I have an overly strong milk ejection reflex problem and don’t know what to do. It didn’t occur for my first baby, and I breastfed for one year. This time it’s really different. He drinks frequently and vigorously, and my breasts feel engorged all the time. It’s very uncomfortable. Additionally, my baby chokes on his milk almost all the time and then cries or gets annoyed. I am having difficulty managing the situation. Can you help? Thanks! Claire 

Claire, there are solutions! This occurs from time to time, especially in women who have already breastfed. Their mammary glands are already well developed, and the baby may receive too much milk too quickly. When your baby breastfeeds, they stimulate your lactation and will lead to you producing more milk. That is why you remain engorged even after breastfeeding. Now, how can you make the breastfeeding experience better for both of you? Here are some basic suggestions:


  • 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 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

Claire, I think these are some things you can try, and if nothing seems to help, consult with a lactation specialist in your region.

Keep at it!


The Baby Expert