• Contact us
• About us
• A-Z topics
• Symptom Checker
• Service Finder
• Linking to us
• Information partners
• Terms of use
• Privacy

Pregnancy, Birth and Baby is funded by the Australian Government and operated by Healthdirect Australia.

Pregnancy, Birth and Baby is provided on behalf of the Department of Health

Pregnancy, Birth and Baby’s information and advice are developed and managed within a rigorous clinical governance framework. This website is certified by the Health On The Net (HON) foundation, the standard for trustworthy health information.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

This information is for your general information and use only and is not intended to be used as medical advice and should not be used to diagnose, treat, cure or prevent any medical condition, nor should it be used for therapeutic purposes.

The information is not a substitute for independent professional advice and should not be used as an alternative to professional health care. If you have a particular medical problem, please consult a healthcare professional.

Except as permitted under the Copyright Act 1968, this publication or any part of it may not be reproduced, altered, adapted, stored and/or distributed in any form or by any means without the prior written permission of Healthdirect Australia.

Support this browser is being discontinued for Pregnancy, Birth and Baby

Support for this browser is being discontinued for this site

• Internet Explorer 11 and lower

We currently support Microsoft Edge, Chrome, Firefox and Safari. For more information, please visit the links below:

• Chrome by Google
• Firefox by Mozilla
• Microsoft Edge
• Safari by Apple

You are welcome to continue browsing this site with this browser. Some features, tools or interaction may not work correctly.

What You Should Know About Your Let Down Reflex

Written by WebMD Editorial Contributors

Reviewed by Dan Brennan, MD on March 17, 2021

In this Article

• How Does the Let Down Reflex Work?
• What Are Signs of a Good Let Down?
• Complications of the Let Down Reflex

When your baby first latches on to nurse, they don’t actually get much milk at first. Instead, their suckling sends a message to your body to release the milk stored in your breasts. The strength and timing of the let down reflex, also called the milk ejection reflex, varies from mother to mother. 

How Does the Let Down Reflex Work?

If milk came out of your breasts instantly when your baby latched on, you’d probably leak constantly. Instead, your breasts store the milk until it’s needed. Most often, your let down reflex is triggered by a particular suckling motion your baby makes to stimulate milk production.

The let down reflex is a physiological response to your baby’s sucking. They stimulate small nerves in the nipple, which causes prolactin and oxytocin to produce milk and let down milk, respectively. The reflex is often accompanied by a tingling sensation in the nipple, but not all women experience that.‌

If you pay attention to your baby’s nursing patterns, at first their suckling will be faster and shallower to stimulate the release of milk. Once your milk lets down and your baby is drinking, their suckles will be deeper and longer. If they nurse longer and need more milk, they may adjust how they suck to stimulate more milk flow. 

Other let down triggers. Since your brain is wired to care for a newborn, other things may trigger the let down reflex. If your baby cries, or if you hear any baby cry, your milk may let down in response. If you go too long without nursing and your breasts get too full, your let down reflex may trigger to relieve the pressure.

Strong emotions may also trigger a let down of milk. If you are feeling intensely stressed, angry, or sad, your body may take that as a sign that you need to nurse your baby or release milk to alleviate pressure.

If your milk is not letting down, you can physically stimulate the nipple to allow let down. Try gently rolling your hand down your breast toward the nipple, then massage gently. It can also help to relax and think about your baby.

What Are Signs of a Good Let Down?

Breastfeeding is wonderful for your baby, but it is often full of doubts and questions. Are you producing enough milk? Are you doing it right? This extends to the let down reflex, too. You may wonder if your let down is strong enough or too strong. 

Here are signs of a healthy, functioning let down response:

Uterine cramps. You may notice that your uterus cramps during a let down in the days following birth. This is natural and nothing to be concerned about. As with menstrual cramps, for some the cramps are mild and barely noticeable, while for others the contractions can be more painful.

Change in sucking pattern. You may notice a change in your baby’s sucking pattern during a nursing session. Their suckle will go from being short and fast to long and slow once milk lets down. If they need more milk, their sucking may change again to encourage another let down.

