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Baby and toddler

Let-down

The milk ejection reflex: when a baby nurses, the hormone oxytocin makes the breast squeeze milk out through the ducts so the baby can drink it.

What It Means

Let-down is the reflex that moves breast milk out toward the nipple during a feed. When a baby sucks, levels of the hormone oxytocin go up, and that makes small muscles in the breast squeeze milk along the milk ducts. The Office on Women's Health (OWH) calls it the let-down reflex or the milk ejection reflex, and says it usually begins somewhere between a few seconds and several minutes into a feed and can happen more than once before the feed ends.

Try It: Check What Might Be Slowing Your Let-Down

Tick anything that's true for you today. Every item is on the Office on Women's Health list of things that can affect let-down.

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Nothing from the list today. Let-down can still take from a few seconds to several minutes to start.

Had breast surgery? OWH says nerve damage from it can interfere with let-down, so mention it to your doctor.

How Parents Say It

  • "I get this tingle right when my milk lets down."
  • "She pulls off coughing every time the let-down hits."
  • "Someone else's baby cried at the store and I started leaking."

The Breakdown

Let-down by moment and by stage, per the Office on Women's Health

WhenWhat happens
Start of a feedLet-down begins a few seconds to several minutes after the baby starts nursingBreastfeedingFeeding a baby milk directly from the breast. The AAP recommends breast milk alone for about the first 6 months, then alongside solid foods. See more
Later in the same feedIt can happen a few more times
Away from a feedHearing your baby cry, or simply thinking about your baby, can set it off
About 3 to 5 days after birthMature milk replaces colostrum, and breasts may feel full and leak
First 4 to 6 weeksBreasts may become softer and leaking may slow down

What it can feel like. OWH says some parents feel a tingle, some feel a little uncomfortable, and some feel nothing at all.

If it comes as a gush. When milk lets down so fast that it bothers your baby, OWH suggests hand expressing a little milk before the baby latches.

When to talk to someone. If you're worried your baby isn't getting enough milk, call your baby's doctor; OWH says wet diapers and weight gain are how you can tell. A lactation consultant can watch a feed and help with a let-down that seems slow. Cleveland Clinic describes a condition called dysphoric milk ejection reflex (D-MER), in which a wave of sadness or other negative feeling arrives with let-down, and notes one study's estimate that 5% to 9% of lactating women have it. Tell your doctor or midwife if that sounds like you.

Good to Know

OWH lists the things that can affect let-down: anxiety, stress, pain, embarrassment, cold, too much caffeine, alcohol, smoking and some medicines. It also says nerve damage from past breast surgery can interfere with it, so tell your doctor if you've had surgery on your breasts. For low moods after birth, the National Maternal Mental Health Hotline from HRSA is free and confidential, 24/7, by call or text at 1-833-TLC-MAMA (1-833-852-6262). Call or text 988 in a crisis, and call 911 in an emergency.

FAQ

What does let-down feel like?

The Office on Women's Health says you might notice a tingling in the breast or mild discomfort. You also may not feel anything, and milk can still be flowing.

Why does my milk let down when I hear a baby cry?

OWH says let-down can happen away from a feed, for example at the sound of your baby crying, or just from thinking about your baby. Breast pads in your bra can catch the leaks.

What can slow down let-down?

OWH lists anxiety, stress, pain, embarrassment, cold, too much caffeine, alcohol, smoking and some medicines, plus nerve damage from breast surgery. A lactation consultant or your doctor can help if let-down seems slow.

Do It in Buhata

Notes (Premium)

Jot down in Notes (Premium) in Buhata what was going on at feeds when let-down felt slow, and bring the list to your lactation consultant or doctor.

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Related Terms and Categories

  • Breastfeeding

    Feeding a baby milk directly from the breast. The AAP recommends breast milk alone for about the first 6 months, then alongside solid foods.

  • Milk supply

    How much breast milk a parent's body makes. It's driven by supply and demand: the more often milk is removed, the more the body makes.

  • Engorgement

    Breasts that become overfull, swollen, firm and sore because milk and fluid build up faster than they're removed, as when feeds are missed.

  • Pumping schedule

    A plan for when and how often to express breast milk with a pump, usually matched to how often the baby would otherwise feed.

  • Cluster feeding

    When a baby wants several feeds close together over a few hours, often in the evening, instead of feeding at spaced-out times.

Baby and toddler

Sources

Office on Women's Health (HHS), "Making breastmilk"; Cleveland Clinic, "Dysphoric Milk Ejection Reflex (D-MER)"; HRSA Maternal and Child Health Bureau, "National Maternal Mental Health Hotline"

Last updated .