Does stress affect your breast milk letdowns?

Stress doesn't directly interfere with your letdown

Even though you might often hear it said that stress can interfere with letdowns, there's no good reason - nor reliable evidence - to suggest this is the case.

• Believing that stress directly interferes with letdowns is like believing that stress interferes with your capacity to secrete bile into your bile duct, or acid into your stomach, or sebaceous sebum from your skin's oil glands, or pancreatic enzymes into your pancreatic duct. I disagree that psychological stress or nipple and breast pain directly impacts on milk production.

• But stress certainly affects how a woman goes about breastfeeding, which impacts on milk supply. Pain in particular will affect how often you can offer the breast, and requires urgent attention so that you can get rid of the breast tissue drag.

It’s true that catastrophic physical stress from severe injury or a serious medical condition can impact on the capacity of a gland to secrete. But overall, it is much more likely that behaviours associated with being stressed affect your breastfeeding and the amount of milk your baby is transferring, rather than the stress itself.

Stress can interfere with breastfeeding because feeling stressed changes behaviours and neuromuscular dynamics

Stress can result in breastfeeding problems, because feeling stressed might

• Interfere with you offering frequent and flexible feeds

• Result in you tightening up your shoulders and arms while breastfeeding, which worsens breast tissue drag, which worsens nipple pain

• Result in you accidentally pressuring or coercing your baby to fill up with milk (becaause you're worried about baby's weight), which can cause a conditioned dialling up with the breast

• Make it hard for you to expose your baby to adequate sensory motor nourishment, e.g. causing you to spend a lot of time in the low-sensory interior environment of your home, which dials a baby up, which might make you worry that your baby is hungry but "won’t take the breast" or "is breastfeeding all day" even though the problem is actually one of baby's sensory motor needs

• Make it hard for you to relax back into the deck-chair position while breastfeeding

• Make it hard for you to relax into tiny experimental micromovements while breastfeeding.

This is comforting to know, because once you're aware of these possible behaviours, you can alter them, even if you continue to feel stressed inside. You might be managing difficult thoughts and unpleasant stressed or distressed feelings, but what matters for your breastfeeding and for your relationship with your little one overall, is the actions you take and how you behave.

Your nipple still tightens and becomes more prominent when you roll it, no matter how stressed you are. Your stomach still secretes acid to digest the chocolate bar you just ate, no matter how stressed you feel. Your letdown will happen once baby is stimulating the breast. This is a reliable, hardwired neural and hormonal reflex, no matter how stressed you feel - even if you don't feel letdowns at all.