Let down refers to the release of breast milk from the mammary glands during breastfeeding. It occurs in response to the infant’s suckling, which stimulates the release of hormones that cause the milk to “let down” into the milk ducts and become available to the baby. But how much milk is actually released during a let down event? That depends on several factors. In this article, we will explore how many ounces a typical let down produces, what influences let down volume, and how to optimize let down for efficient milk removal and feeding.
What is a Let Down?
A let down, also called a milk ejection reflex or milk let down, is the release of breast milk from the alveoli (milk sacs) into the milk ducts behind the nipple in response to infant suckling. It is controlled by the hormones prolactin and oxytocin.
When a baby suckles at the breast, sensory nerves in the nipple and areola carry signals to the hypothalamus. This triggers the release of oxytocin from the pituitary gland. Oxytocin causes the myoepithelial cells that surround the alveoli to contract and force milk into the milk ducts. At the same time, prolactin inhibits further milk production to avoid milk overload.
Together, oxytocin and prolactin enhance milk flow so the baby can efficiently remove milk from the breast. Let down occurs multiple times during breastfeeding, typically 2-3 times per feeding, and lasts anywhere from 30 seconds to a few minutes.
How Many Ounces is a Typical Let Down?
The amount of milk released during a let down can vary significantly between women and even between breasts. However, most lactation experts agree that a typical let down releases anywhere from 0.5-2 ounces per breast.
According to La Leche League International, the average let down releases around 1 ounce of milk per breast. However, let down amounts in the range of 0.5-2 ounces are still considered normal and adequate for the infant’s needs.
So for both breasts combined, the average let down quantity is around 2 ounces of milk. Some women may have smaller or larger let downs, but 2 ounces serves as a reasonable benchmark.
Factors That Influence Let Down Volume
Several factors can affect the amount of milk released during each let down, including:
- Time Postpartum: Let down volumes are smallest right after birth and increase during the first 2 weeks postpartum as milk supply is established.
- Stage of Feeding: Let downs are largest at the beginning of a feeding session. Milk ejection volumes decline as the breast is emptied.
- Breast Storage Capacity: Women with larger breast storage capacities and milk supplies tend to have larger let downs.
- Breastfeeding Experience: Milk ejection volumes increase with the number of pregnancies/children breastfed.
- Milk Removal Efficiency: Complete and frequent milk removal results in larger let downs over time.
- Mother’s Relaxation: Stress and tension can inhibit let down. Relaxation before feeding helps optimize the reflex.
- Feeding Patterns: Frequent breastfeeding with few long intervals between feedings maintains larger let downs.
As women gain more experience breastfeeding over weeks and months, their milk supply increases and becomes more responsive to infant feeding. Let down volumes and maximum storage capacities grow to accommodate the baby’s changing nutritional needs.
Maximizing Let Down Volumes
While let down quantities are mostly physiological, mothers can take steps to maximize their milk ejection reflexes:
- Massage or gently compress the breast tissue before and during feeding to enhance milk flow.
- Ensure proper nipple latch and suction rhythm during nursing.
- Breastfeed frequently on cue to train the body to release milk.
- Allow the infant unrestricted access to the breast for nutritive suckling.
- Feed from both breasts at each session to maximize prolactin release.
- Avoid delaying feedings when possible to minimize breast engorgement.
- Express milk after feeding to train the breasts to empty more thoroughly.
- Limit sources of stress and create a relaxing environment for nursing.
Making sure the breasts are emptied regularly and completely is key for increasing both milk production and milk ejection efficiency over time.
How Let Down Quantity Relates to Infant Stomach Size
To understand the significance of let down volumes, it helps to know how they align with an infant’s stomach capacity.
Newborns have tiny stomachs that can only hold small volumes at a time. Colostrum (the earliest breastmilk) is produced in volumes of around 2-10mL (about 0.5-2 teaspoons) per feeding. As babies grow, so does their stomach capacity.
Here are the approximate stomach sizes by infant age:
| Infant Age | Stomach Capacity |
|---|---|
| Newborn | 5-7 mL |
| 1 week | 22-27 mL (0.75-0.9 oz) |
| 2-3 weeks | 45-60 mL (1.5-2 oz) |
| 1-2 months | 80-150 mL (2.5-5 oz) |
| 4-6 months | 200-300 mL (7-10 oz) |
As you can see, a typical let down of 0.5-2 oz perfectly aligns with the infant’s stomach capacity at various ages. The volumes are tailored precisely to what a baby can comfortably handle per feeding.
