Milk Ejection Reflex (Letdown)

Having milk in your breasts is not enough. The baby needs to be able to get the milk out to breastfeed successfully.

What is letdown?

  • Nipple stimulation causes the muscles around milk-producing cells to contract.
  • This pushes the milk into the milk ducts and the reservoirs underneath the areola. This is called letdown.
  • If the reservoirs are already full and/or a lot of milk is produced and pushed out, milk may drip or even spray from your nipples spontaneously.
  • However, this spontaneous milk ejection is not necessary for breastfeeding. By using her or his jaw and tongue, your baby can drain the milk from the reseroirs (lactiferous sinuses).
  • Letdown may occur several times during a breastfeed.

How does letdown work?

  • Nipple stimulation causes the brain to release the hormone oxytocin, which causes certain muscles to contract.
  • The milk sacks are surrounded by this kind of muscle.
  • When these muscles contract, whatever milk there is in the sacs is pushed out.
  • The hormone prolactin is also released. This hormone causes the breast to produce more milk.
  • Other things can release oxytocin and cause letdown as well:
    • Seeing, hearing, or picking up a baby (especially your baby). Many women will leak milk as a result of this. This shows you how beautifully established your nursing relationship is. As soon as your baby cries or turns her or his head toward your breast and opens her or his mouth, your milk starts flowing for her or him.
    • Sometimes, just thinking about your baby can start a letdown reflex.
    • Sexual arousal. This is why some women leak or squirt milk during sex.

How to promote letdown:

  • Certain things can interfere with letdown.
    • Stress or embarrassment. You might want to nurse in private until your letdown reflex is well-established (usually two or three weeks).
    • Dehydration. Make sure you are drinking and eating well.
    • Excessive amounts of alcohol or caffeine. Alcohol and caffeine also pass into the breastmilk and can harm your baby. It’s a good idea to drink no more than one alcoholic drink and a couple of cups of coffee a day.
    • Nicotine. Smoking harms your baby in more than one way!
  • Relax. Make yourself comfortable.
  • Put on some of your favorite music.
  • Dim the lights if this helps.
  • If your baby is crying frantically, ask your mate or someone else to try to comfort the baby a little first. Then nurse.
  • If necessary, apply warm wasclothes to your breast.
  • Massage your breast gently, stroking towards the areola.
  • Use your labor relaxation and breathing techniques.
  • As a last resort, you can drink a half glass of beer. Don’t drink any more than that, though! Remember, alcohol passes to the baby through your milk.
    • Alcohol is dehydrating and may reduce your milk supply.
    • However, a great milk supply is of little use if the milk isn’t coming out. If half a glass of beer relaxes you and lets the milk down, that’s great.
    • Beer is preferable to other alcoholic drinks, because it contains vitamin B, which helps prevent dehydration. You might want to ask your doctor about taking extra vitamin B if you want to drink other drinks.
    • It’s best to drink unpasteurized and unfiltered beer. Unpasteurized beer contains live yeast, which manufactures more vitamin B, and helps prevent dehydration.
  • In just a few weeks, your letdown reflex will be so conditioned that nothing will keep it from working. You’ll even be able to nurse your baby in the middle of your killer speech at a corporate board meeting!

Additional resources on picking baby carriers for breastfeeding:

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