How to Manage Overactive Letdown While Breastfeeding

If breastfeeding leaves you with a screeching baby who is mad because you sprayed milk all over their face like a firehose (again), you may have what’s called “overactive letdown.” 

While it sounds good to know that you’re releasing a lot of milk, it can lead to a fussy, gassy baby and breast milk all over your glider chair. 

Don’t worry, we’ve been there! We’re here to give you tips on how to manage your overactive, forceful letdown so you can have a much more pleasant nursing experience with your little one.

What You Should Know about Overactive Letdown

• Overactive letdown with nursing happens when your milk ejection reflex (also called “oxytocin reflex”) is too strong, leading to discomfort and feeding difficulties for you and your baby. 
• You may have a gassy baby when you have overactive letdown, causing fussiness and pain between feedings.
• Overactive letdown is often accompanied by breast milk oversupply, which can cause its own set of issues for you and baby both.
• Pumping to drain off milk before your breastfeeding session will tell your body to produce more milk, which can cause even worse overactive letdown in the future. 
• Fortunately, there are easy fixes for overactive letdown, including changes in your nursing position and possibly breastfeeding more frequently.

Why Trust Us

After dealing with forceful letdown and oversupply during their collective decade-long breastfeeding journeys with a combined total of 6 kids, Katy Huie Harrison, PhD and Samantha Radford, PhD, CLC offer their expertise in managing the challenge of breast milk oversupply. Radford is also a Certified Lactation Counselor.

Signs of an Overactive Letdown

Overactive letdown can cause symptoms for both mom and baby. Here’s what to look for:

Forceful Letdown Symptoms in Baby

Spraying milk everywhere isn’t necessarily a problem as long as your baby is happy and gaining well (and you’re not suffering from any breast or nipple discomfort). 

But if you have a gassy baby or if every nursing session feels like a battle… that’s a sign there’s a problem. That’s why it’s important to know the signs of overactive letdown in your baby.

These signs include:

• Coughing/choking/sputtering during a feed (especially at the beginning). This may look/feel like you’re “drowning” them
• Biting at the beginning of a let-down
• Arching away or stiffening during a feed (especially at the beginning)
• Baby pulling away from breast during a feeding
• Gassy, fussy baby
• Excessive/forceful spitting up after a feed (due to swallowing too much air)

Signs of Overactive Letdown in Mom: 

You may only experience the first symptom listed here–spraying milk like a firehose. But if you’re having other breastfeeding pain or difficulties, it’s good to know that they may stem from your forceful letdown.

Other signs of overactive letdown in mom: 

• Lots of milk leaking from the other breast when nursing your baby
• Slightly painful pins-and-needles tingling in breasts or nipples with letdown
• Lipstick-shaped, painful nipple after baby unlatches (due to them clamping down on your nipple to manage milk flow). Extreme clamping can lead to vasospasm, where your nipple blanches white and hurts after unlatching

Important Note

Overactive letdown is often (not always) a symptom of oversupply, and oversupply can lead to mastitis (clogged milk duct). Mastitis can be quite painful, so if you develop chills, fever, and/or a warm, red wedge-shaped area on your breast, you should contact your doctor immediately. Your doctor will likely prescribe antibiotics for treatment. 

You can and should still breastfeed/pump while being treated for mastitis.

Potential Solutions for Overactive Letdown

Luckily, there are some easy ways to manage overactive letdown. With that said, overactive milk ejection reflex often accompanies engorgement and breast milk oversupply. 

Fair warning: Nursing your baby when you have an overactive letdown can get messy until you get the letdown (and potential oversupply) under control! Make sure you have lots of burp cloths handy.

Okay, on to the important part–the solutions:

1. Address Oversupply if Needed

While forceful letdown isn’t always related to oversupply, it often is. If you think you have oversupply, be sure to check out our article on ways to relieve this problem. Likely, your overactive letdown will lessen as well.

2. Consider Feeding Frequency

If you’re only nursing/pumping 6-8 times a day, this allows milk to build up in your breast for too long. When you finally do nurse, it ends up spraying everywhere due to excess pressure. 

Try to nurse at least 10-12 times per day at baby’s cues, even if each individual nursing session is shorter. This will soften your letdown, insure your milk supply, and increase baby’s weight gain (which is a good thing!). 

Nurse at your child’s early feeding cues (fluttering eyelids, lip smacking, turning the head/rooting) and nurse enough so that your baby’s hands are relaxed at the end of the session (a good sign that they’re satisfied). 

3. Try the “Laid-Back” Breastfeeding Position

Recline in your bed or in a reclining chair/glider (NOTE: If you are in a rocking chair or glider, have someone present with you to be absolutely sure you do not fall asleep with baby).

Let your baby nurse while lying on top of you. Gravity helps stem the flow of your milk.

4. Gently Press Back Against Your Breast During Let Down

You can try to press back into the side of your breast (make sure your hand is far enough away from your areola that it doesn’t affect your baby’s latch). 

You could also use two fingers in a scissors sign around your nipple to push gently back against your areola. Both of these techniques can slow your initial letdown (and you can remove your hand once the letdown has subsided).

5. Pull Away During Your Initial Let-Down

While you usually have 2-3 “let-downs” during each feeding session, usually only the first one causes issues. Either let your baby nurse or hand express until you feel the tingling of a let down. 

Pull away and cover your nipple with a breast pad or a burp cloth until the initial spray subsides a little. Then, put your baby back on the breast.

6. Step Away From the Haaka, Mama

I know, a Haaka can be a great tool for a lot of mamas who want to collect excess milk. But remember, it functions through suction (thereby stimulating extra milk production).

If you really want to use your Haaka, just hold it against your breast to let it collect leaks. Don’t squeeze and suction it to your breast.

7. Burp Your Baby Frequently

Especially if they’re fussing! Babies take in a lot of air when they’re fighting an overactive let down. Frequent burping and holding your baby upright in a carrier after a feeding will help them feel better later (and hopefully give you an easier time too!)

If you continue to experience overactive letdown and/or oversupply after taking these steps, be sure to talk to a lactation consultant. Your lactation consultant may have other ideas for slowing your milk flow, and they can tell you whether or not you should speak to a healthcare provider about any underlying medical conditions that might be contributing to your overactive letdown.

Final Thoughts for Overactive Letdown 

A forceful let down can cause breastfeeding problems for both you and your baby, and nobody needs that when you’re postpartum and trying to learn the ropes of breastfeeding. Fortunately, it’s often fixed with just a few tweaks in positioning and how you start your feeds!

If your strong letdown is associated with an oversupply, make sure you manage any underlying causes of this problem at the same time for best results.

You should see better feeding sessions within just a few days of implementing these tips. If not, be sure to check in with a lactation consultant for more personalized help! You and your baby deserve the best.

You’ve got this, Mama!