Coping with a Forceful Letdown

#breastfeeding Jan 15, 2024

Are you and your baby struggling with a fast letdown? The medical term for a fast letdown is an overactive milk ejection reflex. This occurs when you experience a very forceful letdown of a large volume of milk that is often too great for a small infant to handle. Mothers with a fast letdown often report that their baby will begin pulling off, coughing or sputtering, and will have a difficult time latching. Meanwhile, milk may begin spraying onto baby’s face or chest or mom’s arm while the milk continues letting down. Typically, a forceful letdown only occurs with the first letdown, but it’s possible to happen multiple times in one breastfeeding session.

Usually, an overactive letdown reflex is indicative of an ongoing issue with oversupply, although not always. Over time, a fast letdown may result in gassiness and an upset tummy due to increased air intake while breastfeeding. In addition, a poor latch increases the risk of nipple breakdown, supply issues, and poor milk intake. If you think you have a fast letdown and are struggling with breastfeeding, it’s important to address it and get the help you need to get you and your baby on track towards a successful breastfeeding journey.

There are a few things you can do to help manage a fast letdown.

First, try feeding in a reclined or laid back position. This allows gravity to work to your advantage, helping your baby to more easily handle the flow of milk.
Second, you can try pumping off the first letdown with a milk collector like a haaka or a hand pump. This will remove some of the initial large volume of milk to avoid a forceful spray of milk at the start of the feeding.

Especially if oversupply is involved, pumping should be as minimal as possible and shouldn’t be used as a long term solution as this will likely just prolong the issue. In the meantime, work on managing your oversupply and you will likely experience some relief in your forceful letdown as your supply regulates.

It’s more common for younger babies to struggle with the effects of a fast letdown. Issues with a fast letdown are often temporary as your baby grows and is better able to manage a faster flow of milk. Remember to stay in communication with your baby’s provider with any concerns and to monitor your baby’s weight and intake. If you’re continuing to struggle with breastfeeding or new problems are cropping up, reach out for help from a trained lactation specialist for more assistance. You got this, mama!