Breastfeeding: Painful let-down reflex

My wife is experiencing quite painful let-down with our newborn daughter. We have been told this is called hyperactive letdown. Is this serious? And how can the pain be erased?

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Debbi Donovan

Debbi Donovan is a Board Certified Lactation Consultant, as well as a retired La Leche League Leader. For more than a decade, Debbi... Read more

A hyperactive or very forceful let-down usually occurs in moms with a very abundant milk supply. This pain, which seems to be caused by the stretching of the milk ducts, may be particularly bothersome in the early weeks of breastfeeding. This is uncomfortable, but is not a serious problem unless it is causing other difficulties with the breastfeeding relationship. Your wife might want to discuss the use of ibuprofen for pain relief with her doctor.

Feeding your baby from just one breast per feed (or a three-hour period) is often very helpful in regulating a mom's milk supply. Over the first two or three days, your wife should express just enough milk from the "unused" breast to remain comfortable. Change sides at each feed. Allowing your baby to stay at one breast gives her a chance to access the rich hindmilk. Often a baby whose mom has a very abundant supply is getting very large quantities of foremilk, going back and forth between breasts. It is the high-fat hindmilk  that helps to keep your baby satisfied for longer periods of time, and may reduce fussiness and gassiness. She will need to take in a lower (total) volume of milk to be satisfied.

If your wife has any questions or further difficulties, she should seek about a lactation consultant for further support. 

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