The Let Down Reflex

The let down reflex is when the nerves in your breasts send out signals that releases the milk in the milk ducts when the baby begins to nurse.It is normal for let-down not to feel as strong as your baby gets older. Some mothers never feel let-down, and some stop feeling the let-down sensation as time goes by. This does not necessarily indicate that let-down is not taking place (1a).

Reliable signs of a healthy, functioning let-down include: (1b)

  • In the first week or so, mother may notice uterine cramping during letdown.
  • Baby changes his sucking pattern from short and choppy (like a pacifier suck) at the beginning of the feeding to more long, drawing, and rhythmic a minute or so into the feeding.
  • Mother may have a feeling of calm, relaxation, sleepiness or drowsiness.
  • Mother may have a strong sensation of thirst while breastfeeding.
  • Baby is swallowing more often. A swallow sounds like a small puff of air coming out the baby’s nose and you can usually see the muscle moving in front of the baby’s ear, giving the baby the appearance of his earlobes subtly wiggling.

Occasionally, mothers will also experience other symptoms during let-down, including itching, nausea, headaches, or negative emotions. It’s quite normal for a mother to have a harder time letting down when pumping than when nursing. The milk may be there, but you may have a hard time letting down and “releasing” the milk. Some mothers also have a let-down which is not functioning properly when baby is nursing. (2a)

Many things can be the cause of a slow or inhibited let-down: anxiety, pain, embarrassment, stress, cold, excessive caffeine use, smoking, use of alcohol, or the use of some medications. Mothers who have had breast surgery may have nerve damage that can interfere with let-down. In extreme situations of stress or crisis, the release of extra adrenaline in the mother’s system (the “fight or flight” response) can reduce or block the hormones which affect let-down (2b).

Sometimes a cycle is created, where baby fusses and pulls off because the let-down is slow, which makes mom tense up, which makes the let-down even slower, etc. You can use relaxation techniques and let-down cues to break this cycle (2c).




Cluster Feeding Babies

Breastfeeding Question: What Is Cluster Feeding?

Cluster feedings are apparent when a baby has periods where he constantly breastfeeds for about three hours or so. Sometimes baby might fall asleep on the breast, refusing to let go and wanting to nurse more when waking. These babies are usually cranky and fussy and extremely demanding. Cluster nursing usually happens in the evenings, but can happen any time during the day or at the middle of the night. Cluster breastfeeding is very common in newborn babies. Cluster feeding at night can become very tedious, mom and baby will usually end up sleeping in the same bed. During the day, the baby might breastfeed a few times and sleep in-between, in the evenings they catch up with a period of constant feeding.

Cluster feedings do not mean that the mother has a low milk supply. Supplementing baby with formula will cause the body to produce less milk, continuing with the cluster feeding will make sure the body is making just the right amount of breast milk for baby.

hungry baby, grey eyed baby,Newborn cluster feeding is a temporary thing and learning to work around it and accept it will help you enjoy your breastfeeding experience more. Infant cluster feeding can actually work to the advantage for moms who are returning to work, as babies who cluster feed usually sleep longer at night. Moms can also use this time as a time to relax and bond with baby.

Possible causes for cluster feedings are growth spurts, acid reflux, breast milk supply is generally lower in the evenings and evening feeds are not as rich as morning breast milk, baby having extra sucking needs in the evening, colic, slower milk flow in evenings, or baby wanting more attention in the evening.

Some tips for mothers whose babies are cluster feeding are taking the baby to the pediatrician to make sure that the problem is not caused through acid reflux. Prepare for a cluster feed if you know the baby usually cluster feeds at a certain time of the day. Get baby to breastfeed while in a sling , this will be helpful in doing whatever you want to do while baby is breastfeeding. This also helps if baby is fussy. Try doing something while baby is breastfeeding like reading your favorite magazine, watching a movie or chatting on the phone. And finally, try feeding the baby on demand, not on a schedule.

Read More:

How Long Does it Take to Nurse?
When Is It Time To Stop A Breastfeeding Session?

