A let down refers to the release of breast milk from the breast during breastfeeding. It is a normal part of the breastfeeding process and allows the baby to get milk from the breast. There are several factors that affect how long it takes to get a let down, including the mother’s relaxation, hormones, and breastfeeding frequency. Generally, let down occurs within the first few minutes of breastfeeding, though it may take longer initially or under certain circumstances. Being patient and using techniques to encourage let down can help if it is taking longer than normal.
What is a let down?
A let down, also called a milk ejection reflex or milk let down, is when breast milk starts to flow from the breast during breastfeeding or pumping. It occurs due to a release of hormones, mainly oxytocin, which cause the milk ducts and alveoli in the breasts to contract and push milk out towards the nipples. This allows the baby to get the breast milk.
Letting down and releasing breast milk is a normal part of the breastfeeding process. It allows the baby to get the breast milk they need during a feeding. Some signs that let down has occurred include:
– Feeling a tingling, pins and needles sensation in the breast
– Leaking or dripping milk from the breast
– Hearing an audible gulp or swallowing sound from the baby
– Seeing milk drips or sprays from the breast
– Breasts feeling softer or less full
How long does it take to get a let down?
The time it takes to get a let down can vary, but often it occurs within the first 1-2 minutes once the baby starts suckling or breast stimulation begins. However, it may take a bit longer, up to 5 minutes in some cases. Factors that influence let down timing include:
– **Relaxation** – Being tense or stressed can inhibit let down. Relaxing and doing breast massage/warm compresses helps.
– **Hormones** – Oxytocin is key for let down. Conditions like hypothyroidism or hormonal birth control may affect oxytocin levels.
– **Breastfeeding frequency** – The more often breasts are stimulated, the quicker let down occurs. In newborns, it may take longer.
– **Milk supply** – Let down may be faster when milk supply is abundant vs just starting or declining.
– **Distractions** – Tuning into sensations in the breast and baby helps, while distraction can delay it.
– **History of breast surgery** – Procedures like breast reduction/augmentation may affect nerve pathways and milk ejection.
Generally, let down happens quickest when a mother is relaxed, tuned into her baby, and has an established breastfeeding routine. It may take a few minutes longer for a new breastfeeding mom in the first few days or weeks.
Techniques to help encourage let down
If let down is taking longer than usual or not happening, there are several techniques that may help encourage it:
– **Massage breasts** – Stroke from chest area towards nipples and express some milk manually. This mimics baby’s sucking.
– **Use warmth** – Apply a warm compress or soak breasts in warm water to help stimulate milk flow.
– **Express milk** – Use a breast pump or hand express for a few minutes before nursing to trigger let down.
– **Switch nursing positions** – Try laid-back/biological nurturing position to utilize gravity.
– **Listen to relaxing music** – Play soothing music and meditate to reduce stress.
– **Look at your baby** – Make eye contact and focus on them to boost oxytocin. Skin-to-skin helps too.
– **Gently rub nipples** – Light nipple stimulation can help elicit let down.
– **Avoid distractions** – Minimize TV, phones, etc. and tune into breast sensations.
– **Stay hydrated** – Drink plenty of fluids to support milk production.
– **Pump after feeding** – Pumping for 5-10 mins after can fully drain breasts and train let down.
Being patient is also key, as forcing let down can have the opposite effect. If challenges persist, seeing an IBCLC or doctor may help determine if other factors are inhibiting let down.
When to worry about let down timing
In most cases, let down occurring after a few minutes of nursing or pumping is completely normal and provides baby with the milk they need. However, if let down is consistently taking longer than 5-10 minutes or not happening at all, that warrants discussing with a lactation consultant.
Prolonged let down could indicate:
– Anatomical variations – Hypoplastic milk ducts, tubular breasts, etc.
– Hormonal or thyroid problems – Hypothyroidism, hormonal imbalances, etc.
– Breast surgery effects – Nerve damage from incisions can inhibit let down.
– Retained placenta – Remnants left in uterus may release prostaglandins inhibiting oxytocin.
– Birth control – Methods with estrogen/progesterone can interfere with milk supply.
– Stress and anxiety – Chronic tension makes let down difficult.
– Rare conditions – Pituitary disorders, Sheehan’s syndrome, etc.
– Past breast trauma or injuries – May have impacted nerves and milk ejection.
If let down is inconsistent or taking very long, interventions like medication, pumping regimes, and galactagogues may help improve milk flow. But an IBCLC can best assess for underlying causes and work with a mom to develop a treatment plan if needed.
Does let down mean baby is getting enough milk?
Letting down is an important part of breastfeeding, but it does not automatically mean the baby is transferring enough milk overall or getting enough during feedings. Some other signs to look for:
– **Baby’s weight gain** – Adequate weight gain indicates sufficient milk intake. Recommended is 20-30 grams per day in first months.
