breastfeeding, chestfeeding, milk supply

Overactive Letdown?

Does your baby gag, choke, and cough during feeding? Are they sputtering and tugging on your breast? Ever notice them clicking or leaking milk? What about gas…do they seem to have an awful of it?

There could be a number of things causing baby to struggle with feeding.

  1. It could be a strong letdown (or as we call it in healthcare Milk Ejection Reflex – MER)
  2. I could be an oversupply
  3. It could be ineffective latch.

Let’s learn about the differences.

Strong MER
Inside your breast are milk making cells that form a sphere. These spheres are clustered together so I like to think of them as bunches of grapes with the stems representing the ducts that carry milk to the nipple.
Each grape is wrapped with muscle fibers. When your baby is feeding (or sometimes just when you think about your baby!) your oxytocin rises. Oxytocin is a hormone which plays a role in bonding, pleasure, and MER. It’s the same hormone that kicks starts uterine contractions during birth. The muscle fibers respond to oxytocin and squeeze milk down the ducts and out the nipple.
To have strong MER you need strong muscle contractions. Over the first 3 months, MER starts to chill out because those little squeezing muscles become less sensitive to it.

Oversupply
We actually just talked about oversupply. If you have an oversupply, when the muscles contract the milk making “grapes” are soo full that milk flows very quickly.

Ineffective Latch
Latch, or attachment to the breast, can be ineffective due to positioning, other medical conditions, tongue tie, or due to something else.

Hmmm, I think I know what’s going on. What do I do about it?

Make an appointment with your Lactation Consultant so they can give you personalized instruction and make a plan which will work for you!

All too often, the difficulty is with your baby and not with you. Your IBCLC can direct you to care which can include changing your feeding plan, adjusting your position, suck training exercises, working with a physical/occupational therapist, or SLP.

We are here to help!

❤ Megan

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