What exactly is an overactive/forceful letdown? How can a mother breastfeed when dealing with this condition?
Firstly let’s go back to the basics, what is a letdown? Letdown is when the milk starts to flow into the baby’s mouth after the baby has been suckling at the breast.
The hormone prolactin tells the milk glands in the mother’s breasts to make more breast milk, and the hormone oxytocin is responsible for getting the breast milk from the mother’s breasts to her baby, which is a letdown.
So what exactly is an overactive letdown?
When the baby is latched to the mother’s breast and the milk flows faster than anticipated for the baby or if the milk flows faster than what a baby can regulate, it is termed as an overactive letdown. It can sometimes be an unpleasant experience for the baby. For example, if an adult is drinking a glass of water and someone taps the glass from below – unknown to the adult – it can cause the adult to choke and gag, the water can even get expelled from the nose. This is similar to what a baby experiences with mother’s overactive letdown.
Signs of an overactive letdown:
- Milk flows at a pace that is faster than what the baby can handle.
- Baby unlatches because of the faster flow of milk into its mouth.
- Milk may or may not continues to spray out after the baby unlatches.
- The baby is fussy at the breast and could be choking, gulping, pulling off the breast, tugging the breast, coughing or gasping.
- The baby is unable to establish a deep latch in spite of no anatomical issues in the baby.
- Baby latching-unlatching often during feeds.
- Baby unlatching and crying or getting irritated on breasts (some babies can experience aversion too).
- The baby may also experience painful and excessive gas, hiccuping or spitting up.
This may make the mother think that her milk doesn’t agree with her baby, but that’s generally not the case. It’s more about the fact that the baby can’t handle so much all at once.
What can be done about it?
- Stop/reduce consumption of galactagogues: Galactagogues are items that can lead to an increase in the mother’s milk supply. Examples of Galactagogues are methi seeds (fenugreek seeds)/saunf seeds (fennel seeds)/ methi leaves (fenugreek leaves)/ dill leaves/ shatavari/ excessive garlic etc. If you are consuming galactagogues, try to gradually cut it out as clearly the body is already making more than what the baby needs. Unregulated overactive letdown is not ideal as the baby can clamp the nipples to regulate the flow in turn causing clogged ducts, engorgement and subsequently mastitis, a form of infection.
- Hand express a bit of milk before latching the baby on Be cautious not to hand express too much, as this can make the problem worse (by tricking your body into thinking it needs to produce more milk).
- Release or detach your baby when you start to feel the overactive letdown:
Catch the first milk of the letdown in a towel or bottle (about 30 seconds), and then help your baby get re-latched. - Try laid-back nursing: Lean back as you would in a hospital bed and allow your baby to lay belly-to-belly with you for the feeding. Gravity will help slow the forcefulness of the letdown (This is also known as the biological nurturing position).
- Manually slow the flow of milk at the areola with your fingers. Use a scissors-hold, and “clamp” the areola at the beginning of the feeding to slow the letdown.
- Limit or avoid bottles. Babies are smart and know the difference between the breast and the bottle. They may associate feeding as less stressful with a bottle and become less interested in the breast. Managing the letdown will help ensure your baby continues to breastfeed directly at the breast itself.
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Disclaimer
We understand and acknowledge that parents and babies can be of various genders on a spectrum of LGBTQI+. Families come in diverse flavours. However, in our articles, for the sake of simplicity and convenience, we will be referring to the breastfeeding parent as the mother and using the female pronouns- ‘she’ and ‘her’ for babies. Babies can be nourished and nurtured in different ways and while we have used the terms breastfeeding and nursing, we recognize that parents can opt to chest feed or finger feed.
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