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).