Your feelings. Moms often report that they feel very relaxed and even sleepy when their milk lets down. This is a side effect of the oxytocin released during let down. You may also feel suddenly thirsty, which is your body’s way of preparing to replace the milk being removed during a nursing session.

Complications of the Let Down Reflex

Oversupply milk ejection reflex. A powerful let down is often accompanied by an oversupply of milk, sometimes called oversupply milk ejection reflex (O-MER). When your let down happens, you may notice that your baby sputters, coughs, and even chokes on your milk. Your baby may bite down to slow the milk flow. You may leak when not nursing or notice that your baby has more frequent but short feedings if you have an oversupply.

If this happens, keep a bib or cloth handy to catch your milk when it first lets down so that your baby doesn’t choke. After a moment when the let down slows, you can try latching your baby again. You can also restrict your milk flow by squeezing your areola during breastfeeding.

Talk to your doctor about safe ways to decrease your oversupply so that your let down is less strong.

Dysphoric milk ejection reflex. In some women, breastfeeding can create a negative physiological response, leading to negative emotions like guilt, anxiety, depression, and sadness. It is usually an isolated response that occurs only when you first let down your milk and into the first few minutes of breastfeeding. This is called dysphoric milk ejection reflex (D-MER) and is different from postpartum depression. 

There is still more research needed on the causes and effects of D-MER. Talk to your doctor if you are struggling with negative emotions during breastfeeding. 

Weak let down. You may have a weak let down if your baby seems frustrated while nursing. They may not be getting enough milk, or they may not be getting milk as fast as they want it. Using a breast pump can supplement less successful nursing sessions.‌

When pumping, look at photos and videos of your baby to try and encourage a let down. And just as you do when breastfeeding, try to relax. Take deep breaths and think about your little one, letting go of any stress.

Colds while breastfeeding.

Colds in the cold season do not bypass breastfeeding women. However, you should not despair in this situation. You can create the most reliable protective barrier using the following recommendations:

• Do not stop breastfeeding your baby during this period. Your child is protected from infection much before symptoms begin to appear. With milk, he receives antibodies to the causative agent of the disease. Acute respiratory diseases are not a contraindication to breastfeeding. Therefore, feed the child to health, but in a mask. The mask must be changed every 2 hours. Your breast milk is your baby's immune defense against all possible complications.
• Wash your hands thoroughly. The virus can be transmitted in two ways: by airborne droplets and through touch. Hands should be washed regularly before contact with the child, which will protect him from infection.
• Be sure to get treated. How exactly to treat a breastfeeding woman from an infection? It all depends on the type of pathogen and the condition of the mother. But there are a few key rules. A high temperature can and should be reduced if a woman does not tolerate it well. Paracetamol during breastfeeding is sometimes simply an irreplaceable thing. This drug will help get rid of headaches and bring down the temperature. At the same time, it will not bring any harm to either the mother or the baby. This is the safest remedy available today.
• For the treatment of viral infections (colds, flu, etc.), in addition to antipyretic and symptomatic agents, special antiviral agents based on interferon preparations can be used. But a doctor must prescribe such funds for you. Although some of them, such as geneferon, viferon, can be used independently. Other antiviral drugs are best discussed with your doctor.
• A course of antibiotics is needed to treat a bacterial infection (otitis, tonsillitis, pyelonephritis, mastitis, etc.). Their choice, dosage and rules of admission only on the recommendation of a specialist.
• To relieve nasal congestion during lactation, use drugs to relieve swelling from the mucous membrane, which will help restore normal breathing (saline solutions and vasoconstrictor drugs).
• For a breastfeeding woman, topical antiseptics are ideal for a sore throat. For rinsing, you can use purchased solutions (for example, Chlorhexidine), or prepared at home (with sea salt).
• To combat the cough of a nursing mother, you can resort to natural-based remedies, such as licorice, thyme. During lactation, it is not forbidden to take drugs based on ambroxol. Inhalation with this substance will be the most effective. It is convenient to carry out this procedure using a nebulizer (a device for inhalation).

