When your breast milk “lets down,” or “drops,” as some people call it, it pushes down to the lower part of your breast near the nipple so that you’re ready for the baby to receive the milk. Milk lets down naturally and happens more easily the longer you nurse, and let-down pain (nipple or chest pain while breastfeeding) is not that unusual if you’re feeding the baby. But what if the let-down reflex is painful for you when you’re not breastfeeding at the moment? There are actually numerous reasons why this may happen.

What Is the Let-Down Reflex?

When your milk “lets down,” it causes a constriction of the milk ducts because they are trying to squeeze the milk out so the baby can drink it. When you’re not used to this feeling, it can feel tight and painful, but in most cases, once you get used to it this feeling goes away. Your milk can let down after you start nursing or even when you’re nowhere near your baby. Some women, in fact, can feel their milk let down just by hearing their baby cry!

Nevertheless, if you’re being nursing for a while and you’re used to it, you should rarely experience any let-down pain. If you do experience let-down pain when not feeding your child, especially if it happens consistently, this is usually an indication that something is wrong. Say goodbye to chest pain breastfeeding. Below are a few of those things, and you should always share them with your doctor.

1. You’re Making Too Much Milk

When you breastfeed, you normally make the right amount of milk because in reality, it’s the baby’s suction action that decides how much milk to make. That being said, the baby’s schedule can be sporadic in the beginning, and since you’re still getting used to one another, your breasts can become engorged with too much milk. This will often cause the let-down process to be painful, but there are a few things that you can do about it.

First, you can try to nurse or pump your breasts every two hours or so until they go down a little. You can also gently massage them and move them around as often as you can, or you can take a long hot shower, which usually helps your milk let down and start to leak out into the shower stall. You can also ease the pain by placing a bag of frozen veggies or a head of cabbage on your breasts for roughly twenty minutes.

2. You Have a Yeast Infection

Thrush is a fungal or yeast-like infection that can cause pain when your milk drops. There are conflicting reports about whether or not thrush can be spread from mother to baby and vice versa, but one thing is certain: if you have thrush yourself, the let-down process can be painful even if you’re not in the process of feeding your infant.

If you think that this is your problem, you’ll need to contact your doctor immediately because thrush can only be healed with some type of antifungal medication that only a doctor can prescribe. If you experience shooting pain in the nipples, or nipples that burn or sting, this could mean that you have a yeast infection you need to take care of, which means that contacting your doctor is the first thing you should do.

3. You Have a Condition Called Nipple Vasospasm

Nipple vasospasm is a condition whereby the blood vessels in your breasts tighten up too much. This results in restricted blood flow that tends to make the nipples extremely painful. The condition is made worse and the pain is more noticeable when you’re cold, so make sure that you cover up well when exposed to cool or cold weather. You can also use a device that uses dry heat and place it on your breasts, but the main treatment includes avoiding cool or cold locations.

4. You Might Have Clogged Ducts or an Infection

If your breasts are hurting anywhere, you could have clogged milk ducts or even a breast infection. Depending on your other symptoms, you may need an antibiotic, so if your breasts are tender, engorged, red, or painful when you touch them, you should call your doctor. If you’re also running a fever, calling your doctor is a must. Sometimes a lump or blister forms in the breast as well, but to be sure that it’s not something more serious, you’ll need to contact your doctor as soon as possible.

5. You Experienced an Injury While Giving Birth

If you’ve been breastfeeding for weeks or longer and you still experience pain when your milk lets down, it may be due to an injury you sustained during childbirth. Most frequently, the injury affects your chest muscles and involves a severe strain, which naturally will affect the part of the breast related to the let-down process. When the chest muscles that hold up your breasts are strained or injured, this can directly affect the pain you feel when your milk drops.

6. Your Nipples Are Cracked or Irritated

Sometimes breastfeeding causes cracked, dried, or irritated nipples, which will hurt every time that your milk lets down or drops. The good news about this problem is the fact that there are numerous ointments and creams you can place on your nipples to eliminate the cracks and make them smooth again. Even better, the products are made specifically for breastfeeding mothers, so you don’t have to worry about the cream or ointment tasting bad for your baby.