch a recording of your baby on your phone.

4. Pump or hand-express for a slow let-down

If your let-down takes a few minutes and your baby can't abide waiting, start ahead with pumping or hand-expressing.

"Sometimes the let-down is slower, and your baby will get frustrated when the milk doesn't come at first," Dr Szugye explains. "This is frustrating for the person who is nursing and the baby. Cut this problem off at the pass by pumping or hand-expressing for a minute or so. Then, take up your baby and begin to nurse. Your let-down may come more readily if your baby is relaxed before he nurses."

5. Resolve any breast or nipple soreness

It's not only stress that prevents the oxytocin release. Pain will prevent your let-down, as well.

"Pain while breastfeeding isn't normal, and you don't have to tough it out," says Dr. Szugye. "If you have sore nipples, put on lanolin ointment after nursing. Breast pain may signal a condition such as mastitis, and needs medical attention. If breastfeeding is painful, call a healthcare provider so they can treat the cause."

6. Massage your breasts

Before nursing, massage your breasts lightly.

"A gentle self-massage can activate your let-down reflex," Dr. Szugye says. "You can also try gently rolling or pulling your nipple with your fingers. Don't use force — this won't hurt."

7. Warm up and get comfy

A feeling of cold can naturally cause your body to tense up. If you're prone to feeling cold while nursing, place a warm blanket over your legs or a neck scarf around you.

"Applying a moist heat pad or warm washcloth to your breasts before nursing may also stimulate your milk to let down," says Dr. Szugye.

D-MER: When the let-down triggers unpleasant feelings

For most individuals, oxytocin brings about feelings of peacefulness and serenity. However, if you experience dysmorphic milk ejection reflex (D-MER), you may have the opposite sensation when your milk is released.

D-MER brings a swift tide of unwelcome emotions such as sadness, anxiety or fear when your body releases oxytocin. Ordinarily, the feelings arise rapidly and pass within one to two minutes. But you might experience them several times during a feeding, since your milk lets down more than once.

"D-MER is a hormonal response that doesn't have anything to do with your attitudes about breastfeeding or your baby," says Dr. Szugye. "But if you experience symptoms of D-MER or a history of pituitary or hormonal disorders, speak with a health professional. They can assist you in receiving the care you require."

You might also be able to fight mild D-MER symptoms and decrease their severity by: