How to help milk let down
Let-down reflex | Pregnancy Birth and Baby
Let-down reflex | Pregnancy Birth and Baby beginning of content3-minute read
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The let-down reflex is an important part of breastfeeding that starts milk flowing when your baby feeds. Each woman feels it differently, and some may not feel it at all. It can be affected by stress, pain and tiredness but once feeding is established, it requires little or no thought.
What is the let-down reflex?
The let-down reflex is what makes breastmilk flow. When your baby sucks at the breast, tiny nerves are stimulated. This causes two hormones – prolactin and oxytocin – to be released into your bloodstream. Prolactin helps make the milk, while oxytocin causes the breast to push out the milk. Milk is then released or let down through the nipple.
Some women feel the let-down reflex as a tingling sensation in the breasts or a feeling of fullness, although others don’t feel anything in the breast.
Most women notice a change in their baby’s sucking pattern as the milk begins to flow, from small, shallow sucks to stronger, slower sucks.
Some women also notice, while feeding or expressing from one breast, that milk drips from the other.
Your let-down reflex needs to be established and maintained to ensure a good supply of milk. This reflex requires no thought, unless you are having problems with breastfeeding.
When does it occur?
The let-down reflex occurs:
- in response to your baby sucking at the breast
- hearing, seeing or thinking about your baby
- using a breast pump, hand expressing or touching your breasts or nipples
- looking at a picture of your baby
- hearing your baby (or another baby) cry
The let-down reflex generally occurs 2 or 3 times a feed. Most women only feel the first, if at all. This reflex is not always consistent, particularly early on, but after a few weeks of regular breastfeeding or expressing, it becomes an automatic response.
The let-down reflex can also occur with other stimulation of the breast, such as by your partner.
Strategies to encourage the reflex
The let-down reflex can be affected by stress, pain and tiredness. There are many things to try if you are experiencing difficulty.
- Ensure that your baby is correctly attached to the breast. A well-attached baby will drain a breast better.
- Feed or express in a familiar and comfortable environment.
- Try different methods to help you to relax: calming music, a warm shower or a warm washer on the breast, some slow deep breathing, or a neck and shoulder massage.
- Gently hand express and massage your breast before commencing the feed.
- Look at and think about your baby.
- If you are away from your baby, try looking at your baby’s photo.
- Always have a glass of water nearby.
Milk let-down can be quite forceful, particularly at the beginning of a feed. This fast flow of milk can upset your baby, but it might not mean you have oversupply. It can be managed through expressing before a feed, reclining slightly and burping your baby after the first few minutes. If you continue to have problems, seek advice.
How to deal with unexpected let-down
Until you and your baby fine-tune breastfeeding, many sensations and thoughts can trigger your let-down reflex. Leaking breasts can be embarrassing, but should stop once breastfeeding is fully established.
In the meantime you can feed regularly, apply firm pressure to your breasts when you feel the first sensation of let-down, use breast pads and wear clothing that disguises milk stains.
If you need help and advice:
- Pregnancy Birth and Baby on 1800 882 436
- your maternal child health nurse
- a lactation consultant (your maternity hospital might be able to help)
- Australian Breastfeeding Association on 1800 686 268
Sources:
Australian Breastfeeding Association (Breastfeeding - naturally : the Australian Breastfeeding Association's guide to breastfeeding - from birth to weaning), Australian Breastfeeding Association (Let-down reflex)Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: April 2021
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Related pages
- Breastfeeding your baby
- How to increase breast milk supply
- Oversupply of breastmilk
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Is Yours Normal, Tips to Improve It, and More
What are some benefits of breastfeeding?
Breastfeeding not only creates a bond between you and your baby, it also provides your baby with nutrients that promote healthy growth.
Breast milk has antibodies that strengthen your baby’s immune system, protecting them from infections and diseases.
Breastfeeding also has long-term benefits. For example, breastfed babies are less likely to be obese or develop type 2 diabetes later in life.
Even if you’re convinced that breast milk is the best choice for your baby, you may have questions. Among your list of concerns, you may wonder whether your let-down reflex is normal. Find out more here.
What is the let-down reflex?
Between sore nipples, latching issues, and problems with milk flow, breastfeeding can be tricky. The let-down reflex, however, can make breastfeeding easier for both you and your baby.
“Let-down” is the release of milk from the breast. It’s a normal reflex that occurs when nerves in your breasts are stimulated, usually as a result of your baby sucking. This sets in motion a chain of events, and hormones are released into your bloodstream.
The hormone prolactin stimulates milk production, and the hormone oxytocin causes your breast to release or “let down” milk.
What is a normal let-down reflex?
Let-down, or the availability of milk, is different for every mother. Some women let down within seconds of their baby beginning to suck, but it takes others several minutes to let down. Therefore, you shouldn’t compare your reflex with another mother’s reflex.
Knowing what to expect during let-down can help you determine whether your reflex is normal.
Some breastfeeding mothers can feel their milk flow from their ducts to their nipples, but others don’t. You may notice different sensations in or around your breasts, such as:
- a tingling sensation, which feels like pins and needles
- a feeling of fullness
- milk leaking from your other breast
These sensations can develop immediately after giving birth, or they may not start until several weeks into breastfeeding. It varies from mother to mother.
Other bodily responses
Let-down can also trigger other natural responses. Although you may only feed your baby from one breast, let-down typically happens in both breasts simultaneously.
You shouldn’t be surprised if your other breast begins to leak. Also, don’t be alarmed if you feel your uterus contract when you let down. This is also normal.
Pacing
Your milk may let down at a slow and steady pace. Sometimes, however, let down is fast and forceful.
Your baby could choke if they suck too much milk at once. The flow of milk does gradually slow down, though, and it becomes more comfortable for your baby.
If you don’t want to risk your baby choking, use your hand and squeeze out a little milk before each feeding. Fast-flowing milk not only increases the likelihood of choking, but some people believe it can cause gas and colic.
Which actions can prompt let-down?
Let-down is a normal reflex when your baby sucks on your breasts, but it can also take place before your baby latches on. You may notice your milk let down when you hear your baby cry or if you’re overdue for a feeding.
Additionally, touching your breasts or using a breast pump can prompt let-down. This is called “expressing.”
How can you improve your let-down reflex?
Let-down comes easily and naturally for some breastfeeding mothers, but others have trouble getting their milk to flow.
If you have trouble with let-down — whether you’re feeding or expressing — there are several things you can do to help the process:
- sip on a warm beverage
- listen to soothing, calm music
- take a warm shower before feeding
- hold your baby close to your body
- gently massage your breasts to stimulate milk flow
What is the takeaway?
It’s important to remember that let-down is different for every person. You may have a physical response and feel tingling or fullness around the breasts every time milk is ready to flow, or you may feel nothing.
If you have concerns about your let-down reflex, talk to your doctor. Also, let your doctor know if you’re having pain during let-down. A painful let-down reflex isn’t unusual, and the pain typically goes away once you adjust to breastfeeding.
If pain doesn’t improve, it can be a sign of:
- a clogged milk duct
- a breast infection
- a strained muscle from giving birth
- your breasts producing too much milk
Termination of breastfeeding | Stopping breastfeeding
When is it time to stop breastfeeding and what is the best way to do it? Read our article for useful practical tips on weaning.
Share this information
How long should breastfeeding continue? Three months? Six? Year? Or maybe a few years?
The World Health Organization (WHO) and other authorities recommend that infants be exclusively breastfed for the first six months and then continue to be breastfed along with other foods (complementary foods) for at least two years. 1
The fact is that breast milk is not just food. It is a natural sedative if the child is anxious or tired. In addition, milk contains immune-boosting components, the amount of which increases dramatically when the baby gets sick. 2
According to anthropologists, the natural age of a person to stop breastfeeding is even more than two years. Given factors such as tooth development, body weight, comparison with other primates, and historical evidence, some scientists believe that breastfeeding may last up to two to four years. A number of researchers even believe that our ancestors breastfed children up to six or seven years of age. 3
Today, more than 60% of mothers in developed countries start giving their babies formula or complementary foods before six months of age, 4 although WHO does not recommend this.
When is it time to stop breastfeeding?
Weaning means that you gradually stop breastfeeding your baby. Ideally, the first step in this process is the gradual introduction of complementary foods, starting at about six months of age. In this case, breastfeeding continues. The weaning process continues until the mother's milk has been completely replaced by other foods and drinks.
“After six months, the baby needs higher doses of certain nutrients, such as iron, zinc, vitamins B and D, that he cannot get from breast milk or from his own reserves,” says Sarah Beeson, health visitor from Great Britain.
“But solid food should at first only supplement the main diet with breast milk and gradually replace it. Mother's milk remains the main source of nutrition for the baby for many months to come.”
On average, a seven-month-old baby gets 93% of its calories from breast milk. And even between the 11th and 16th months, milk provides him with about half of the daily calorie intake. 5
“Sometimes moms think that breastmilk isn't that important once a baby has started solid foods, but the truth is, no matter how many months old a baby is, there's nothing better than your milk,” continues Sarah.
In fact, the process of finishing breastfeeding can take as long as mother and baby want. “When to stop breastfeeding is up to you,” says Sarah. The only thing that matters is what you think is right for you and your child.”
How to wean
Whenever you decide to start weaning your baby, it's best to do it gradually. An abrupt cessation of breastfeeding can lead to lactostasis, blockage of the milk ducts and mastitis, and in a child such a sudden change can adversely affect the state of the digestive and immune systems. In addition, it will be difficult for both of you psychologically.
When should I stop breastfeeding?
Sometimes mothers mistakenly believe that it is time to stop breastfeeding, when in fact there is no reason to. If you're returning to work, breastfeeding can be a great way to stay close to your baby during this difficult time for both of you. You can express milk at work, and morning and evening feeding sessions will give you the opportunity to spend time alone with your baby. If you need to leave without your baby, you can also express milk and bring or send it home.
If you get sick, this is not always a reason to stop breastfeeding. Read our advice in the article on breastfeeding when sick and consult with your healthcare professional.
Weaning up to six months
If you cannot continue breastfeeding until six months and want to try weaning your baby, start by replacing one feeding a day with a bottle of formula.
“It's best to start with midday feedings. Babies are very alert and able to smell breast milk nearby, so ask your partner or relative to give your baby a bottle when you're in the other room,” Sarah advises.
“Be hygienic when preparing meals. Be prepared for the fact that the baby will take fewer servings of expressed milk per day than if he was fed directly from the breast. Don't make him eat more milk than he wants."
You will probably feel that your breasts are fuller and more tender. This is due to the fact that your body is rebuilding to produce less milk. If this creates discomfort, try expressing some milk—just enough to relieve the discomfort without stimulating extra production.
When your body adjusts to the new volume - usually after a few days - replace with formula for one more meal a day. Continue this until you have changed all feedings and your baby is completely weaned.
“I had complications after my first birth, as a result I lost a lot of weight very quickly, and besides, I developed mastitis. Lactation was very weak, and at three months I was forced to stop breastfeeding,” recalls Jennifer, a mother of two from the UK, “I gradually replaced one feeding, so physically it was easy, but mentally it was hard for me.”
If you want to maintain closeness with your baby and all the health benefits of breastfeeding, but still need to cut down on breastfeeding, try partial weaning, replacing only a few feeds a day with formula.
Weaning after six months
Once your baby starts eating solid foods (about six months old), you will notice that breastfeeding naturally occurs less and less. For a year, it can be reduced to just a couple of times a day, and feedings will be replaced by full meals and healthy snacks.
Anyway, if you intend to continue to reduce breastfeeding, do it gradually, replacing one feeding at a time. Use formula milk if your baby is under 12 months old. With cow's milk, you should wait at least up to a year.
“When I decided to wean my son, I breastfed him three times a day and gave him other foods three times plus light snacks. Gradually, I replaced all breastfeedings with formula. By 11 months, we only had one nighttime breastfeed left,” says Ruth, a UK mom.
There are various ways to distract a child from changes in his diet. Some mothers suggest that instead of breastfeeding something to drink and eat together to maintain a sense of closeness. You can also change your daily routine, play your favorite game, or replace feeding with caresses - from you or from your partner. Some children take longer to get used to the new food, but in the end everything falls into place. If you are having difficulty weaning, ask your healthcare provider for advice.
Ending breastfeeding naturally
Ending breastfeeding can be guided by the baby's wishes. This is called baby-initiated weaning, or the natural termination of breastfeeding. Such a process is likely to be long and gradual. Month after month, feeding sessions will become shorter and less frequent, until one day the child completely loses interest in the breast.
“My daughter stopped breastfeeding on her own when she was four years old,” says Sarah, a mother from the UK. And once, when we were on vacation, she seemed to just forget about her breasts. Now, six months later, she sometimes still asks for breasts, but she already knows that there is no milk there.
You will have a huge amount of time for the body to adapt, so there should be no discomfort or swelling of the breast. However, you may find it difficult emotionally, so spend more time petting and bonding with your baby.