It is very important to treat a cold and not forget about your well-being! With properly selected therapy, relief comes on day 3, but some symptoms can persist up to 7-10 days. In doubtful situations, you should consult a doctor for advice. So you can avoid complications in the form of tonsillitis, sinusitis and pneumonia.

obstetric observation department

Stasevich S. M.

Feeding when sick | Medela

If you or your baby are unwell, you may wonder if it is safe to breastfeed. The great news is that breastfeeding when you're sick is most often good for both of you. Read more about this in our article.

Share this information

Did you know that a breastfed baby is usually much less prone to illness? Although it is impossible to avoid them completely, the protective properties of breast milk help babies get sick less often and recover faster than formula-fed babies.

Breast milk contains antibacterial and antiviral agents. ² The longer you breastfeed your baby, the lower the risk of colds and flu, ear and respiratory infections, nausea and diarrhoea. ¹ Scientists are already exploring the use of breast milk to treat everything from conjunctivitis to cancer. ^3.4

Should a sick baby be breastfed?

Yes. Breastfeeding promotes recovery and also helps to calm the baby. Breast milk contains antibodies, white blood cells, stem cells, and protective enzymes that help fight infections and help your baby recover faster. ^1,5,6 In addition, the composition of breast milk (the balance of vitamins and nutrients) is constantly adjusted to the baby's body to help him recover as soon as possible. Thus, you will spend less time on sick leave and visit the doctor less often. ⁷

“Breastfeeding gives the baby everything she needs when she is sick. This is his medicine, food, drink and comfort. For a baby, this is the best thing in the world,” says Sarah Beeson, a health visitor from the UK.

Surprisingly, when a child becomes ill, the composition of breast milk changes. When you come into contact with pathogens of bacterial and viral infections, your body begins to produce antibodies to fight them, which are then passed through milk to your baby. ⁸ When your baby is sick, the levels of immune-boosting cells (white blood cells) in your milk also skyrocket. ⁵

In addition, breast milk is very easy to digest, making it ideal for babies with indigestion.

“At 12 months my daughter contracted norovirus and could only breastfeed,” recalls Maya, a mother of two in Spain. produce more milk. It was amazing. After 48 hours, I was able to meet the daily requirement for milk. It saved my baby from a drip."

It should be taken into account that sometimes during an illness it is necessary to change the habitual breastfeeding regimen. For example, with a cold, a baby may want to eat more often, but little by little, both to calm down and because of nasal congestion, which makes it difficult to apply to the chest for a long time. If your baby has a stuffy nose, an upright breastfeeding position may be more comfortable, so don't be afraid to try different breastfeeding positions.

What should I do if my baby is seriously unwell and cannot breastfeed?

Occasionally, if a baby is not feeling well, they may not have the appetite or energy to feed. If your baby is not eating well, seek advice from your healthcare provider, nurse practitioner, or lactation consultant to help prevent dehydration.

You may be asked to express milk to feed your baby with a bottle, a Soft Cup*, or other suitable method that requires minimal effort from the baby. Pumping on a regular breastfeeding schedule will also help keep your milk supply stable.

You can express milk with one of our convenient breast pumps, such as the modern electronic Swing Flex** or the Harmony** manual breast pump. Rest assured, freshly expressed breast milk is just as good as breast milk, so your baby will get all the protection and support it needs.

If you have concerns about your baby's health or how much milk they are drinking, see your doctor as soon as possible.

Can I continue to breastfeed if I become ill myself?

You may not want to do this if you feel unwell, but in most cases it is best to continue breastfeeding. If you have a cold, runny nose, diarrhoea, vomiting, or mastitis, continue breastfeeding as normal with your doctor's approval. The baby is unlikely to become infected through breast milk. What's more, the antibodies in your milk will help reduce your baby's risk of contracting the same ¹³ virus.

“Breastfeeding when sick is not only safe most of the time, but also beneficial. Your baby is the least at risk of catching your upset stomach or cold, as he is already in close contact with you and receives a daily dose of protective antibodies from milk, ”says Sarah Beeson.

If there is a risk of contracting a viral infection by airborne droplets, it is advisable to temporarily switch to expressing breast milk and bottle feeding.

