Breastfeeding When Milk Flows too Fast: Forceful or Overactive Letdown

Learn how to manage breastfeeding when the milk flows too fast for you baby. This is called overactive letdown or forceful letdown. It is the milk ejection reflex that is causing the milk to flow too fast. Overactive or forceful letdown does not necessarily mean that the mom also has an oversupply but it seems that the two are very common together. It is possible for a mom to have one and not the other. Today we will focus on the letdown aspect.

With an overactive or forceful letdown, both mom and baby can have some trouble with breastfeeding. I always think of overactive letdown like a garden hose on full blast, you just can’t keep up with it. For mom, her milk might start spraying everywhere without her being able to control it. This can lead to a lot of laundry, wet clothing when in public, and can cause some problems when it is time for the baby to latch as the milk is already spraying everywhere and becomes very slippery, baby is usually covered in a milk bath by the end of the feed. It generally seems to be very messy and a lot to handle on top of taking care of a new baby. The baby also tends to show some signs that mom’s milk is flowing too fast. They may be very gassy, fussy, or spitty after feeding as they just took a whole lot of milk in a very short time (think how you feel after eating a meal very quickly). When these babies eat so quickly, their suck need is not fully satisfied which makes them want to go back to the breast for comfort and the whole cycle starts again. The baby may also latch shallow on the breast because if they latch shallow they can control the flow of milk better and protect their airway. A shallow latch can cause pain for mom during feeding and often lead to the baby compensating during the feed which is not ideal and can cause problems later on down the road. These babies may also choke and sputter at the breast in response to the fast flow, leading them to come off the breast more and swallow more air which then intensifies the gassiness. Another compensation that these babies might do while feeding is to make clicking noises at the breast. Generally, clicking noises tell us the baby is losing suction, in the case of a fast letdown, the babies are intentionally losing suction which leads to messy eating, more air, and more gas. The baby might also clamp down at the breast to try and slow or stop the flow, again causing sore nipples for mom as the clamping down includes their little jaws of life between your sensitive nipple. Some of these babies also have some digestive issues and green stools.
As you can see, feeding with a forceful letdown is quite the cycle and sometimes can make feeding less enjoyable for both mom and baby. There are some things you can try to see if it helps the problem.
The easiest thing is to try first is to practice “laid back nursing” Laid back nursing does not need to be fully on your back, just lean far enough back to bring baby’s head higher than the level of the breast. This does two things, first it uses gravity to pull the milk back towards your chest wall meaning that the baby has more control over the flow and gravity is working against the fast flow instead of just sitting straight up and it pours out. Second, it helps baby to get a deeper latch which is a more effective way to feed and moms nipples are less likely to be sore. You will likely find the choking and sputtering and fussing at the breast improves almost immediately with a a small position change as it did in this video
You can start nursing and when you notice the first letdown happens, detach the baby and let the first letdown spray into a container or cloth. The first letdown is usually the most forceful, and once that spray is complete, put the baby back to breast to complete the feeding. This will allow baby to have a more leisurely and enjoyable feed instead of just trying to keep up with the flow. Some people will also pump or hand express for a couple min before nursing baby with the same idea of getting past the first letdown, but it seems like a lot of extra work to do it that way.
You can consider block feeding- this should only be done under the direction of your lactation consultant as it can very effectively decrease your supply and we do not always want that

There are many other options to try and each is specific to your individual situation,If you think you may have a forceful letdown, make sure to reach out for help from your local lactation consultant for a plan that works for you and your baby. The good news is, over time this problem tends to lessen but it can be really frustrating when you are in the middle of it. This information is not intended for medical advice, it is for educational purposes only. I hope you learned something new today about managing a fast flow of milk, be sure to like, share, and subscribe for more breastfeeding and baby videos!