REF breastfeeding: the strong ejection reflex

If you have a strong ejection reflex, a few actions can help you reduce or control it:

• Choose a breastfeeding position in which you feel comfortable. The BN or biological nurturing position is often recommended in case of a strong let-down reflex. In this position, the mother lies semi-recumbent or on her back and lets her baby lie on her stomach spontaneously. In contrast to other breastfeeding positions, in the event of an untimely milk ejection, the baby's head and mouth are higher than the nipple and can therefore open it to let the milk flow out too quickly rather than swallowing it hastily. They will be better able to regulate the amount of milk they take in.
• Contrary to what you might think, reducing the number of feedings will not solve your milk ejection problem, quite the contrary. It is better to breastfeed more often to reduce the amount of milk in the mother's breast, which the baby can then better control when feeding.
• When you breastfeed your baby, there may be several milk ejection reflexes, but often the strongest ones occur at the beginning of the feed. For this reason, before you put your baby to the breast, you can hand express your milk onto a cloth to avoid the first spurts of the FER. Once your baby has passed the first spurts, settle him or her down to feed.
• If you see your child coughing or drinking quickly, you can also take him off your breast for a few moments to allow him to take a break and calm down. Once you have wiped off the spurts of milk on a nappy, for example, you can put your child back to the breast.
• Breastfeeding your baby as soon as he wakes up can also be a solution because he will suckle more gently, his suction will be less strong and consequently the milk ejection reflex may be slower.
• Finally, try to avoid things that may increase your let-down reflex such as milk collection shells, herbal teas or foods that promote lactation. 

If after several weeks of breastfeeding you do not see any improvement and you still feel that you have a BFN that is bothering you or your baby, you should seek help from a lactation consultant.

It should be noted that REF is often associated with hyperlactation but this is not systematic at all, and vice versa, one can have hyperlactation without having REF.