“Child-initiated termination of breastfeeding was right for me because I never gave my son formula or a bottle. I didn’t want to abruptly stop feeding and refuse him,” recalls Kelly, a mother from the UK, “He himself lost interest in breasts at the age of two and a half years. For us, it was the best scenario, although emotionally it was not very easy for me.”
What if you need to stop breastfeeding quickly?
It is best not to stop breastfeeding abruptly, but sometimes it is necessary for medical reasons or because you cannot be near the baby.
If you have been breastfeeding your baby up to this point, you will most likely have to express your milk to avoid breast swelling. Some mothers prefer to use a breast pump for this, others find it easier to express milk manually. You only need to pump a little, just to eliminate the discomfort, otherwise your body will take it as a signal to produce more milk.
At first, the breasts may swell and become tender, but this will pass. Breast milk contains a so-called feedback lactation inhibitor. When breastfeeding is stopped, this inhibitor tells your body to slow down milk production, but it can take days or even weeks for your breasts to rebuild.
Certain medications can relieve pain and should be discussed with your doctor. Always follow your pharmacist's instructions or directions, and consult your healthcare professional before taking any medication.
“I had to abruptly stop breastfeeding when my daughter was eight months old because she had to take strong painkillers,” says Peggy, a mother from Switzerland. “It was very difficult because the baby was constantly looking for a breast and crying. I held her tightly to me as I gave her a bottle. This calmed her, and after a month everything was all right.
Can I continue breastfeeding if I want to get pregnant again?
Breastfeeding is a natural contraceptive. However, this method is not the most reliable, especially after six months or if you are not exclusively breastfeeding. This means that you can get pregnant even while you are breastfeeding.
Pregnant and breastfeeding mothers sometimes receive conflicting advice about whether to stop breastfeeding. Consistent feeding of two children of different ages is of course possible, and with the advent of the second baby, your body will produce the kind of milk that both of them need.
It is not uncommon for an older child to refuse to breastfeed or skip feedings if the mother is pregnant. This may be due to changes in milk composition that occur during pregnancy. Milk can change the taste and become less sweet. 6 If your baby is under one year of age when he starts to stop breastfeeding, make sure he continues to gain weight.
Talk to your doctor if you want to continue breastfeeding during pregnancy, but have had a preterm birth or miscarriage, or have any bleeding in the past.
If you need medical help to conceive, certain drugs and procedures may not be suitable while you are breastfeeding. Discuss all possible options before deciding to stop breastfeeding.
And finally...
Whenever you decide to end breastfeeding, and whatever method you choose to do so, be kind to yourself and your baby. This is a huge change for both of you physically, hormonally, and emotionally, so proceed thoughtfully and carefully.
“Although my body responded normally to stopping breastfeeding, it was psychologically difficult for me. The thing that united us for so long is over, - Jane, a mother of two children from the USA, shares her impressions, - I worked long hours, five days a week, and breastfeeding made me feel that I occupy a special place in the lives of children. But when it stopped, we soon found other ways to be together.”
Literature
1 World Health Organization. [Internet] Health Topics: Breastfeeding: 2018 [Accessed: 02/08/2018]. Available from : http://www.who.int/topics/breastfeeding/en - World Health Organization. "Health Issues: Breastfeeding" [Internet]. Geneva, Switzerland: WHO; 2018 [Visit 02/08/2018]. Article linked: http://www.who.int/topics/breastfeeding/e
2 Hassiotou et al. Maternal and infant infections stimulate a rapid leukocyte response in breastmilk. Clin Transl Immunology. 2013;2(4): e 3. - Hassiot F. et al., "Infectious diseases of the mother and child stimulate a rapid leukocyte reaction in breast milk." Clean Transl Immunology. 2013;2(4):e3.
3 Dettwyler KA. When to wean: biological versus cultural perspectives. Clin Obstet Gynecol . 2004; 47(3)712-723. - Dettwiler KA, "Time to wean: weaning from a biological and cultural point of view". Klin Obstet Ginekol (Clinical obstetrics and gynecology). 2004; 47(3):712-723.
4 Victora CG Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-490. - Victor S.J. et al., "Breastfeeding in the 21st century: epidemiology, mechanisms and long-term effects". Lancet 2016;387(10017):475-490.
5 Dewey KG et al. Breast milk volume and composition during late lactation (7-20 months). J Pediatr Gastroenterol Nutr . 1984;3(5):713-720. — Dewey C.G. et al., "Amount and composition of breast milk in late lactation (7-20 months)". F Pediatrician Gastroenterol Nutr. 1984;3(5):713-720.
