Overactive let-down

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Overactive let-down (OALD) is the forceful ejection of milk from the breast during breastfeeding. In some women it occurs only with the first let-down in a feeding, occasionally women may have multiple strong letdowns during a feeding. OALD can make breastfeeding difficult and can be the source of some breastfeeding complications. It may also be known as hyper milk-ejection. A woman may have OALD in addition to an oversupply of breastmilk. (Often called foremilk-hindmilk imbalance, hyperlactation syndrome, [1] oversupply colic syndrome, and other near synonyms.) The physical or medical cause of an overactive let-down is still unknown. Whether mothers with OALD have a higher overall milk volume – or a strong reaction to the hormone oxytocin (which causes the let-down reflex) also remains to be seen.

Contents

Complications

The forceful spray of milk can cause the baby to consume too much milk too quickly as well as to swallow air during the period of rapid swallowing following the let-down. The speed of the flow of milk into the mouth can cause the baby to react with reduced nursing times and aversion to nursing often described by mothers as "fussiness", "colicky", "dislikes nursing", or "is weaning". Some babies, especially those of approximately 2–4 months of age, become increasingly upset with the spray of milk which may increase their aversion to nursing to the point of refusing the breast (a nursing strike).

Overactive let-down can be a part of a constellation of symptoms that make up oversupply syndrome or oversupply colic. Babies coping with OSS, gain weight quickly in the early months, even while nursing for short period. Some OSS babies sleep for surprisingly long periods of time and depth, possibly due to an over-full feeling, while others have very disturbed sleep, possibly due to gastrointestinal pain.

Treatment

There are effective remedies[ example needed ] for overactive let-down, and oversupply syndrome, however aggressive treatment should be watched carefully by someone familiar with the condition as the mother is at a higher risk for plugged ducts, mastitis and other breast infections.

Overactive let-down can take a long time to control and can be frustrating for the mother and baby, but when controlled effectively a long and satisfying breastfeeding relationship is possible. Mothers with this condition are often given various incorrect rationales for their concerns such as "having weak milk", or "bad milk", it's "just colic", the baby will "grow out of it", or the child is "allergic to your milk", or a food in the mother's diet.

There are no valid reasons to stop breastfeeding due to this condition.

A strong letdown reflex often coincides with overactive milk production, engorgement, and problems with the sucking/breathing pattern of the baby.

Remedies for Engorgement include:

Remedies for OALD include:

Pumping off milk should be done only with the guidance of an experienced breastfeeding counselor, as part of a unilateral ad lib protocol.

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Breast pump

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Wet nurse

A wet nurse is a woman who breast feeds and cares for another's child. Wet nurses are employed if the mother dies, or if she is unable or elects not to nurse the child herself. Wet-nursed children may be known as "milk-siblings", and in some cultures the families are linked by a special relationship of milk kinship. Mothers who nurse each other's babies are engaging in a reciprocal act known as cross-nursing or co-nursing. Wetnursing existed in cultures around the world until the invention of reliable formula milk in the 20th century.

Mastitis

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Nursing bra

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Breast engorgement

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Inverted nipple

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Erotic lactation Sexual activity involving the stimulation of womans breast

Erotic lactation is sexual arousal by breastfeeding on a woman's breast. Depending on the context, the practice can also be referred to as adult suckling, adult nursing, and adult breastfeeding. Practitioners sometimes refer to themselves as being in an adult nursing relationship (ANR). Two persons in an exclusive relationship can be called a nursing couple.

Breast shell

Breast shells are hollow, lightweight plastic disks worn inside the brassiere to help correct flat or inverted nipples either in preparation for or during breastfeeding. Also known as milk cups, breast cups, breast shields, or Woolwich shields, they can also be used to ease sensitive nipples or collect milk when the baby has not finished the teat. Breast shells function by applying gentle but firm pressure to the region surrounding the nipple to stretch underlying adhesions and draw out the nipple. Nipple shields may be confused with breast shells, but shields are intended for use during the act of breastfeeding, whereas breast shells are worn in preparation for or after breastfeeding.

Breastfeeding difficulties

Breastfeeding difficulties refers to problems that arise from breastfeeding, the feeding of an infant or young child with milk from a woman's breasts. Although babies have a sucking reflex that enables them to suck and swallow milk, and human breast milk is usually the best source of nourishment for human infants, there are circumstances under which breastfeeding can be problematic, or even in rare instances, contraindicated.