Is It Okay To Let My Baby Breastfeed For Comfort?
Common Misconceptions about Breast Milk Supply
More On Cluster Feeding

Tandem Breastfeeding

Breastfeeding more than one child at a time can be quite a challenge.  On one hand it is a great way to keep older child connected with their mother and also introduce them to the concept of sharing.

Tandem does not necessarily mean simultaneously nursing more than one child.  Usually it refers to nursing the new born baby first and then the older child.  It may also mean sequential nursing of children from a multiple birth experience.

What is the let-down in Breastfeeding?

The let-down reflex

How your body responds to your baby’s suckling:
Infant suckling stimulates the nerve endings in the nipple and areola, which signal the pituitary gland in the brain to release two hormones, prolactin and oxytocin.
How Your Breast Responds to Your Baby’s Suckling:

Prolactin causes your alveoli to take nutrients (proteins, sugars) from your blood supply and turn them into breast milk.
Oxytocin causes the cells around the alveoli to contract and eject your milk down the milk ducts. This passing of the milk down the ducts is called the “let-down” (milk ejection) reflex.
Let-down is experienced in numerous ways including:
Your infant begins to actively suck and swallow.
Milk may drip from the opposite breast.
You may feel a tingling or a full sensation (after the first week of nursing) in your breasts or uterine cramping.
You may feel thirsty.
NOTE: There may be many let-downs during a feeding, of which you may or may not notice. Because the brain plays such a large role in the release of hormones that cause the milk to eject, it is very normal for let-downs to occur in other situations as well. For example, let-down may occur when you think about your baby, hear your or another baby cry, when it is your scheduled nursing time, when you are sexually stimulated or during orgasm.

If the let-down occurs at an awkward time, cross your arms over your chest, or press the heel of your hand over the nipple area and apply pressure until the leaking stops. It may also help to wear cotton breast pads (without plastic liners) in your bra to protect your clothing, especially during the first weeks. This type of response will usually lessen after the first few weeks of nursing.

The Flipple

Breastfeeding Technique: The Flipple

This breastfeeding technique for getting your nipple into your baby’s mouth is called The Flipple.  It is based on rolling the underside of your breast, but with a twist.  As your baby opens its mouth wide press on your breast just above your your nipple with a finger running parallel to your baby’s upper lip.   This will point your nipple up and away from your baby.

Continue pressing your finger onto your breast to first roll the underside of your breast into your child’s open mouth. Once the breast is in use the same finger to push the nipple into your baby’s mouth before removing your finger.  This will your baby gets a large amount of the underside of the breast and gets the nipple into your child’s mouth.

The Flipple is useful when you may not have a good view of the underside of your breast, but can be useful in any breastfeeding position.

Read About Breastfeeding Supplies:

Five Essential Breastfeeding Items
Breastfeeding Fashion

Read More About Proper Breastfeeding Positions:

Cradle Hold
Breastfeeding While lying Down

Failure of Lactogenesis

While some woman suffer from engorgement other new mothers find themselves at the other end of the spectrum wondering if their milk came in.  Occasionally, lactogenesis, the onset of milk production that usually occurs two to five days after childbirth is delayed in women who experience complication in labor and delivery.  Conditions that can affect lactogenesis are high blood pressure, infection, anemia, or extreme emotional turmoil.

If by the fourth day after your child is born you have concerns about lactogenesis be sure to have your baby checked for signs of weight loss and their absorbing adequate nutrition.  Some things you can do is to use a breast pump after each nursing to continue stimulating your breasts to produce milk.  It may be that hospital grade breast pumps are needed to provide the necessary stimulation.

In very rare occasions a mother’s body cannot produce sufficient quantity of milk for her child.  If you feel you fall into this category please contact your physician or lactation consultant for the best steps going forward to preserve your child’s nutrition.

Breastfeeding on Demand

You may find yourself on the receiving end of comments that confuse your attentiveness of your baby’s hunger with spoiling them.

