Fast let-down during breastfeeding involves a quick and forceful flow of milk, bringing some challenges for both you and your baby. Understanding these effects and learning how to manage a fast let-down can make breastfeeding more comfortable for both you and your little one.

What is a fast let-down?

Fast let-down, also referred to as overactive let-down, occurs when a breastfeeding mother's milk flows too quickly and forcefully from the breast. It is most common in the first few weeks postpartum as your body learns to adjust your milk supply to your baby’s needs. This rapid flow can sometimes overwhelm a baby, leading to difficulties in latching, choking, gagging, or fussiness during feeding sessions.

What causes fast let-down?

1. Oversupply of Milk: Some mums naturally produce more milk than their baby requires. This abundance can accelerate the flow of milk during breastfeeding sessions, causing a faster and more powerful release.

2. Forceful Milk Ejection Reflex: This reflex, also called the let-down reflex, involves muscles around the milk ducts contracting to push milk toward the nipple. In some mums, this reflex occurs more vigorously, leading to a quicker flow of milk.

What are the signs of fast let-down?

For Babies:

• Restlessness during feeding: Babies may arch away, stiffen, cry, or struggle with latching and unlatching, making feeding challenging.
• Signs of discomfort: Coughing, choking, or gulping quickly, particularly noticeable during each let-down phase.
• Nipple discomfort: Babies might clamp down on the nipple, causing soreness or pinching in an attempt to manage the rapid milk flow.

For Mums:

• Sensations During Forceful Let-down: Some women feel sensations like tingling, pressure, or pins-and-needles during let-down, which can be painful with forceful let-down. Not all mothers feel these sensations.
• Excessive Leaking & Spraying: Mums might observe increased leaking from the breast their baby isn't nursing from. Additionally, you might notice forceful streams of milk when your baby unlatches from the breast.
• Nipple Symptoms: Whitening of the nipple and burning pain post-nursing might occur due to baby's compression, leading to temporarily reduced blood flow. Applying dry heat or gently massaging blood back into the nipple can offer relief.

How can you manage fast let-down?

If you're dealing with fast let-down, there are strategies to help manage this issue:

1. Positioning: Trying out various breastfeeding positions allows you to use gravity to naturally slow down the milk flow.

• Laid-back Nursing Position: Get comfortable on a couch or with pillows, leaning slightly back. Your baby lies on top of you, tummy to tummy. This position allows your baby to adjust their head and latch on their own, or you can gently guide them.
• Clutch or Football Position: The clutch hold, sometimes known as the football hold, involves holding your baby under your arm, similar to holding a football. Your baby's body rests at your side, with their legs tucked under your arm and their head positioned at breast level for nursing. This position offers better control and visibility during breastfeeding, especially useful for situations like managing a fast milk flow.
• Side-Lying Position: Lie on your side with your baby facing you, allowing gravity to slow down the milk flow.
• Upright Positions: Sitting a bit more upright during feeding can also help moderate the milk flow, making it more comfortable for your baby.

2. Breast Compression: Before and during feeding, gently compress the breast to control the flow. This helps slow down the milk and allows the baby to manage it better.
3. Nursing Frequency: Nurse more frequently but for shorter durations. This can help prevent excessive milk buildup between feedings, reducing the force of the let-down.
4. Block Feeding: If oversupply is the issue, try block feeding, where you nurse from the same breast for consecutive feedings to reduce milk production in the other breast.
5. Seek Support: Consult with a lactation consultant or a healthcare professional experienced in breastfeeding. They can provide tailored advice and support for managing fast let-down.

Resources:

Fast flow. Fast flow | Australian Breastfeeding Association. (n.d.). https://www.breastfeeding.asn.au/resources/fast-flow

Kabiri, M., Kamalinejad, M., Sohrabvand, F., Bioos, S., & Babaeian, M. (2017, October). Management of breast milk oversupply in traditional Persian medicine. Journal of evidence-based complementary & alternative medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871304/

Trimeloni, L., & Spencer, J. (2016a, January 1). Diagnosis and management of breast milk oversupply. American Board of Family Medicine. https://www.jabfm.org/content/29/1/139.full