Breastfeeding Feeding of babies or young children with milk from a womans breast

Breastfeeding, also known as nursing, is the feeding of babies and young children with milk from a woman's breast. The World Health Organization (WHO) recommends that breastfeeding begin within the first hour of a baby's life and continue as often and as much as the baby wants. During the first few weeks of life babies may nurse roughly every two to three hours, and the duration of a feeding is usually ten to fifteen minutes on each breast. Older children feed less often. Mothers may pump milk so that it can be used later when breastfeeding is not possible. Breastfeeding has a number of benefits to both mother and baby, which infant formula lacks.

Lactation

Lactation describes the secretion of milk from the mammary glands and the female equivalent of ejaculation. The process naturally occurs when a female mammal is sexually aroused, although it predates mammals. In humans the process of feeding milk is also called breastfeeding or nursing. Newborn infants often produce some milk from their own breast tissue, known colloquially as witch's milk.

Dysphoric milk ejection reflex (D-MER) is a condition where women who are breastfeeding develop negative emotions that begin just before the milk ejection reflex and last less than a few minutes. It is different from postpartum depression and a dislike of breastfeeding. Hundreds of women personally describe the condition. There has, however, been little to no research into it as of 2015.

Human–animal breastfeeding

Human–animal breastfeeding has been practiced in many different cultures in many time periods. The practice of breastfeeding or suckling between humans and other species has gone in both directions: women sometimes breastfeed young animals, and animals are used to suckle babies and children. Animals were used as substitute wet nurses for infants, particularly after the rise of syphilis increased the health risks of wet nursing. Goats and donkeys were widely used to feed abandoned babies in foundling hospitals in 18th- and 19th-century Europe. Breastfeeding animals has also been practised, whether for health reasons – such as to toughen the nipples and improve the flow of milk – or for religious and cultural purposes. A wide variety of animals has been used for this purpose, including puppies, kittens, piglets and monkeys.

Cracked nipple is a condition that can occur in breastfeeding women as a result of a number of possible causes. Developing a cracked nipple can result in soreness, dryness or irritation to, or bleeding of, one or both nipples during breastfeeding. The mother with a cracked nipple can have severe nipple pain when the baby is nursing. This severe pain is a disincentive for continued breastfeeding. The crack can appear as a cut across the tip of the nipple and may extend to its base. Cracked nipple develop after the birth of the infant and is managed with pharmacological and nonpharmacological treatment.

A blocked milk duct is a blockage of one or more ducts carrying milk to the nipple for the purpose of breastfeeding an infant. The symptoms are a tender, localised lump in one breast, with redness in the skin over the lump. The cause of a blocked milk duct is the failure to remove milk from part of the breast. This may be due to infrequent breastfeeding, poor attachment, tight clothing or trauma to the breast. Sometimes the duct to one part of the breast is blocked by thickened milk. A blocked milk duct can be managed by improving the removal of milk and correcting the underlying cause.

Latch (breastfeeding)

Latch refers to how the baby fastens onto the breast while breastfeeding. A good latch promotes high milk flow and minimizes nipple discomfort for the mother, whereas poor latch results in poor milk transfer to the baby and can quickly lead to sore and cracked nipples. In a good latch, both the nipple and a large portion of the areola are in the baby's mouth.

A nipple bleb is a blister on the nipple that can be filled with serous or other fluid. It may be pink or light yellow. It is thin-walled and may appear as a small blister, more than 5 mm in diameter. It can also be referred to as a bulla. Some clinicians may also include milk blisters as a type of bleb. In addition, a blocked Montgomery gland may also be called a nipple bleb though its cause is different than a milk or serous-filled bleb on the nipple. In some cases the bleb may be associated with an adjacent blocked sebaceous cyst.

In breastfeeding women, low milk supply, also known as lactation insufficiency, insufficient milk syndrome, agalactia, agalactorrhea, hypogalactia or hypogalactorrhea, is the production of breast milk in daily volumes that do not fully meet the nutritional needs of her infant.

Hyperlactation Syndrome is the condition where breast milk overflow occurs because of increased milk production. The milk may come out fast and forcibly, making it difficult for the baby to nurse well.

References

  1. Parikh, Himali (2018-03-28). "What is Hyperlactation Syndrome? Causes & Signs". Mom And Baby Care (Mom ABC). Retrieved 2019-01-10.