– **Dirty diapers** – Regular, heavy wet diapers and frequent stools show baby is getting milk and digesting it.
– **Swallows heard** – Audible swallowing sounds during feeding is a good sign of milk transfer.
– **Changes in breast fullness** – Breasts feeling fuller before feedings and softer after is another positive indication.
– **Nursing duration** – Baby contently feeding for 10-30 minutes is reasonable. Short feeds may be insufficient.
– **Satisfied after feeding** – Baby seems calm and content after time at the breast.
So while let down is important, also monitor these additional cues of milk intake. If concerned about supply, an IBCLC can do a weighted feed to measure milk transfer. Moms can also track diapers and know when to feed baby based on hunger cues.
Tips for troubleshooting delayed or inconsistent let down
If let down is routinely taking longer than expected or is sporadic, here are some tips that may help:
– **Nurse or pump more frequently** – 8-12 times in 24 hours helps maintain milk supply and quicker let downs.
– **Ensure proper flange fit** – For pumping, use correctly sized breast shield flanges for optimal stimulation.
– **Limit caffeine** – Caffeine sensitizes receptors that trigger let down, so avoid excess intake. 1-2 cups daily is ok.
– **Try power pumping** – Pump for 10-15 minutes, rest 10 minutes, repeat 2 more cycles to mimic cluster feeding.
– **Minimize stress** – Do relaxing exercises, get support, and carve out me-time.
– **Discuss medications** – Certain medications like pseudoephedrine, estrogen birth control, etc. can affect let down.
– **Supplement with galactagogues** – Herbs like fenugreek, fennel, and blessed thistle may support milk ejection.
– **Consider prescription options** – Medications like domperidone and metoclopramide enhance let down.
– **Practice switch nursing** – Swap breasts frequently so each breast gets stimulated consistently.
– **Seek postpartum support** – Join lactation support groups and get qualified IBCLC help.
Consistency is key, so try to feed/pump at the same intervals daily. Tracking patterns may also reveal if let down correlates with certain times, breast fullness, or other factors.
When to call a doctor about let down issues
If the above techniques do not improve let down after a couple weeks, it’s a good idea to consult a doctor or lactation consultant. They can help identify any underlying issues interfering with milk ejection reflex and provide targeted solutions.
See a doctor or IBCLC if:
– Let down is inconsistent or taking over 10 minutes routinely
– Let down is not happening at all during feedings
– Breasts never feel full or soft after nursing
– Baby seems unsatisfied, fussy at breast or has slow weight gain
– Normal interventions like massage, relaxation techniques don’t help
– Mother has hormonal disorders, Sheehan’s syndrome, breast hypoplasia/IGF, etc.
– Mother is taking medications known to impact milk supply
– Other red flag symptoms are present
A doctor can check for hormonal imbalances or other health conditions that may be inhibiting let down. Prescription medications like domperidone may be recommended in some cases. An IBCLC can observe breastfeeding sessions and provide individualized troubleshooting. Ongoing monitoring of weight gain, milk transfer, and diaries tracking patterns is key.
How pumps can help stimulate let down
Using a breast pump is another technique that can encourage and train let down. Pumps help stimulate milk ejection in various ways:
– **Creates suction rhythm** – Mimics baby’s suck-and-swallow pattern.
– **Provides tactile stimulation** – Massaging and compression from pump parts.
– **Allows nipple conditioning** – Draws nipple back and forth to elicit reflex.
– **Aids milk removal** – Draining breasts regularly keeps supply active.
– **Offers control over variables** – Can adjust suction strength, speed, etc.
Some tips for using pumps to improve let down response:
– Begin on lower suction setting then increase as let down starts
– Massage breasts before and during pumping
– Visualize milk flowing or look at baby photos
– Lean forward to utilize gravity
– Power pump after feedings to fully empty breasts
– Try different size flanges to ensure proper fit
– Use warm compress before and during pumping
– Listen to calming music and do deep breathing
– Ensure flanges are centered on nipples
Being patient and keeping pumping sessions relaxed, while using multiple techniques simultaneously, can help get the most benefit from pumping for let down training.
Conclusion
Let down is a normal part of breastfeeding that allows milk to flow from the breast to nourish baby. Though timing varies, it typically occurs within the first few minutes once stimulation begins. Being patient, practicing relaxation techniques, ensuring frequent breast emptying, and getting professional lactation support can help if let down is slower than expected or inconsistent. Paying attention to other signs of milk transfer beyond let down is key as well. With consistency and a full milk supply, most mothers can achieve a let down response that provides their baby with the breast milk needed to grow and thrive.