This is an elegant example of the body’s innate ability to synchronize milk production with infant needs. As stomach size grows, let down capacity increases right along with it.
Let Down vs. Total Milk Production
It’s important to understand the difference between let down volume and total milk production:
– Let down is the amount of milk released per ejection reflex (typically 0.5-2 oz).
– Total milk production refers to the entire amount of milk made by the breasts in 24 hours (typically 25-35 oz).
Due to multiple let downs per feeding, the total milk consumed at a single feeding can exceed the let down quantity. For example, if a mother has three let downs of 1 oz each during one nursing session, the baby may transfer 3-4 total ounces at that feeding.
Therefore, assessing weight gain over several days is a better indication of overall milk intake than measuring let down volumes alone. As long as the infant is gaining well and exhibiting hunger/fullness cues, then milk supply is adequate regardless of let down amounts.
Signs of Normal vs. Low Let Down Volumes
Mothers can watch for the following signs of let down:
Normal Let Down Signs:
- Audible gulping/swallowing
- Milk dripping from the second breast during feeding
- Seeing or hearing milk spray from the nipple
- Leaking from the breast not being nursed from
- Multiple pauses during feeding with baby content after pausing
These cues indicate active and efficient milk ejection. As long as the infant seems satisfied after feedings, the let down reflex is functioning normally.
Signs of Low Let Down Volumes:
- Fussy or restless behavior at the breast
- Prolonged feedings with little pausing
- Frequent nursing without long pauses
- Poor weight gain or dehydration
Babies who fail to exhibit signs of milk transfer and who nurse extensively without pausing likely need larger let downs to meet their nutritional needs. But first, causes like poor latch or infrequent feeding should be addressed.
If no other issues are identified, low let down volumes may be the reason for fussiness or poor weight gain. This warrants an evaluation from a lactation consultant.
Increasing Low Let Downs
If let down quantities seem inadequate, the following tips can help boost the milk ejection reflex:
- Massage, compress, and warm the breasts prior to nursing
- Ensure proper nipple and areola suction and stimulation
- Nurse on one side for at least 10-15 minutes before switching sides
- Pump after feeding to fully empty the breasts
- Stay hydrated and maintain adequate calorie intake
- Nurse frequently and avoid long stretches between feeds
- Consider lactation supplements to support milk production
In most cases, low let downs are temporary and supply will increase within 2-6 weeks. A supportive breastfeeding routine along with mother-infant skin-to-skin contact helps augment milk ejection reflexes over time. But if problems persist, medical attention is warranted.
When to Seek Help for Let Down Issues
Consult a lactation consultant or physician if your let down quantities seem chronically low or if your baby is excessively fussy at breast and not gaining weight well. Potential medical causes include:
- Retained placenta fragments
- Thyroid problems
- Hormonal imbalances
- Breast hypoplasia (insufficient glandular tissue)
- Breast surgery
- Polycystic Ovarian Syndrome (PCOS)
- Certain medications
Speech therapy can also help if the baby has oral motor impairments interfering with milk removal. Once any underlying issues are addressed, let down volumes should improve over time.
Let Down During Pumping
The same principles of milk ejection apply when pumping breast milk. However, let down volumes may be lower when pumping instead of nursing:
- Pumps only initiate let downs through mechanical nipple stimulation
- Pumps do not replicate the oral stimulation of an infant
- Stress can inhibit let down during pumping
- Pumping fewer times per day signals lower milk needs
Due to these factors, the average let down when pumping is around 1 ounce or less per breast. But the number of let downs impacts the total quantity pumped—with more let downs resulting in more total milk.
If pumping output is lower than expected, be patient and keep pumping regularly. Output typically increases within 2-6 weeks as the body adjusts to the pump. Drinking water, massaging breasts, and using breast compression during pumping can also enhance pumped volumes.
Conclusion
Let down is a complex but amazing physiologic process that ensures infants get just the right amount of milk tailored to their stomach capacity. While let down volumes vary, a typical milk ejection reflex releases around 0.5-2 ounces per breast. This aligns perfectly with the baby’s small stomach size immediately after birth, while allowing ample milk transfer as the stomach grows.
Watching for signs of efficient milk removal and weight gain are the best ways to assess if let down quantities are adequate. If milk transfer ever seems impaired, there are many techniques mothers can use to boost let down reflexes and ensure abundant milk for the developing baby.