You’re breastfeeding and you notice that the sessions don’t always go very well? Despite the fact that baby is drinking often, and very vigorously, you feel a tingling in your breasts, especially at the start of a feed, with a sensation that your breasts remain engorged, even after feeding, and you find yourself uncomfortable? At feeds, baby chokes almost every time; he cries and is shocked by the situation. – Your ejection reflex may be too strong.

Signs of a strong ejection reflex

How can you tell if you have a strong ejection reflex when breastfeeding? Here are a few signs to look out for in your baby, which may indicate a strong let-down reflex.

• The baby is drinking very quickly and you can hear him swallowing loud;
• He seems uncomfortable, squirms and cries;
• He alternately releases and reclaims your breast;
• He throws his head back, arches his back and pushes your breast away;
• He often chokes and seems to have difficulty managing his milk intake; he gets upset;
• He may have foamy green stools;
• He may gain weight slowly or rapidly;
• He may have more regurgitation, vomiting and reflux.

If you think you have a strong ejection reflex, don’t worry, there are solutions! This situation is not at all uncommon, especially in women who have already breastfed, since the mammary glands are already well trained. With a high ejection reflex, the baby receives too much milk, too quickly. During an effective feed, the baby stimulates lactation to the maximum, and the amount of milk produced is always greater. This is why you remain engorged, even after certain feeds.

Now, how can you make breastfeeding more enjoyable for both of you? Here are some basic tips:

• Breastfeed frequently, because the longer the time between sessions, the stronger your ejection reflex will be
• Breastfeed from one breast at a time. You can pump a bit of milk from the second breast if you feel pain, which will gradually reduce stimulation and thus production. Your production should balance itself over time in regards to your baby’s needs
• Don’t wait for the baby to get angry before giving them your breast. If they are calm, they will breastfeed better, and your reflex may be weaker
• Use a breastfeeding position that helps reduce your reflex or its management. You can use the biological position (rearward tilt (INSPQ 2024)), the football position, with you lying on your back and the baby on your stomach (if they are over 3-4 weeks old). You can also use the sitting position with your baby on your thigh, stomach to stomach (anti-reflux position). You can better manage your reflex because your baby is in a vertical position. 
• Burp them frequently to reduce the amount of air in their stomach
• If your breasts are overly engorged, you have to pump some of your milk to soften them and reduce the ejection reflex
• Don’t pump your milk between sessions because it increases stimulation
• Check to see if a nipple shield could help

If the situation doesn’t improve despite your best efforts, don’t hesitate to seek help, whether from a healthcare professional or a community resource.

Marie Fortier
The Baby Expert 

Updated article : March, 2025.

References :

• Nourri-Source Montréal. Le réflexe d’éjection fort (RÉF). Repéré le 11 mars 2025 à https://portail.nourrisourcemontreal.org/documents/download/407#:~:text=Pour%20diminuer%20l’intensit%C3%A9%20du,stimuler%20la%20production%20de%20lait.

• CHU Sainte-Justine. (2022, septembre). Bébé semble s’étouffer. Repéré le 11 mars 2025 à https://www.chusj.org/fr/soins-services/A/Allaitement/Du-soutien-durant-l-allaitement/AllaitWeb/Mon-bebe-n-arrive-pas-a-prendre-le-sein/Bebe-semble-s-etouffer 

• Deitra L. Lowdermilk, Shannon E. Perry, Kitty Cashion. (2012). Éjection et expression du lait. Dans Chenelière Éducation (Éd.), Soins infirmiers – Périnatalité, 2e édition.