I mention multiple letdowns to moms frequently, especially when I am trying to
get them to understand the value of "finishing the first breast first." If mom
is waiting to take baby off the breast (typically because she's heard the 10
minute bit), she may mistake the first lull or two in nutritive sucking as an
indication baby needs to be switched.

Often I ask moms if they have ever noticed that baby will suck quickly until
milk lets down (cautioning that she may not feel letdown per se), and then pause
and then go back to quick sucks and then more long sucks. The typical reaction
is that I am some kind of psychic who has "seen" her baby nurse! I go on to
reassure her that her body is doing exactly what it is supposed to be doing, and
by letting baby stay on long enough to get those later letdowns he is more
likely to get a "complete" meal of both fore- and hindmilk. This seems to be
very empowering to help mom see that what is going on is SUPPOSED to be going
on. By describing to her something she's already seeing, she may be more willing
to listen to any other suggestions I might have to help her.

Melissa Vickers, IBCLC
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