The Let-Down Reflex During Breastfeeding

What Is It and What Does It Feel Like?

The Let-Down Reflex, Signs of Let-Down, Problems With Let-Down
What is the let-down reflex and what does it feel like?. Tetra Images/Getty Images

What Is the Let-Down Reflex?

The let-down reflex also referred to as milk-ejection, is a reflex or involuntary natural reaction that occurs when your baby breastfeeds. The infant suckling at your breast sends a message to your brain to release the hormones prolactin and oxytocin. While prolactin is responsible for making more breast milk, it's the oxytocin that lets your breast milk leave the milk ducts.

This release of milk is the let-down reflex.

Let-down is the key to successful breastfeeding. It allows your breast milk to flow out of your breasts to your baby. Without a good let-down, your baby will only receive a small amount of foremilk, so he may not grow at a healthy pace — or he may become frustrated and refuse to breastfeed.

How To Tell if Your Milk Is Letting Down: The Signs

  • You feel tingling, pins and needles, or a burning sensation in your breasts while your baby is breastfeeding.
  • The breast that the baby is not nursing on is leaking or spraying milk.
  • You can hear your baby gulping and swallowing.​
  • There is breast milk dripping out of your baby's mouth.​
  • You feel menstrual-type cramping in your uterus, especially in the early weeks following childbirth.​
  • Your baby is gaining weight, having at least 6 to 8 wet diapers a day, and appears content after breastfeeding.

You may also notice let-down at times other than when the baby is at the breast.

It can come on quickly and unexpectedly when you hear your baby cry, when it's getting close to feeding time, when you take a warm shower, or during sexual activity.

What Does the Let-Down Reflex Feel Like?

Let-down occurs many times during a feeding. The first release is usually the only one that is noticeable.

The let-down reflex may feel like pins and needles, tingling, burning, or pressure, and it could be a little uncomfortable or even mildly painful. Some women feel the sensations very strongly while others do not feel anything at all.

The hormone oxytocin is associated with love and bonding. It is released during childbirth, when you nurse your baby, and during sex. This hormone can bring about feelings of peace, calmness and relaxation. When let-down occurs, the oxytocin causes contractions in the uterus, so you may feel cramping: a good sign that breastfeeding is going well. Other effects of oxytocin that you may feel when you are nursing could include sleepiness, thirst, headache, nausea and vomiting, hot flashes, and night sweats.

If you do not feel any of these sensations, it doesn't necessarily mean that something is wrong. As long as you can see the signs that your baby is getting enough breast milk and growing well, you do not need to be concerned. But if you do not feel let-down, or you have stopped feeling it, and you do not see any of the signs listed above, it could indicate that your supply of breast milk is low.

Problems with the Let-Down Reflex

The let-down reflex does not always work perfectly. It can be slow, difficult, painful or hyperactive. Problems with let-down can lead to feeding issues. It can also cause a decrease in your breast milk supply because if only a small amount of breast milk is removed from your breasts at each feeding, your production of breast milk will decline.

A Slow or Difficult Let-Down

A slow or difficult let-down can be frustrating to a hungry child. The baby may cry, bite down on your breast, or refuse the breast altogether. Let-down can be delayed for many reasons, including:

  • Cold Temperatures
  • Exhaustion
  • Embarrassment
  • Stress
  • Pain
  • Alcohol Use
  • Smoking

Things You Can Do if You Have a Slow or Difficult Let-Down

  • Pump or hand express a little milk before each feeding to stimulate let-down. Put the baby to your breast once the milk is flowing.
  • Place a warm compress on your breasts for a few minutes before feeding time.
  • Gently massage your breasts before and during each feeding.
  • Nurse or pump in a quiet place away from distractions.
  • Get into a comfortable position. Use a nursing pillow and a footstool, try to relax, take some deep breaths and concentrate on your baby.
  • If you are in pain, ask your doctor if you can take a pain reliever.
  • Try a nursing supplementer device.
  • Do not drink alcohol or smoke.
  • Stay hydrated and eat a balanced diet.

A Painful Let-Down Reflex

Hard, swollen breasts, sore nipples, and an overabundant milk supply are known to cause pain during let-down. Shooting pains through your breast could be a sign of thrush. Uterine contractions can also be strong and very uncomfortable, especially in the first week or so after your baby is born.

What You Can if Let-Down Is Painful

A painful let-down can make breastfeeding unpleasant, and can lead to nursing less often, a low milk supply, and early weaning.

Here's what you can do if you have a painful let-down:

  • Treat sore nipples, engorgement, or an overabundant milk supply.
  • Call your doctor if you think you have developed thrush.
  • Ask the doctor if you can take a pain reliever such as acetaminophen or ibuprofen.

A Strong or Hyperactive Let-Down Reflex

If you have a strong or hyperactive let-down reflex, it can cause your baby to gag, choke, and cough during feedings. The baby may swallow a lot of air as he gulps down your breast milk to and tries tto keep up with the very fast flow. Taking in all that air can lead to gassiness and fussiness. The baby may also gain weight very quickly and show signs of colic.

Mothers with hyperactive let-down often have an overabundant milk supply as well.

What To Do if You Have a Hyperactive Let-Down Reflex

  • Express some milk before nursing. Allow the first let-down to pass before putting your baby to the breast.
  • Try the laid-back nursing position. Lie back and place the baby on top of you so that the baby is sucking against gravity. This may help slow the flow.
  • Burp the baby during and after each feeding to help bring up any air that was swallowed.
  • Breastfeed from only one side each feeding.
  • If the baby begins to choke or gag, take her off the breast, remove some more milk and try again.
  • Treat an overabundant milk supply.

Pumping and Your Let-Down Reflex

Many women need to pump breast milk because they are returning to work, or they have a child in the hospital. The stress of having a sick or premature infant, feeling rushed while pumping, or pumping in an uncomfortable environment can interfere with let-down and your milk supply.

What You Can Do To Stimulate Let-Down if You're Pumping

To help you relax and get the milk flowing, here are some tips:

  • Go to a quiet, private area to pump.
  • Try to get comfortable and relax.
  • Look at a picture or watch a video of your baby while you pump.
  • Listen to a recording of your baby cooing or crying.
  • Hold and smell a piece of your baby's clothing.
  • For moms of preemies or hospitalized children, spending time engaged in kangaroo care with your little one can help you pump more milk.


American Academy of Pediatrics. New Mother’s Guide To Breastfeeding. Bantam Books. New York. 2011.

Lawrence, Ruth A., MD, Lawrence, Robert M., MD. Breastfeeding A Guide For The Medical Profession Sixth Edition.  Mosby. Philadelphia. 2005.

Newman, Jack, MD, Pitman, Theresa. The Ultimate Breastfeeding Book of Answers. Three Rivers Press. New York. 2006.

Sears, James M. Breast Infection-Yeast? Ask Dr. 2013. Accessed January 14, 2013:

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