In order not to lose the amount of milk produced when the body is still weakened by the disease, it is best to use the Swing Maxi Flex ** double breast pump, which helps to stimulate lactation, increase the amount of milk (by 18% on average) and increase its fat content (+1% ) ¹⁴ .

However, breastfeeding and pumping when sick can be very tiring. You need to take care of yourself so that you can take care of the baby. Try to drink more fluids, eat when you can, and get plenty of rest. Crawl under the covers for a few days and ask family or friends to help care for your baby if possible, so you can put all your energy into recovery.

“Don't worry about your milk supply, it will last. Most importantly, do not stop breastfeeding abruptly so that mastitis does not develop, ”adds Sarah.

Proper hygiene is very important to reduce the risk of spreading the disease. Wash your hands with soap and water before and after breastfeeding and pumping, preparing and eating food, using the toilet and changing diapers. Use a tissue when coughing and sneezing, or cover your mouth with the crook of your elbow (not your palm) if you don't have a tissue handy. Be sure to wash or sanitize your hands after coughing, sneezing, and blowing your nose.

Can I take medication while breastfeeding?

In agreement with the attending physician and compliance with the dosage, it is permissible to take certain medications. ^9.10

.

“When talking to a doctor or pharmacist for any reason, always state that you are breastfeeding,” she continues.

What about long-term treatment?

If you are on long-term treatment for diabetes, asthma, depression, or other chronic conditions, the benefits of breastfeeding may outweigh the risks. “Breastfeeding is often possible for almost any disease, with the exception of some very rare conditions,” Sarah says, “you will be very familiar with the drugs you are taking, and during pregnancy you can discuss them with your doctor or other specialist. There is guidance on the safe use of various medicines that all healthcare professionals use.” In any case, you should consult with your doctor.

“I was on high doses of epilepsy medication, but I was still able to breastfeed,” recalls Nicola, a mother from the UK. “I saw a neurologist to ensure my son was safe and to minimize the risk of a seizure. Seizures can happen due to lack of sleep, and I fed day and night, but I took good care of myself, and my husband supported me. It was a positive experience."

What if I have to go to the hospital?

If you need to be hospitalized or urgently hospitalized, there are different ways to continue feeding your baby healthy breast milk so that you can return to normal breastfeeding after you are discharged.

“Express and freeze breast milk so that the caregiver can feed the baby. Practice at home ahead of time and be sure to let your doctors know that you are a breastfeeding mother, both before entering the hospital and while in it, ”recommends Sarah.

“If the baby is very small, you may be allowed to take him with you. Find out if the hospital has a supervising doctor or lactation consultant to contact. This specialist will support you, especially if you are in a general ward. If hospitalization is urgent, warn the doctors that you have a baby so that they take this into account.

Surgery under local or general anesthesia does not necessarily mean that breastfeeding will have to be stopped, or milk will need to be pumped and discarded. By the time you recover from surgery and can hold your baby, the amount of anesthetic in your breast milk will be minimal, so breastfeeding will be safe in most cases. ¹⁰ However, in any case, it is best to consult your doctor or attending physician beforehand.

To ensure that the situation of treatment or departure does not affect the baby's diet, it is advisable to create a breast milk bank. This should be done daily by expressing one extra serving and freezing it in the handy, durable Medela Breast Milk Storage Bags. Even stored for several months and then thawed, your carefully prepared milk will still be incomparably healthier than formula.

For hygienic and easy pumping, use a breast pump with 2-Phase Expression technology for a fast, full flow of milk. For example, the ultra-comfortable Swing Flex** breastpump that adapts to the shape of your breasts and allows you to pump milk in a comfortable position, even lying back on the pillows ¹⁵ .

Don't forget to sterilize your breast pump with the Quick Clean microwave bags. Medela milk storage bags do not need to be handled as they are aseptically packaged and ready to use immediately.

Are there times when breastfeeding is not allowed?

In some cases, for the safety of the baby, breastfeeding should be stopped for a while, and instead, milk should be expressed and drained to maintain milk production until the end of treatment. This includes radiotherapy and chemotherapy for cancer, herpes sores on the chest, and infections such as tuberculosis, measles, or blood poisoning that can be transmitted through breast milk. ^11.12 Consult with a qualified professional about your condition to decide if you can continue breastfeeding in such cases.

