From the wonder of when breast milk production begins, allowing you to feed your baby with your body, to the closeness you feel to them while you do, it can be easy for new mothers to romanticise the process of breastfeeding, especially before you do it.
Latching, let-down, milk flow issues and pain can sometimes turn that dreamy fantasy into a frustrating reality, leaving many mums feeling out of their depth.
Understanding your let-down reflex (and why you might experience pain as milk begins) is crucial to those early days of breastfeeding and connecting with your baby.
In that sense, navigating the nuances of your own breast milk ejection reflex is ultimately a part of your motherhood journey, and we're here to help.
What is the breastfeeding let-down reflex?
When your baby starts to suckle on your breast, they trigger nerve endings in your nipple area which causes a rush of hormones to be released, named prolactin and oxytocin.
These hormones are, in many ways, the workhorses of breastfeeding, with prolactin prompting your body to produce milk, and the release of oxytocin kicking off the delivery line in a process called the 'let-down' — making the milk ducts wider so that it's easier for milk flow, and pointing it all in the direction of the nipple for your baby's feeding session.
In other words, the let-down reflex is the process by which milk is released from your breasts.
What does a normal let-down feel like?
Like with most things to do with parenthood, 'normal' is pretty subjective. What's normal for you is going to depend on a lot of things — your body, your baby, even the environment you're breastfeeding in.
That said, there are a few factors that are more common than others. In particular, you might feel:
- A tingling sensation like pins and needles
- A sudden feeling of warmth or fullness
- Milk leaking from your other breast
- Uterine contractions, particularly in the first week
- A change to your baby's suckling rhythm as the milk starts to flow.
While you're only feeding your baby from one breast at a time, let-down occurs in both breasts at once, so don't be surprised if you're feeling similar sensations in your other breast while nursing.
Is let-down only caused by suckling?
Not necessarily! Depending on your body's sensitivity, let-down can be triggered by a lot of things, from hearing your baby cry to touching your breast or even just thinking about your baby, feeding time or expressing milk.
Is it normal to have a painful let-down?
It depends. Certain types of pain, such as pins and needles and some stinging, unfortunately can be common for mothers, especially if your body is still adjusting to breastfeeding.
If the pain persists though, there may be an underlying cause that's impacting your health.
What causes a painful let-down?
There are numerous reasons why a painful let-down can happen, and while some are easily managed, others do require medical intervention.
Overabundant milk supply
Sometimes your body can make too much milk in a process called 'forceful let-down'. In this case, you'll likely experience some pain and notice your baby gulping and struggling with the fast flow and amount of milk.
To combat this, try and recline while nursing until your flow slows, and empty the breast as often as possible through a feed or hand expressing.
Similar to an overabundant milk supply, engorgement is the oversupply of breast milk, but it results in the breasts becoming very hard, swollen and tender, and the nipples becoming flat and taut.
This can make it difficult for the baby to latch, and painful for mothers. You can relieve engorgement by taking your bra off completely before you nurse, using a breast massager, and using cold packs to reduce inflammation.
Sore nipples and vasospasms
During breastfeeding let-down, your baby's suckling can have a big impact on your overall comfort.
If they're latching incorrectly in those early weeks, or clamping instead of suckling, your nipples can become red, sore and cracked, and in some cases, this can cause the blood vessels in the nipple area to tighten and spasm in a process called vasospasms.
Check your baby's latch, and speak to a lactation consultant if necessary.
A common cause of breast pain, these are build-ups of milk in the breast causing blockages. You should be able to feel these as small, hard lumps in your breast, but sometimes they can appear as small white dots at the nipple known as blebs.
To release blockages, place a warm compress on your breast prior to feeding time, take a warm shower, and increase feedings and expressing to try and clear the blockage.
Do not try to pull on a bleb, and instead let it be drawn out on its own through breastfeeding or massage.
There are a number of infections that can target your breasts during breastfeeding, with the most common two being mastitis and thrush. Mastitis is often caused by a clogged milk duct and is seen in red streaks on the breast, painful letdowns and accompanied by cold and flu symptoms.
In both cases, you should seek professional medical advice, as these infections can impact your health and treatment will likely require antibiotics or antifungal medication.
When do painful let-downs stop happening?
This will ultimately depend on what's causing the pain to happen. If it's simply an adjustment period, most new mums report a reduction in painful let-down after the first few weeks.
But, if there's another cause, such as an infection or clogged milk ducts, the milk ejection reflex might continue to hurt. Talking to a lactation consultant will help you to narrow down the cause and continue on your breastfeeding journey.
Preventing painful let-down
The breast milk ejection reflex of some mums is a well-oiled machine, meaning they don't experience any difficulties with painful let-down, while other mothers experience transitional periods or are more prone to experiencing other symptoms that can cause discomfort or pain in the let-down process.
Some things you can do to help ease your body into let down and increase breast milk supply includes:
- Finding ways to relax. Easier said than done, we hear you, but try taking some deep breaths, having a warm shower before feeding, and listening to a podcast or music that helps get you in the zone.
- Stimulating milk flow by gently massaging your breasts and thinking about your baby.
- Cuddling your baby and placing them on your chest muscles for skin-to-skin bonding.
- Investing in comfortable nursing bras that you can get in and out of easily for breastfeeding.
- Investing in a good quality breast pump to help with milk supply issues.
- Finding a comfortable and relaxing spot for breastfeeding, including a supportive chair that lets you feed in a range of positions.
- Having a support person who can talk to you, get you water, or give you a gentle shoulder massage to manage tension or pain.
- Seeking professional medical advice in the case where pain doesn't stop.
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