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  • Your milk ejection reflex: what letdown feels like and how it works
  • Your milk ejections are resilient and hard to disrupt
  • Does stress affect your breast milk letdowns or supply?
  • Busting myths about your letdown or milk ejection reflex
  • Two stories about maternal stress and letdown worries

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  • PBL Intermediate
  • S2: The life and milk of your working breasts
  • CH 5: Your milk letdown is a primordial biological reflex, difficult to disrupt

Busting myths about your letdown or milk ejection reflex

Dr Pamela Douglas12th of Jan 202513th of Oct 2025

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When letdowns are blamed for baby weight gain or breastfeeding problems, the true underlying issues are being missed

Common concerns about milk letdowns Why you can be reassured
I'm not having any letdowns Many women don’t feel their letdowns, or only feel the first letdown in a feed. You don’t need to worry about whether or not you are having a letdown. There are other much more important ways to know if your baby is getting enough milk – these are the things to focus on. You can find out how to know if your baby is getting enough milk here.
I’m not having enough letdowns As above
Stress is interfering with my letdown It is not stress, but the way stress affects your behaviours and body posture, which can interfere with letdown. You might be highly stressed, but your breastfeeding relationship can continue to be a source of calm enjoyment for your baby (and maybe even for you, though I know it's not always easy to enjoy things in situations of stress). Whilst the letdown is a reflex that is hardwired and not interfered with by stress, behaviours or actions which result from stress can impact on breastfeeding e.g. feeling under pressure to make sure baby gets enough in a breastfeed, or spacing out feeds. You can find out about stress and letdowns here.
My baby is fussing at the breast because my milk hasn’t let down Fussing at the breast is typically due to positional instability. A baby who is hungry and is not getting enough milk, but is in a stable position at the breast, will typically 'marathon' feed, suckling for long periods throughout the day and night.
My baby is fussing at the breast because she can’t cope with my strong or overactive letdown Fussing at the breast is typically due to positional instability. Apart from during the first couple of weeks, babies comfortably manage the range of letdown volumes and strengths, as long as they are positionally stable and the sucking biomechanics are working for them. In the early days after the birth, your tiny baby might pull off the breast coughing and spluttering with the letdown. Just make sure the fit and hold is stable, and bring your newborn back on when you're both ready.

Fussy baby behaviour at the breast doesn't tell you about your letdowns or your supply

Breastfeeding women are often wrongly told they have a letdown problem or poor milk ejection reflex as an explanation for why their baby isn't getting enough milk or is fussing at the breast. You might even be told that feeling stressed inhibits your letdown.

  • A baby who is positionally stable can swallow lovely vigorous letdowns with ease (particularly after the first couple of weeks of life).

  • A baby who is hungry and positionally stable stays on the breast suckling for long periods, and is likely to marathon feed, not fuss and pull off.

  • Stress doesn't disrupt your milk ejection reflexes, though it might change some of your breastfeeding behaviours.

Recommended resources

Do you have Dysphoric Milk Ejection Reflex?

What causes Dysphoric Milk Ejection Reflex?

You can find out more about the neurophysiology of your milk ejection reflex here.

Recommended resources

Does stress affect your breast milk letdowns or supply?

Your milk ejection reflex: what letdown feels like and how it works

Why your milk ejections are resilient and very difficult to disrupt

Busting myths about your letdown or milk ejection reflex

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Next up in Your milk letdown is a primordial biological reflex, difficult to disrupt

Two stories about maternal stress and letdown worries

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Case 1. A woman believes that a terribly stressful life event has stopped her letdowns

Once, I saw a woman who’d presented with nipple pain and concerns about the baby’s weight gain. When she came in, she told me she was under an enormous amount of stress, which was was interfering with her capacity to have letdowns, so that she hardly ever felt a letdown now.

This woman’s father was seriously ill. I offered assistance with the breastfeeding and suggested follow-up a week later. It was a couple of weeks before she came back in, and her baby’s weight gain hadn't been good in that time, though the baby…

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Possums acknowledges the traditional owners of the lands upon which The Possums Programs have been created, the Yuggera and Turrbal Peoples. We acknowledge that First Nations have breastfed, slept with, and lovingly raised their children on Australian lands for at least 65,000 years, to become the oldest continuous living culture on Earth. Possums stands with the Uluru Statement from the Heart.