Your baby has a genuine need for frequent routine feedings.  This is due to their initially having a very small stomach and secondarily that breast milk is very easily digested compared to other foods and formulas.

By feeding your baby when they demonstrate they are hungry you are teaching them that you are listening to their needs and are taking care of them.  This will result in a confident and trusting child.

Galactosemia and Breastfeeding

Breastfeeding Contradiction: Galactosemia

Galactosemia is a breastfeeding contradiction. Galactosemia is a rare word to come across in breastfeeding terminology. Babies suffering from galactosemia are unable to process galactose. Galactose is a simple sugars formed as a byproduct of digestion of breast milk and formula.

Galactosemia is a rare inherited disorder that affects about 1 in 60,000 newborns. Galactosemia is a recessive genetic trait and can be carried by one or both of the parents without either of them showing symptoms. If your family or your partner’s family have a history of galactosemia be sure to let your doctor know immediately.

Galactosemia is only detectable through a routine newborn screening check-up. What happens is that galactose begins to build up to dangerous levels and will eventually damage the liver, central nervous system, eyes, and kidneys. If your child is diagnosed then your pediatrician will prescribe a special diet for your newborn to provide proper nutrition.

Even with a positive diagnosis for galactosemia you child will still thrive and grow like any other youngster.

Read More About Common Concerns Breastfeeding:

Warning Signs While Breastfeeding
How Can I Tell My Baby Has Properly Latched?
Is My Baby Getting Enough Breast Milk?
What Should A Newborn’s Diapers Look Like?

Montgomery’s Tubercles

Breastfeeding Question: What Are Montgomery’s Tubercles

First things first! Before we get to the matter of “What are Montgomery’s tubercles?” Where did that awful name come from? Montgomery’s tubercles are named after Dr. William Montgomery an Irish obstetrician who described them in a scientific journal in 1837.

Montgomery’s tubercles are bumps near your nipples on your areola.  The exact number of Montgomery’s tubercles varies from person to person but is in the range of 4-28 per nipple. A breastfeeding FAQ is what role do Montgomery’s tubercles play during breastfeeding?

Montgomery’s tubercles are the external part of glands that make oily secretions to keep the areola and the nipple lubricated and protected. Only the portion of the gland on skin’s surface is called Montgomery’s tubercles in breastfeeding terminology. Montgomery’s tubercles become much more pronounced and raised when the nipple is stimulated. The skin over the surface openings are lubricated and tend to be smoother than the rest of the areola. During pregnancy the Montgomery’s tubercles become increasingly visible on the nipple and areola.

Read More:
Breasts and Breastfeeding:

Breastfeeding with Small Breasts
Breastfeeding and Small Breast Milk Storage Capacity
Breastfeeding and Large Breast Milk Storage Capacity
Breast Surgery and Breastfeeding
Breast Reduction and Breastfeeding
Breast Implants and Breastfeeding

Breastfeeding Myths:

Truth Behind a Few Breastfeeding Myths
Nipple Preparation During Pregnancy
Breastfeeding While Pregnant

What is Amenorrhea?

After your child is born and while you are breastfeeding you may experience a time without your period. The technical term for a time without menstruation is amenorrhea. If you are experiencing amenorrhea it is important to understand the reason why. There are many different reasons for amenorrhea; malnutrition, low body fat, extreme exercise, and a host of less pleasant reasons that you will need to consult your doctor about.

Lactational amenorrhea is when women do not Many women have no menses while breastfeeding. Lactational amenorrhea typically lasts for the first six months of breastfeeding when you are their child’s sole source of nutrition. One of the breastfeeding benefits to the mother is that breastfeeding helps birth spacing. As long as you are exclusively breastfeeding due to lactational amenorrhea you are less likely to become pregnant. Although not a completely effective form of birth control it can be 98-99% naturally effective. Keep in mind especially with your first child you will need to pay attention to your body to see how it is reacting. It is possible to get pregnant while breastfeeding. If you are trying to avoid pregnancy I would use a back up birth control as well.