Letdown is what keeps your milk flowing during breastfeeding. As your breasts begin pushing out milk, you may experience a tingling or pins-and-needles sensation and a feeling of uncomfortable fullness. Some women have painful letdown, with symptoms such as burning nipples and stinging pain in their breasts. This may be linked to other breastfeeding problems – and working with your provider or a lactation consultant can help.
IN THIS ARTICLE
- What is letdown?
- What does letdown feel like?
- What causes painful letdown?
- How to handle painful letdown
Is breastfeeding painful – especially at the beginning of a nursing session? You could have painful letdown, and you don’t have to live with the discomfort. Oftentimes, you can find relatively simple solutions.
What is letdown?
Letdown is a reflex – an automatic reaction – that causes your breasts to quickly begin pushing out milk so your baby can breastfeed.
When your baby begins sucking at your nipple or you start pumping (or sometimes even when you hear a baby cry or just think about your baby) your body initiates letdown. The nerves in your nipples send signals to a gland in your brain that triggers the release of oxytocin and prolactin, two hormones that promote breastfeeding.
Oxytocin makes the muscles in your breasts contract to squeeze milk from the ducts to the nipple, and it widens the ducts to speed up milk flow. Meanwhile, prolactin initiates the production of more milk.
What does letdown feel like?
When your body initiates the letdown reflex, it may cause intense and even painful sensations in your breasts. Some women don’t feel much during letdown, but you might notice:
- A pins-and-needles or tingling sensation in your breasts
- A sudden feeling of (possibly painful) fullness in your breasts
- Milk dripping from the other breast
- Thirstiness, which may be related to the release of oxytocin
As you get used to breastfeeding, you may not notice the letdown reflex as much.
What causes painful letdown?
A number of breastfeeding problems may contribute to painful letdown and general breastfeeding pain. Possible causes may include:
- Overproduction of milk, which can lead to painful letdown and sore nipples
- Plugged milk ducts, which may cause pain during letdown and a painful lump to form in the breast
- Mastitis, or inflammation of breast tissue, which may cause breast soreness and a burning sensation during breastfeeding
- A yeast infection on your nipples: a common fungal infection that often causes shooting pain or stinging and burning nipples during breastfeeding
- Cracked nipples, which can become so painful that it becomes difficult to nurse
- A milk bleb (milk blister), a blocked nipple pore that may cause painful nipples and breastfeeding pain
- Nipple vasospasm, or tightening blood vessels in your breasts that result in restricted blood flow and can cause severe nipple pain – especially when you’re cold
How to handle painful letdown
- Try relaxation techniques. If pain during letdown is relatively mild, it might help to use breathing or other relaxation techniques (including those you may have learned during childbirth classes) each time you start nursing.
- Work on your latch. A bad breastfeeding latch is a common cause of many breastfeeding problems, including cracked or sore nipples, plugged milk ducts, and mastitis. Get help from your provider or a lactation consultant: A few small tweaks may drastically improve your breastfeeding experience.
- Tackle oversupply and rapid ejection. If your baby frequently seems to choke or gag when they begin breastfeeding, you may have overproduction of milk. A number of tactics can help, including ensuring your baby is deeply latched, sitting in a semi-upright position, compressing your breast with your hand during letdown, and hand-expressing a bit of milk before breastfeeding your baby.
- Rule out more serious causes. Infections including yeast infection on your nipples and mastitis may require medication. Call your provider if you experience itchy, red, or burning nipples; shooting pain during feedings; breast tissue that’s red or warm to the touch; or flu-like symptoms, including fever, chills, nausea, or vomiting.
- Treat milk blebs. Pimple-like, painful bumps on the nipples may be milk blebs – which can lead to clogged milk ducts. Several techniques can help clear the bleb, including nursing frequently, applying a warm washcloth several times per day to the breast, and gently exfoliating the nipple with a washcloth after softening the skin for 30 minutes using olive oil.
- Check for clogged milk ducts. A small, tender lump in the breast may be a clogged milk duct, which can potentially lead to mastitis. If you think you have a clogged milk duct, try massaging your breast during a hot shower and while breastfeeding your baby. In the long term, addressing oversupply can reduce the risk of clogged milk ducts, as can getting on a regular breastfeeding schedule.
- Address a tongue-tie. Difficulty latching and associated breastfeeding problems (including cracked nipples and frequent bouts of clogged milk ducts) may be linked to tongue-tie in babies. If you think your baby may have a tongue-tie, check in with a lactation consultant, who can help you to adjust your latching technique. In some cases, research suggests that a frenectomy (a simple surgical procedure that corrects the condition) can help ease breastfeeding pain.
Breastfeeding can be extremely challenging, especially if you’re dealing with painful letdown. Fortunately, the causes behind burning nipples, stinging breast pain, and other breastfeeding discomfort can usually be addressed. It’s essential to reach out to your provider or a lactation consultant, who can provide treatment along with advice that can be a game-changer for your breastfeeding experience.
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