Forceful Milk Ejection Reflex aka Forceful Let-Down

What is it and what do we do about it?

Not every mom feels let-down, even ones that have a forceful let-down. If you do feel it, it probably feels kind of like pins and needles or a tingly feeling in your breasts. Even if you can’t feel it, it I can still be an issue for your baby. With a forceful let-down, or forceful milk ejection reflex, your breastmilk flows out rapidly, maybe even too rapidly for your baby.

Your let-down, or milk ejection reflex occurs within seconds and up to a couple minutes of baby starting to nurse. If you don’t get a pins and needles or tingly sensation when your let-down happens, you may notice some other clues that you’re experiencing let-down. Your other breast will also have let-down and milk will be coming out of that breast as well, probably pretty quickly if forceful let-down is suspected; you may even see it squirting out in a steady stream or it may be a very fast drip. So, that’s how you know for yourself. Now, you may also notice these signs in your baby that you’re experiencing milk let-down: a change in swallowing pattern to include a lot more swallowing, sometimes without baby stoping to take breath, baby choking or coughing, baby gulping, baby clamping your nipple or turning away, baby seeming agitated, or a very gassy or uncomfortable baby after nursing.

There’s a few things you can try to help with the issue. 1. Switch to a position in which you are reclined with your baby tummy-to-tummy with you and their head is above their bottom with their eyes above your nipple - think an uphill position. You can recline in the recliner and have baby almost in an up and down position to nurse. Gravity is working in baby’s favor here. 2. When you feel your milk let-down, or notice the signs, pull baby off your breast and let your milk squirt or drip into a bottle or burp cloth. When the milk flow has slowed after a minute or so, then let baby latch again.

You can work with a forceful milk ejection reflex. This doesn’t have to be an end to your breastfeeding relationship or the start of exclusively pumping. Try changing positions or pulling baby off the breast during let-down.

TL;DR - Forceful let-down, or forceful milk ejection reflex, kind of chokes your baby and makes them unhappy and uncomfortable, BUT it’s fixable. Try popping baby off your breast for a few seconds until your milk slows or try nursing in another position, like an ‘uphill’ nursing position.