Nursing mothers may occasionally encounter situations when they try to nurse their babies but are puzzled by their behaviour. The babies may seem to cough, choke, gasp or gulp excessively while swallowing, they may try to pull back from the breast or tug hard on the nipple, they may cry a lot and refuse to nurse, pass a lot of gas and often spit up the milk.
The milk may be dribbling down the baby’s mouth and also leaking excessively from the nipples. If you are going through any of these symptoms, then you may be having an overactive letdown reflex.
What Is Overactive Let-Down Reflex?
The let-down reflex is a natural process of the milk dropping lower in the breast so that it can easily flow from the nipple to the baby’s mouth. It means that the muscle tissues around the milk-producing cells that make and store milk are contracting and releasing their contents. This contraction propels the milk down the milk ducts to the openings in the nipple so that the baby is fed. This is a normal reaction to your baby’s suckling and the resultant stimulation of your nipples; it typically occurs within a minute or two of a feeding session.
Overactive let-down or forceful let-down occurs when the breast milk is released too fast, forcefully and in large volumes.
It is important to note that overactive let-down is different from an oversupply of milk. This refers to how fast the milk comes out with regard to the speed of milk and not the volume. Although sometimes an overactive let-down can be a by-product of oversupply of milk, it is common for excessive milk to flow very fast.
Causes Of Overactive Let-Down
The let-down reflex is generally dependent on the production of the hormone oxytocin. The excessive let-down may probably be due to an abnormally strong reaction to this hormone.
When your baby latches on to your breast and starts to suckle, nerves in your nipple are triggered and a signal is sent to your brain to release the two hormones: prolactin and oxytocin. Prolactin acts on the milk-making tissues in your breasts and is thus responsible for the production of breast milk. Oxytocin causes your breast milk to leave the ducts thus enabling the ‘let-down’ of the milk to your baby. Oxytocin also causes the milk ducts to widen and makes it easier for the milk to flow through your nipple to the baby’s mouth.
Remedies For Overactive Let-Down
It is important to remember that your body takes time to get adjusted to the needs of your baby. As this happens, improvement may be observed within a few days. As your baby starts drinking more aggressively, there will be a normalization of the milk flow.
In the meantime, here are some things you can do to manage an overactive let-down:
- Check The Latch Of The Baby
Being latched well to the breast will help the baby to be in better in control of the flow of the milk.
- Nurse In Different Positions
The most effective positions are those where the baby’s head and throat are above the level of your nipple.
You can also try these different positions:
- Semi-Reclined Position:
In this position, your baby is placed on your chest facing you. Either a reclining chair can be used or pillows can be placed behind you for support. By using this position, your baby’s tongue will be able to latch on to your breast better.
- Laid-Back Position:
In this position, your baby is placed on top of you so that you both are facing belly to belly. By using this position, your baby is nursing uphill in relation to your breast. This works against gravity, therefore slowing the flow of milk into the baby’s mouth.
- Side-Lying Position:
In this position, you lie down on your side and bring your baby close, facing your breast, with a supporting hand behind the baby’s neck and shoulder blades. By using this position, it is easier for your baby to pull away from the breast while the flow is fast and then latch back on, hence helping the baby be more in control of the flow. In this way, excess milk can also easily dribble out of both the breast and the side of the baby’s mouth.
- Unlatch Your Baby:
A great way to ease your baby’s discomfort is to take the baby off the breast. Unlatch your baby when let-down occurs and catch/remove the overflowing milk in a container or towel until it slows. This can also be done when your baby begins to choke or a cough. Once let-down is complete, re-latch baby and continue nursing.
- Burp Baby Frequently:
As your baby gulps and pulls off from the breast during feeds, there may be an excessive swallowing of air which can cause more discomfort to the baby. Burp your baby multiple times during and after each feed, to help bring up any swallowed air and reduce the amount of spit-up and fussiness.
- Nurse More Frequently
Nursing your baby more often will help reduce the amount of milk that accumulates between feeds, and also decrease the amount of milk your baby drinks at each feed. Less milk in the breasts will lead to the flow of milk typically being slower. Thus feeding more often will make nursing more manageable for the baby.
- Get Professional Help
Seek the help of your doctor to plan and select the best way to deal with an overactive let-down.
An overactive let-down can make the nursing experience distressing for both the mother and the baby. It does not last for a long time and can be dealt with effectively. Do not let it prevent your baby and you from enjoying this nurturing experience.