Overactive Let-Down

A let-down is when milk sprays from the breast as the milk is pushed out by hormonal release. Some mothers have such a strong let-down at times that the baby can't always handle the volume of milk well.

If your baby chokes, gags, or pushes off of the breast a minute or 2 after starting to feed, an overactive let-down may be the cause. Fortunately, women with an overactive let-down often have a large milk supply.

What can help

Most babies learn to handle let-down as their ability to coordinate sucking, swallowing and breathing matures. Until then, here are some strategies you can try to help manage until your baby learns to handle the fast volume of milk:

• Allow your baby to come off your breast as she or he needs to.

• Let your baby nurse until let-down. Then quickly remove the baby from your breast. And catch the rapid flow of milk in a towel before latching your baby back on to feed. (To remove your baby from your breast while actively nursing, gently put your finger into the side of his or her mouth to break the suction. Then position baby away from the nipple).

• Hold your nipple between your forefinger and your middle finger. Or gently press your hand into the side of your breast during let-down to slow the rapid flow of milk.

Positions that can help

It may help to position the baby so that the back of the baby's throat is higher than your nipple. This way the milk will not collect in the back of the baby's mouth. This position also gives the baby more control of the flow of milk. To do this, try these positions:

• A laid-back nursing position. You are lying back comfortably on a couch or pillow. Your baby is lying on top of you, directly tummy to tummy. Your baby can then bob his or her head. Or you can guide your baby to latch.

• Football or clutch position. Your baby is on your side. His or her back is supported by your arm. The baby's head is supported by your hand at the level of your nipple. You can gently raise your baby to your nipple to latch.