What It Looks Like and What to Do

Have you heard of the milk ejection reflex when breastfeeding? Picture this: Your baby latches and begins to suck. You feel a little tingling, warm sensation in your breast, and your milk starts flowing, and the baby begins feeding. This process is called the milk ejection reflex, commonly known as your “letdown.”³ 

Letdowns vary in strength for breastfeeding moms. Some moms can even experience a more forceful or overactive letdown. When this occurs, breastfeeding may feel a bit more stressful, with an added challenge to overcome. Although an overactive letdown can make breastfeeding feel overwhelming, there are tips to help facilitate a successful breastfeeding relationship between mom and baby.

What is an Overactive Letdown?

An overactive letdown is the expression of breast milk in a large volume at a rapid rate. This occurs soon after the baby latches and begins suckling. The large influx of milk quickly becomes too much for your baby to handle.¹

Some moms may even experience pain related to an overactive letdown. Pain is never fun, but there is usually an end in sight for mothers experiencing an overactive letdown. Pain with a mother’s milk ejection reflex usually lasts about a month.³ In contrast, some moms will not feel any pain. For some, if they are pumping to express milk, they may not even notice the forceful letdown. However, when breastfeeding, the baby will likely show signs that will alert the mom.

Signs of an Overactive Letdown

Here are several signs you might see from your baby that indicate you may have an overactive letdown:

Unlatching

The baby may quickly pull off and can even seem to push off the breast soon after letdown occurs. The amount of milk your baby receives is too much for them.² You may even notice “spraying” of breast milk after the baby pulls off.

Fussiness

When the baby unlatches, you may notice crying and arching of their back, and they may even seem distressed. When your baby is this upset, it can make it difficult to latch again.⁴

Gulping or Choking

After letdown, you may hear your baby gulping down a large amount of breast milk and possibly start to choke.²

Feed Refusal

You may notice your baby showing signs of not wanting to feed when offered the breast. They may push the breast away or even turn their head away.

Many women who experience a forceful letdown also have an oversupply of breastmilk. The two are commonly associated, but it’s not always the case.⁴

What to Do if You Have an Overactive Letdown

The good news is that as babies grow, many can handle the large volume of milk they receive after letdown. As they get older, their feeding skills improve, but there are some methods to try that may help mom and baby breastfeed more comfortably until then.¹

Try a New Position

By simply trying a new breastfeeding position, you may be able to help your baby feed comfortably with the help of gravity. Two positions to try are semi-reclined when mom is laying on her back, slightly reclined when baby is placed on top of mom to feed, and upright when mom is in the upright position holding baby to her breast to feed. One way mom could do this is by sitting up and keeping the baby upright.^4,5

Stimulate the Letdown First

Use a breast pump, manual or electric, or hand express to stimulate your letdown. Once your milk begins flowing, latch your baby to your breast.¹

Release Letdown and Continue Feeding

Allow your baby to suckle at the breast until you feel your letdown. Then, quickly unlatch the baby, catch the letdown with a towel and let your baby latch and continue feeding.⁴

Use a Nipple Shield

Try using a nipple shield at the beginning of the feeding. The shield will help slow the flow of breast milk to your baby and allow them to feed more comfortably. After your letdown, remove the nipple shield and continue feeding. You will want to use this method cautiously, ensuring your baby can comfortably switch from the nipple shield and back to the breast.⁴

Let Your Baby Unlatch When Needed

Do not force your baby onto the breast; allow them to come off when needed.²

Try Compression on Your Breast

Compression on the breast can help you slow the milk flow by blocking milk ducts. Using your hand, you can compress the breast, helping decrease the forceful flow, and allowing the baby to manage the amount of milk they receive.⁵

Ask for Help

You can also get some help from a lactation consultant. They are very knowledgeable about all things breastfeeding. Together, you can work to find a plan to maintain a successful breastfeeding experience for both you and your baby.

A letdown can occur even when your baby is not at the breast. You could be at work thinking about your cutie pie, smelling your baby’s scent, or even hearing a baby cry. You never know what may trigger a letdown, but being prepared for “leaking” when out and about is always helpful, especially with a forceful letdown. Absorbent breast pads are a great idea if you think this may be a concern for you.⁴

An overactive and forceful letdown may feel overwhelming, mama, but it doesn’t mean the end of your breastfeeding journey! By giving yourself grace and lots of patience, you and your baby can try some methods to help you navigate this challenge and continue successfully breastfeeding. When you have questions or encounter a problem during breastfeeding, please reach out to a lactation consultant for further guidance and help.

Resources

1. Conaway, E. M. (2022). Troubleshooting Common Breastfeeding Difficulties. Osteopathic Family Physician, 14(2), 22–27.

2. https://www.hopkinsmedicine.org/health/

3. Wambach, K., & Riordan, J. (2016). Breastfeeding and human lactation. Jones & Bartlett Learning.

4. Wilson-Clay, B., & Hoover, K. (2017). The Breastfeeding Atlas (6th ed.). LactNews Press.

5. https://www.llli.org/