6 Prosser CG et al. Mammary gland function during gradual weaning and early gestation in women. Aust J Exp Biol Med 9021 9029 Sci. 1984;62( Pt 2):215-228. - Prosser S.G. et al., "Breast Function During Gradual Weaning and Early Gestation." Aust J Exp Biol Med Sai. 1984;62( Pt 2):215-228.
How to stop breastfeeding | Philips Avent
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When and how to stop breastfeeding? Like all good things, breastfeeding eventually comes to an end.
Weaning is an important decision for both mother and baby, and the decision is entirely up to them. When the mother and baby are ready to start weaning, there are a few tips and techniques to help make the transition a positive one.
3 Philips Avent products to support you when you stop breastfeeding:
When should I start weaning my baby?
There is no definite and correct period for weaning a child. The mother-child relationship is different for everyone, and weaning is a purely personal decision for mother and baby, which they make when both are ready.
The World Health Organization (WHO) recommends exclusive breastfeeding for infants up to six months of age. Until a child reaches the age of one year, both solid food and breast milk must be present in his diet. If the baby is weaned before he is one year old, adapted infant formula can be fed instead of breast milk. If a baby is stopped breastfeeding at one year of age or older, infant formula milk products can be given instead. While the recommendations are, many mothers stop breastfeeding before their babies are 12 months old, and others breastfeed for up to two years or longer. The second option is called extended breastfeeding, and it's a completely healthy choice for mothers and babies who want to continue breastfeeding.
Signs that a baby is ready to wean
Mothers often wonder how to stop breastfeeding, because babies rarely just stop suckling. Weaning a baby from the breast is usually a gradual process for both the mother and the baby.
There are several signs that will let you know that the baby is ready to start weaning:
- disinterest or fussiness during feeding;
- reducing the duration of feedings;
- baby is easily distracted while feeding;
- the child plays while suckling, eg pulling or biting the breast;
- baby suckles lightly but does not extract milk.
How do I wean a baby?
When mom and baby decide it's time to stop breastfeeding, there are a few things to keep in mind to make the transition smoother.
Here are our tips for weaning your baby when the time is right:
1. Wean gradually. When you decide to wean a baby, remember the main thing: do it gradually. This is necessary so that both mother and baby can adapt to physical and emotional changes. In addition, the gradual cessation of breastfeeding helps mothers avoid problems such as engorgement and general breast discomfort.
2. Express milk. To prevent breast engorgement when breastfeeding is stopped, the mother may need to express her milk, especially if the baby is less than a year old. One way to reduce and gradually stop breast milk production is to express less and less milk so that less milk is produced. Since pumping stimulates the flow of milk, it is important to use the pump for a shorter time than the duration of feeding the baby. Gradually, milk production will decrease and eventually stop completely.
Check out the Natural Motion Electronic Breast Pump, which combines nipple stimulation and pumping like a baby does for natural and gentle pumping.
3. Reduce the number of daily feedings by one every week. We recommend eliminating one of the daily feedings each week, such as feeding at noon or at another time, depending on which one the child likes the least. The latter, as a rule, exclude feeding before bedtime and immediately after waking up.
During the weaning period, the mother's breasts will continue to produce milk until she completely stops breastfeeding.
During this period, mums will love these soft bra pads to keep their clothes dry and clean all day long.
Check out this Natural bottle with an ultra-soft, breast-like nipple to help make the transition from breast to bottle easier.
4. Extra hugs may be needed. In addition to the physical changes that stopping breastfeeding brings, moms and babies will also experience emotional changes. During this period, you should hug the baby more often and express your love to him. Caress and other acts of love can help mother and baby retain the closeness and togetherness that breastfeeding has given them.
5. Introduce complementary foods at your baby's usual feeding times. Another way to help your baby adjust to change is to give him complementary foods at his usual feeding times. Babies who are a year old or older can substitute cow's milk for breast milk or offer other foods if the baby has already switched to solid foods.
We also recommend watching the webinar "How to End Breastfeeding Comfortably and Painlessly: Tips and Tricks".
Although weaning is the natural end to breastfeeding, a mother can make a huge difference in her baby's life at this stage. Along with a new sense of pride in a child who is growing and developing, it is quite natural for a mother to feel sadness. Breastfeeding creates a special bond between mother and baby. Therefore, breastfeeding mothers often find it difficult to say goodbye to breastfeeding.
If you have any questions, be sure to contact a specialist to get his opinion.
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