*The Let-Down Reflex*
Your Body's Response to the Baby's Suckling
Infant suckling stimulates the nerve endings in the nipple and areola, which signal the pituitary gland in the brain to release two hormones, prolactin and oxytocin.
- Prolactin causes your alveoli to take nutrients (proteins, sugars) from your blood supply and turn them into breast milk.
- Oxytocin causes the cells around the alveoli to contract and eject your milk down the milk ducts. This passing of the milk down the ducts is called the *"let-down"* (milk ejection) reflex.
Let-down is demonstrated in numerous ways including:
- Your infant begins to rapidly suck and swallow.
- Milk may drip from the opposite breast.
- The mother may feel a tingling or a full sensation (after the firstweek of nursing) in her breasts or uterine cramping.
- You may feel thirsty.
*NOTE*
There may be many let-downs during a feeding, of which you may or may not be aware. Because the brain plays such a large role in the release of hormones that cause the milk to eject, it is very normal for let-downs to occur inother situations as well. For instance, let-down may occur when you think about your baby, hear your or another baby cry, when it is your scheduled nursing time, when you are sexually stimulated, or during orgasm.
If the let-down occurs at an awkward time, cross your arms over your chest,or press the heel of your hand over the nipple area and apply pressure until the leaking stops. It may also help to wear cotton breast pads (withoutplastic liners) in your bra, especially in the first weeks, to protect your clothing. This type of response will usually diminish after the first fewweeks of nursing.
*Uterus Response Postpartum*
Release of the hormone Oxytocin while breastfeeding will cause the uterus to contract and this may be more noticeable if you have previously had children. It is this mechanism that helps your uterus to return to itspre-pregnant size quickly.
*Interference with Let-Down*
A variety of factors may interfere with let-down:
- Emotions: embarrassment, anger, irritation, fear or resentment
- Fatigue
- Inadequate sucking (Improper positioning or insufficient amount of timebaby is actively nursing.
- Stress
- Negative remarks from relatives or friends
- Fear of pain in your breasts or uterus (i.e., sore nipples or after birth pains)
- Breast engorgement in the first few days
*Suggestions for Creating a Supportive Nursing Environment*
- Find a peaceful atmosphere for nursing. Before beginning the feeding,unplug the phone, turn on relaxing music, and take four or five deepabdominal breaths.
- If breastfeeding in public inhibits you, insist on your privacy and/ordrape a light cover over your baby and your shoulder to cover up.
- Interact with friends and breastfeeding professionals who aresupportive of breastfeeding. Do not let well-meaning friends and relativeswho have different attitudes discourage you. Restrict visitors until you arecomfortable.
- Be around other nursing mothers. Attend a postpartum exercise class and/or postpartum support group.
- Be sure your baby is positioned properly and allow adequate suckling.
*Tingling Sensations - "Let-Down":*
After baby has nursed for a few minutes, many (but not all) womenfeel a tingling sensation followed by a strong surge of milk. Thisis known as the "let-down" response, and is natural and expected.This can happen with nursing, with just seeing a baby, hearing a babycry or even thinking about your baby. Often this let-down isaccompanied by a leakage of milk from one or both breasts.The hormone oxytocin is released into your blood, and as a result thetiny muscles surrounding the milk-storage cells of the breast pushthe fattier hind milk into the ducts - this is the let-down reflex orthe milk-ejection reflex.
General Expressing Tips
- Expressing milk is easier if you are relaxed
- try deep breathing exercises. Some women from Bach Rescue remedy helpful for calming them down if they are trying to express when stress.
- A routine also helps to relax the body in preparation
- This could be laying your pump out on a table, looking through a little photo album of baby pictures, making your self a cup of tea or anything else which you do which you could make into a ritual.
- Many women find it easier to express if baby is with them. If you can't express in the same room as your baby, then a looking at a photo may help, as may something which smells of baby or visualising yourself feeding your baby.
- Don't worry about the amount of milk you are producing
- babies are much more effective at removing milk from the breast, and worrying that you might not be expressing as much milk as you need releases adrenaline, which works against the oxytocin which the body needs to let down milk.
- It is important that you continue expressing until hind milk flows
-this is the richer, whiter milk which come after the thinner, more see through hind milk.
- Many women find that they can have multiple let downs in a session,so if you milk flow slows down it is worth continuing to see if you have a second let down.
- On the other hand, expressing for more than 20 minutes on one breastis not recommended as this could damage your breast.
- Stroking firmly but not too hard from the outside of the breastto the nipple, and working your fingers in little circles, spiraling from the outside of the breast to the nipple is a great way to prepare the breast for expressing, and can be down each time the milk flow slowsdown.
- You may be most successful at expressing while your baby feeds fromthe other breast
- this does take some dexterity, and possibly a helping hand from your partner
- Applying heat the breast may also help
- a warm rung out flannel ora shower can often start things going If you need to express regularly, then try to express at the same time and place. Your body will adaptto this quicker.
- Learning to express is about teaching your body to respond to an additional set of cues, so don't be surprised if your first expressing sessions aren't very productive. Try again another day, perhaps at a different time, and see what happens.
- Most mums find that they can express more milk in the morning, andless at night. The level of your supply does vary through the day andfrom day to day, so don't expect to always get the same amount.
- If you are trying to build up your supply, it is very helpful toexpress in the later evening. Even though you may be producing less milk,the level of hormones in your body mean that late eveningfeeds/expressing session are the best at 'demanding' a higher supply.
- Most experts say that it takes about 3 days of stimulation for thebody to fully catch up with demand, so if you add an expressingsessioninto your day, your baby may fit in an extra feed as well until yourbody realises what you want.
- Studies have shown that breast milk from hand expresion contains themore of the fatty hindmilk than breastmilk from pumping, and that Moremilk, and especially more hindmilk, is produced when milk is expressed from both breasts at the same time.
- If you are expressing from one breast at time, it is recommended that you express from one side until the milk flow slows down significantly, and then from the other side until that flow slows down,and then back to the first side etc.
Sumber : milist asiforbaby
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