Use the Force: How to Fix Forceful Letdown

By Jordan Berns

Is your baby fussy or agitated while breastfeeding? Maybe your little one is prone to colic? Do your breasts feel full and hard even after just nursing? Does your baby leak, choke, or spit up breast milk that seems to come out all in a rush? If so, you may have a case of “forceful letdown.” This condition usually occurs two weeks to three months postpartum in some, but not all, cases. Forceful letdown is when milk is released too quickly from the nipple. This can make nursing difficult. Read on to learn the ins and outs of how to approach this issue at home, and when to ask a professional for a little help.

Oversupply can be caused by over-pumping; hand expressing too often; stress; changes to breastfeeding schedules; babies not getting to the fat-rich milk at the end of the feed, which causes them to feed more frequently, contributing to oversupply. Breast milk output can also be increased by unbalanced hormone levels, a poor latch, and draining breasts incorrectly.

Does your breast milk seem to come out too fast and hard for your baby to nurse?

Pumping or hand expressing too much milk can actually increase the amount of breast milk that you produce. However, there is a bit of a sweet spot when it comes to forceful letdown and oversupply. Hand expressing a small amount of milk just before a feed can help your baby not be overwhelmed by milk. You can hand express just to the point where the pain subsides and then start nursing.

Forceful letdown can sometimes be caused by oversupply. If babies drink too much milk, they might be under or over weight. Your baby might have bloody or frothy, green bowel movements or have an excess of gas. The milk that is first expressed from a feed is called foremilk, and it contains large quantities of lactose, making it harder to digest. The fat-rich milk that babies need to gain weight comes at the end of a feed. When babies full up on foremilk and don’t get enough of the fat, they may become underweight. Breasts become softer when the fatty milk is drained.

Babies who drink too much milk may feel bloated and uncomfortable. Some babies comfort nurse to fix that discomfort which can exasperate the problem. Keep an eye on growth charts, which should be tracked over the course of a couple weeks to monitor weight gain and loss. If something appears abnormal, it’s best to contact your doctor.

Tips and tricks to help with forceful letdown!

There are specific breastfeeding positions and techniques that can help your baby master nursing with forceful letdown.

• The football hold, laid back position, and side lying position could all be your ally.
• You can also slow down milk flow by clasping your nipple as your baby nurses.
• Breastfeeding while babies are feeling relaxed, like just as they wake up or before they start to feel really hungry can help them from stopping nursing as frantically or as harshly. This could help them adjust to a stronger letdown.
• You can try burping more to help your baby not swallow too much air.
• Another option is “block feeding.” This technique involves trying to feed your baby on one breast exclusively for every nursing session done in a three-hour block. After that, offer the other breast. This could help decrease milk supply or deplete it if done incorrectly. Talk to a lactation consultant before you try block feeding to avoid mastitis or ending you milk supply.

Sometimes issues masquerade as forceful letdown, but are really entirely separate issues, such as tongue-tie and a faulty latch.

Tongue-tie is when a short strand of muscle connects a baby’s bottom side of the tongue to their mouth in a way that inhibits a correct latch and later in life can lead to speech difficulties. Tongue-tie can be diagnosed by your doctor and takes a simple surgery to correct.

Another occurrence that may be mistaken for forceful letdown is an incorrect latch. A helpful tip to identifying a latch issue is by listening to your baby! Specifically, what noises does your baby make when breast feeding? Babies who make clicking or clucking sounds could mean that the latch isn’t holding suction. It isn’t just the potential feelings of engorgement that can feel painful to mothers, babies often respond to forceful letdown with a “shallow latch,” and bite on the nipple in an attempt to control milk letdown.

To help position your baby to get a deep latch, babies should be aligned with their heads tilted back, with the chin turned into the breast, and nose tilted away. Babies can swallow more easily if their ears are positioned in the same direction as their shoulders. Mothers can help their babies take short breathing breaks supporting their neck and shoulders with your hands. A lactation consultant can help you help your baby.

Forceful letdown can make breastfeeding a difficult process, but it doesn’t need to be. Reaching out to doctors or lactation consultants, like the ones at Lactation Lab, can help slow the flow of both milk and frustration! Breastfeeding is different for everyone, but the one thing all women should be able to depend on is a support system that assists you no matter where you are in your breastfeeding journey.