What is an Overactive Let-down?

Does your baby gag, choke, gasp, or even cough while nursing?  Maybe your baby is pulling off your breast during a feed or making a clicking sound when they are nursing?  Are they quite often gassy and spitting up?  If any of this sounds familiar to you, you may have what is called an overactive let-down reflex.

Breastfeeding can definitely come with its challenges and one that exists for some mamas, is an overactive let-down or fast flow.  Often these mamas have lots of breast milk as well (oversupply), making it hard for their baby to breastfeed without some degree of difficulty.

So, what is an overactive let-down? 

This is when milk is ejected forcefully from the breast in great quantities.  If this overactive let-down is happening early in the feeding, the baby may swallow air and be consuming too much foremilk in proportion to hindmilk.  The foremilk is watery, and when baby fills up on this, they may get a stomach ache from the combination of filling their stomach too fast, swallowing a lot of air to keep up with the fast let-down, and the laxative effect of a large amount of lactose.  This can be quite uncomfortable for babies, not to mention the forceful spray of milk that they are getting their way!  This can be so upsetting for some that they refuse the breast or go on a nursing strike.

What can you do to help your baby with an overactive let-down?

Trying different nursing positions (even when baby is only a few weeks old) can help.  You want your baby to be nursing in an “uphill” position from the breast.  This ensures that gravity will be working against your milk flow.  Positions that seem to work the best, are when baby’s head and throat are higher than the level of mom’s nipple.

Some examples of this are mom leaning back with baby in a cradle hold position or mom lying reclined with baby on top facing down (tummy to tummy with mom).  With mom lying reclined and baby facing down, baby would be able to control their head and come off the breast if the milk is ejecting too forcefully.  Lying beside your baby to nurse is not out of the question, if you are finding other positions too difficult.  When baby is lying on their side, extra milk can dribble out of their mouth if it’s hard for them to keep up with the flow of the milk.

Burping your baby more frequently can also help with baby’s discomfort because of the large amount of air they may swallowing.

Catching the overflow in a clean cloth is also an option.  In order to do so, you would nurse your baby until the let-down begins and than take baby off your breast to catch this overflow in a clean cloth.  Once you notice the flow of milk slow down, you can latch baby back on to the breast to continue nursing.

There are also ways you can adjust your milk supply down to what your baby needs, but there are  certain times (approximately the first 4-6 weeks postpartum), that it’s best not to do this.  During these weeks, your body should be producing an increasing milk supply for your baby.

A lot of moms with an overactive let-down (and potentially oversupply) do find that approximately around 3 months postpartum (can be a little sooner or later), their overactive let-down and oversupply do become less intense.  This is all due to hormonal changes making a mom’s milk supply more balanced!

If you are feeling as though you need help managing your milk supply or adjusting your milk supply down to baby’s needs, we can help!  Reach out to The Mama Coach nearest you!  We are here to help you with any feeding issues and support you along your journey!


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