Overactive Letdown

Breastfeeding is a delicate balance – on the one hand you want to ensure your milk supply meets your baby’s needs and she’s able to suckle properly for adequate nourishment. On the other hand, sometimes overactive letdown and oversupply can become an issue that hinders your breastfeeding experience and causes some uncomfortable side effects for your baby.

Overactive letdown, also known as forceful letdown, occurs when your milk is forcefully ejected in great quantity early in a feeding to the point that your baby is overwhelmed by it. Your baby may immediately unlatch or clamp down on your breast to slow the flow of milk. She may also start to choke, gag, spit up, or swallow air that leads to gas and fussiness. In some cases babies refuse to nurse out of fear of the overactive letdown.

Overactive LetdownFor those moms who experience it, overactive letdown usually begins between three and six weeks once your mature milk is in and your milk supply is strong – in this case perhaps too strong. All the wonderful efforts you have made to increase your milk supply may lead to an oversupply, one of the most common causes of overactive letdown. Usually the issue naturally resolves by around three months because your body learns to adjust to your baby’s needs and your milk supply stabilizes.

In the mean time, there are several methods to control an overactive letdown and how it affects your baby. Most experts first recommend trying to position your baby to use gravity to her benefit. This means your baby will be more upright than sideways the fast flow of milk will more easily drain down her throat.

You can also try nursing your baby more frequently to avoid a larger build-up of milk in your breasts between feedings. If that doesn’t work, you can let your baby nurse until the letdown occurs, then remove her from the breast for a few minutes to allow the forceful ejection to occur (into a towel or cup) and then resume feeding. Or you can pump through the letdown and then begin feeding your baby. Another tactic is nursing when your baby is drowsy so she won’t suck as hard and hopefully the letdown will come slower and smoother.

If overactive letdown is still an issue, you may need to address the root cause, your oversupply of breast milk. It’s important to first note that trying to decrease an oversupply of milk should not be attempted in the first month of breastfeeding as it may backfire and lead to low milk supply.

Pumping may seem like the obvious solution to oversupply but pumping may actually increase your milk supply. Experts suggest two methods. The first is simply switching sides frequently during a feeding. However, one issue with this method (which also may be true of the entire issue of overactive letdown): your baby is primarily getting foremilk and not the valuable fatty hind milk.

The other method is block feeding. In this scenario moms will feed from only one breast for a period of time and then switch to the other breast for the next block of time. This allows one breast to drain fully and letdowns are not as forceful. Of course the other breast may then be rather full so you can pump it until you are comfortable, trying to pump less and less day-by-day. Cold compresses between feedings may also restrict milk supply but be careful not to cause plugged ducts and engorgement.

The delicate balance of your milk supply can be challenging to say the least. Overactive letdown is a temporary issue, though. With the right combination of solutions and handling the problem in stride, you and your baby will find this balance.

Sources: Kelly Mom, La Leche League and Mama Natural