Updated August 12th 2023
Have you ever felt a tingling sensation in your breast while your baby is feeding or you are pumping? This sensation begins a few seconds after your nipples are stimulated and you feel it within the breast. You might wonder what’s going on, why you’re feeling it and why it’s happening at every single feeding.
This “pins and needles” feeling is your letdown reflex. The letdown reflex happens when your milk starts flowing. Many describe it as a tingling sensation, feeling similar to “pins and needles” like when your arm falls asleep or feeling a warmth in your breast. It is triggered by the hormone oxytocin. Oxytocin is also called the “love hormone”. This hormones is not only responsible for your letdown but also fosters bonding and reduces the size of your uterus after birth.
Oxytocin is released when your baby suckles at breast or when your pump turns on and the suction starts. It’s also triggered when you hear your baby cry or look at pictures of your baby (the reason you can let-down without your baby being on your breast!). It’s also released during orgasm so not uncommon to spray some milk then too.
Oxytocin causes the muscles around the milk sacs inside the breast to squeeze (contract) which effectively pushes out (ejects) the milk from the nipple. This can create a tingling sensation. Your letdown reflex is also known as the Milk Ejection Reflex.
When this happens, your baby isn’t actually sucking the milk out but rather working with your body and your let-down to remove the milk. They do this by creating a vacuum inside their mouth to effectively remove the milk as your body is helping by pushing it out. When there are challenges with latching, this can affect their ability to create a vacuum and effectively empty the breast. If you’re not sure if your baby’s latch is optimal, check out this post I wrote about 4 Signs Your Baby’s Latch Might Not Be Ideal.
Some have described feeling a warming sensation when letdown happens and some have described never feeling it and for some it’s painful or uncomfortable. Some women feel only one letdown during a feeding while often more than one happens.
What if you don’t feel your letdown?
This is completely normal as not everyone feels it. Your milk is still likely flowing and the best way to determine this if your baby is nursing is to watch them while they feed. Watch your baby for swallowing.
To watch your baby for swallowing, you want to be looking at their jawline from their chin up to their ears. When your baby swallows milk, you will see their chin drop down (lower than when they are sucking) and pause for a brief moment. This pause is a swallow. Depending how old your baby is, you may also be able to hear your baby swallowing. Hearing them swallow sounds like a soft “kah” sound.
What if my let-down hurts?
If you’re feeling pain with a let-down you first want to rule out any underlying issues with a lactation consultant (IBCLC).
Things that can block oxytocin can impact let-down
There are several factors that can interfere with oxytocin and therefore your milk letdown. This may translate into challenges with pumping or nursing. Pain, anxiety, fear, stress and fatigue can block and interfere with oxytocin. This is why it’s important to feel comfortable, relaxed and pain free while nursing or pumping.
Do you need to find a different room to nurse or pump in to feel more comfortable? Are you experiencing pain with latching or pumping? Are you worried about how much milk you’re producing? All of these can impact your body’s ability to let the milk flow.
How you can support having a letdown
If you’re pumping and you don’t start to see the milk flowing or you’re nursing your baby and you’re noticing they are frustrated or not swallowing, connect with a lactation consultant to help you rule out something else that might be going on.
If it’s related to your milk not letting down due to anxiety, pain or stress blocking oxytocin, you can try a few of the following techniques:
- Find the root cause of the pain and address it with a lactation consultant
- Hand express or massage your breasts before baby latches to encourage a let down
- Back rubs stimulate nerves that serve the breasts (central part of the spine), these too can help so ask your partner for some support on this one or find a Registered Massage Therapist trained to support those who are lactating
- Increase skin to skin holding time with your baby and relax together for at least 30 minutes everyday
- Take a warm bath/feed in the bathtub (if you have one) or pump after having a relaxing bath
- I also like suggesting a version of the box breathing technique to my clients. Breathe in for 4 seconds, hold for 4 and exhale for 6. You can do this anytime during the day where you’re feeling overwhelmed
- Laugh – watch a funny show or listen to a funny podcast. Laughter will help the oxytocin flow
Intense negative feelings with let-down
There are people who experience a wave of intense negative emotions when their milk begins to flow. This is known as dysphoric milk ejection reflex or D-MER. The feelings can range from sadness, despair, homesick, anger, irritability, anxiousness or a hollow feeling in the stomach. These feelings are often experienced in the 30-90 seconds before the milk begins to flow.
D-MER can be experienced at breast feedings or when pumping. Those with D-MER feel fine prior to let-down and fine after the let-down.
To learn more about D-MER and how to manage it (as well as find helpful resources) visit https://d-mer.org/understanding-d-mer
Your let-down reflex can also change overtime. It may start off feeling more intense on those early newborn weeks and become much less noticeable as the months go on. Everyone’s experience is different.
If you’re feeling like you need some support around feeding your baby, you can click here to view my services and work with me.
References:
(2023). Understanding Dysphoric Milk Ejection Reflex. D-Mer.org. Retrieved August 12, 2023, from https://d-mer.org/understanding-d-mer