Is your breastmilk flowing out too quickly and forcefully for baby to handle? Our tips for identifying and managing forceful or overactive letdown can help make breastfeeding more enjoyable for your little one.
If you’re breastfeeding and feel like your milk is flowing out too quickly for your little one, you may wonder if you have a forceful or overactive letdown. If you do, the good news is that this is common, so you’re not alone – and there are several ways to manage it.
Forceful or overactive letdown most commonly occurs between 4 and 6 weeks after giving birth, although it could start at any time and continue through, or past, baby’s second month of life. It often happens when you have an especially abundant milk supply – much more than your baby needs – but that isn’t always the case. Here’s how to identify, and act to slow, forceful or overactive letdown.
Signs of forceful or overactive letdown
If baby can’t handle the speed and intensity of your milk flow, you likely have a forceful letdown. Here are some signs that your letdown is too forceful for baby to handle:
- Baby gags or chokes during a feed
- Baby often coughs, gasps, or sputters during a feed
- Baby gulps or squeals several times as they nurse
- Baby often hiccups or spits up after a feed
- Baby makes a clicking sound during nursing
- Baby tugs or pulls at your breast or nipple
- Baby refuses the breast when you offer it
- Baby stops nursing suddenly and pushes away after only a minute or two
- Baby is excessively fussy during a feed
- Baby is gassy, in addition to other signs above
- You’ve noticed you have an oversupply of milk and you notice any of the above baby behaviors
- You have nipple pain and you notice any of the above symptoms. Baby might bite down hard on your nipple to combat the fast flow of milk.
There are other reasons why baby may exhibit these symptoms. Baby may not have the proper latch on your breast, may not be in the best feeding position for their and your needs, or may have a tongue-tie. Or, you may have waited too long to feed baby. A lactation consultant can help you determine if you have forceful letdown.
Learn more about how to manage a forceful letdown from lactation consultant Natalie Marcus:
How to manage overactive letdown
Noticed signs of overactive letdown and suspect that this forceful milk flow is the cause? Here’s how to slow down your flow, plus other ways to make things easier for baby:
Try the laid-back nursing position, where you lean back a little on a bed, sofa, or comfortable chair so you’re reclined a bit. Place baby’s tummy against yours, support their head with your elbow and their back with your forearm and let them nurse. This position helps slow down your flow because you’re using gravity to your advantage – the milk won’t flow down as strongly, as gravity pulls the milk towards your chest rather than towards your nipple.
Hand-express first. Hand-expressing some milk at letdown, before feeding your little one, can help slow down the flow once your little one starts nursing.
Catch the milk when let-down starts. Have a towel ready. Let baby nurse for about 30 seconds to a minute, until you feel your letdown kicking in. Then, quickly remove baby from the breast by gently sticking your finger in the side of their mouth and turning them away from the nipple. Catch your milk with the towel, or use a breast milk bag (or special milk saving device) if you want to save the milk for later. Once you feel your letdown slowing, let baby continue nursing.
Pump sparingly. While pumping’s helpful for unclogging milk ducts and relieving over-engorged breasts, it also signals your body to produce more milk – which can worsen a forceful letdown. So, it’s best to pump for only a short time before nursing, and only pump when you absolutely need to (say, when you’re away from baby). If you’ve tried other strategies to relieve letdown and baby still doesn’t want to nurse, you could try pumping during letdown. But only use this as a last resort.
Use your hands to slow the flow. There are a few ways to do this. You could press your hand into the side of your breast during your letdown. You could also hold your areola between your index finger and middle finger (like it’s in the middle of “scissors” from rock-paper-scissors) and squeeze your areola.
Try feeding more often, but with a shorter duration of each feed. This may help slow down the flow at each feed, since it gives your milk less time to build up.
Let baby stop and start as needed. If baby needs a break from the breast, let them stop for a moment and choose when they’re ready to resume. Burp baby when they want a break, as overactive letdown can sometimes lead them to swallow more air and become more gassy.
Don’t fall back on the bottle too often. When you have overactive letdown and you give baby bottles too often, they may learn that the bottle flow is easier to manage than the flow from your breast. If this happens, it will make baby more likely to prefer the bottle over the breast – and baby may develop nipple confusion and start refusing the breast altogether.
Seek help from other moms who’ve been there. For example, you could find La Leche League meetings, a free resource that any mom can attend. Or, you could join another breastfeeding meet-up (or seek out an online group of breastfeeding moms). There, you might find other moms who had similar letdown issues, who might tell you about strategies that worked for them.
Talk to a lactation consultant. If you’ve tried several different strategies to manage overactive letdown, but you’re still struggling, a lactation consultant can help. They might closely guide you through different approaches to manage overactive letdown, at the same time as you use them with baby, to help you find a strategy that works for you. Or, they might find that what you thought was overactive letdown can be traced back to something else
Try a nipple shield if a lactation consultant recommends it. Nipple shields hold back fast bursts of milk when you apply them correctly. This way, baby won’t be overwhelmed by overactive letdown. But use the shields carefully, and only with a lactation consultant’s guidance. Since they go over the nipple, there’s the risk that baby could develop nipple confusion, or that your milk supply could drop, if you use shields for too long.
Try “block feeding” with a lactation consultant’s guidance. Block feeding means only giving baby one breast to nurse on during a given feeding, or during a given amount of time (say, three to four hours). This may help baby out, as they won’t have to deal with a rapid letdown twice in a feeding – and as your breast empties, the milk won’t flow out as quickly. Also, since you won’t be stimulating milk production in both breasts at once, it may help you manage oversupply as well. But you should only try this strategy if a lactation consultant suggests it or gives you the OK. After all, if you don’t use block feeding correctly, it could lead to a compromised milk supply or mastitis.
Wait it out. As baby matures, they might learn how to latch to adapt to your fast flow, and their signs of discomfort will disappear. Or, your flow might just balance out on its own. If the overactive letdown continues to cause discomfort, though, don’t hesitate to reach out to a lactation consultant.
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