During breastfeeding, your baby's
suckling is the main and most powerful trigger of more milk production. This
occurs by the stimulation of the nerves in the nipples; which will transfer a
message to the brain to release oxytocin, a hormone, which will be released
into the bloodstream to your breasts, inducing tiny muscles to contract to push
the milk out. When these events occur it’s called the let-down reflex or milk
ejection reflex.

Breastmilk
let-down requires sometime before it becomes well established, which usually
occurs by 2 weeks after delivery. With this, you may experience numbness and
tingling in your breasts during nursing or pumping of milk. Milk usually will
drip from one breast while you are feeding on the other side.

A painful let-down
reflex can occasionally happen during the period when your body is adjusting to
feeding your baby. This is called an
overactive let-down reflex, and is characterized by a forceful let-down that causes too
much milk to flow out of the breast too quickly, and which may be accompanied
by a sharp, shooting pain in the breasts. This happens most often within the
first month of breastfeeding.

The main causes of
painful let-downs are:

1. Abundant
breastmilk: Some women may produce large amounts of breastmilk and/or they have
a milk-ejection reflex (let-down) that is very strong. If this is the case, you
will notice your baby choking or sputtering on the volume and intensity of the
milk as it is let-down.

2. Engorgement.
Engorgement can cause breast discomfort.

To decrease your
milk flow:

• Some mothers report that breastfeeding
  on one breast only per feeding is helpful. When your milk lets down
  heavily, you may try to gently interrupt feeding, allow the milk to spray
  into a towel, and then re-latch your baby onto your breast when the flow
  slows down. In time, your supply and let-down will become more manageable
  for the baby to handle.


• Do not stimulate your breasts by
  pumping them or taking long hot showers.


• Put cool cloths on your breasts for 15
  to 30 minutes between feedings.

To
help your baby deal with forceful let-down:

• Hold your baby upright, with his bottom
  much lower than his head. Support him in this position while he nurses.


• Lie back and place your baby’s tummy on
  your tummy. This laid-back nursing position lets gravity slow down the
  flow of milk.


• You can hand express or pump your
  breasts when your breasts first let down to relieve the pressure, and then
  put your baby on your breast.