For quality lactation support during this period, you can use the dual electronic breast pump with innovative Flex technology or rent a Symphony Clinical Breast Pump** if available. A list of cities where you can rent a breast pump can be found on the "Rent a Medela Clinical Breast Pump" page.

Literature

1 Victora CG et al. 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.

2 Lönnerdal B. Bioactive proteins in breast milk. J Pediatric Child Health. 2013;49 Suppl 1:1-7. - Lönnerdahl B., "Biologically active proteins of breast milk". F Pediatrician Child Health. 2013;49 Suppl 1:1-7.

3 Australian Breastfeeding Association [Internet]. Topical treatment with breastmilk: randomized trials. [ cited 2018 Apr 4]. Available from https://www.breastfeeding.asn.au - Australian Breastfeeding Association [Internet]. "Topical treatment with breast milk: a randomized trial". [cited 4 April 2018] See article at https://www.breastfeeding.asn.au

4 Ho JCS et al. HAMLET–A protein-lipid complex with broad tumoricidal activity. Biochem Biophys Res Commun. 2017;482(3):454-458. - Ho J.S.S. et al., "HAMLET - a protein-lipid complex with extensive antitumor activity". Biochem Biophys Res Comm. 2017;482(3):454-458.

5 Hassiotou F 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.

6 Hassiotou F, Hartmann PE. At the dawn of a new discovery: the potential of breast milk stem cells . Adv Nutr . 2014;5(6):770-778. - Hassiot F, Hartmann PI, "On the threshold of a new discovery: the potential of breast milk stem cells." Adv. 2014;5(6):770-778.

7 Ladomenou F et al. Protective effect of exclusive breastfeeding against infections during infancy: a prospective study. Arch Dis Child . 2010;95(12):1004-1008. - Ladomenu, F. et al., "The effect of exclusive breastfeeding on infection protection in infancy: a prospective study." Arch Dis Child. 2010;95(12):1004-1008.

8 Hanson LA. Breastfeeding provides passive and likely long-lasting active immunity. Ann Allergy Asthma Immunol . 1998;81(6):523-533. — Hanson, L.A., "Breastfeeding provides passive and likely long-term active protection against disease." Ann Allergy Asthma Immunol. 1998;81(6):523-533.

9 Hale TW, Rowe HE. Medications and Mothers' Milk 2017. 17th ed. New York, USA: Springer Publishing Company; 2017. 1095 p . — Hale T.W., Rowe H.I., Medications and Breast Milk 2017. 17th edition. New York, USA: Publishing House Springer Publishing Company ; 2017. p. 1095.

10 Reece-Stremtan S et al. ABM Clinical Protocol# 15: Analgesia and anesthesia for the breastfeeding mother, Revised 2017. Breastfeed Med . 2017;12(9):500-506. - Rees-Stromtan S. et al., AVM Clinical Protocol #15: Analgesia and Anesthesia for Nursing Mothers, 2017 edition. Brestfeed Med (Breastfeeding Medicine). 2017;12(9):500-506.

11 Lamounier JA et al. Recommendations for breastfeeding during maternal infections. J Pediatr 2004;80(5 Suppl ):181-188. - Lamunier J.A. et al., Guidelines for Breastfeeding during Maternal Infectious Diseases. J Pediatrician (Journal of Pediatrics) (Rio J). 2004;80(5 Suppl):181-188.

12 Hema M et al., Management of newborn infant born to mother suffering from tuberculosis: Current recommendations & gaps in knowledge. Indian J Med Res .

Learn more

• 
  How to teach your child before and after numbers
• 
  How to fast correctly
• 
  How to help autistic child in classroom
• 
  Hemorrhoid creams during pregnancy
• 
  How many gifts should a child get for birthday
• 
  How do you know if your child is special needs
• 
  How many operation christmas child boxes
• 
  What helps newborn babies with constipation
• 
  How old must child be to sit in front seat
• 
  What a doctor that delivers babies called
• 
  Tubal pregnancy miscarriage