The woman at La Leche League had the bedside manner of a mastodon.

“You’re not having a nursing problem,” she said. “You are having a problem with your head.”

Relax. Right.

I had called La Leche League, desperate, a week after my daughter Vivian was born. Though my milk had come in normally, and breastfeeding had been fine, a week later my milk ejection reflex (MER), also known as “let down,” was letting me down. Though my breasts were full, it took several minutes of suckling before the milk would actually come out. While waiting for the rush of milk, the baby would cry out of hunger and frustration. I would get more nervous. And the more nervous I got, the more of a problem it became.

Though I wanted to hang up on the La Leche League representative, she was right. My inability to nurse was, in fact, due to my own anxiety. Some people store tension in their neck. Some store it in their back. Apparently I, and some other nursing moms, store it in our mammary glands.

I consulted several experts. Apparently, it’s not unheard of for a woman to have a hard time with her let down, but it’s not that normal, either. Suffice to say I had some very stressful issues that I was working through unrelated to the baby, and stress is a major inhibitor of the MER.

Searching the internet, I found no firsthand accounts of women like me. I found no real advice besides “relax.” Or as the woman at La Leche League said, “Don’t think about it.”

Right. That’s like saying don’t think of a white elephant. The moment it is mentioned, it’s already there. How am I supposed to not think about compromised nursing when that is what my hungry baby wants to do every two hours?

“Have a glass of wine,” one midwife suggested. Sure. At 5 a.m.? I needed more than a quick fix. I needed something I could rely on round the clock. Time after time.

Eight Ideas for Getting Milk to Let Down

For nursing moms having a hard time getting their milk to let down, here are some of the thoughts and practices that helped me work through my let down problems and got me on the track to healthy breast feeding.

1) Distraction
The woman at La Leche League was correct. The brain is the problem. The body, left to its own devices, will do what it is supposed to do. The answer: Preoccupy the brain with something else. This is the opposite of what most of the experts will tell you. They say things such as “Focus on your baby,” and “Think about how much you love your baby.” These thoughts seemed to amplify the problem for me. All I could think about was how much I was letting the baby down. But if I read a book, talked on the phone, watched a movie with my toddler or tried to recall the dream I was having before I woke up to nurse, I could disengage my mind enough to disarm my fear of not being able to nurse and the milk would let down just fine. Later, after I had more confidence in the process, I was able to focus completely on her, stroking her hair, looking into her eyes, smiling and enjoying the connection like I thought I was “supposed to” be able to do before.

2) Do Nothing Else
One of my midwives, Marlene, gave me the best advice. “If she is happy to nurse all day, let her do it. So what if she nurses for an hour before anything comes out. Take off your clothes, hang out in bed and devote the day to nursing.” That was easier said than done. I have a toddler, too. But for the days he was in daycare, I would spend the day with Vivian skin to skin, doing nothing but nursing. Marlene’s permission to just let her nurse as long as she was happy, regardless of the output, was salve for my feelings of inadequacy. And it worked.

3) Take off the Pressure
A good mother is one who provides for her child. That doesn’t mean breastfeeding. Though I very muchly wanted to be breastfeeding, in some ways it helped me to have a can of formula and a bottle in the house. It took off the pressure in case I couldn’t “perform” my duties. I never did use it. But knowing that my baby wouldn’t go hungry if the breastfeeding didn’t work helped my state of mind.

4) Celebrate and Remember the Successes
Eventually, when it seemed as if it were taking a long time for the milk to let down, I would remind myself, “Hasn’t it always let down before?” And somehow, trusting in history, the body relaxes into doing what it has done before.

5) Take a Deep Breath. And Another
I noticed that when I sang to my baby and made a conscious effort to breathe using my diaphragm (belly breathing as opposed to chest or shoulder breathing), the milk let down easier.

6) Don’t Tell a Lot of Folks About It
Be sure to share your concerns with a few folks—your partner and medical advisor, for instance. But don’t tell too many folks who will then be watching you as you nurse, wondering if it is going okay, which adds its own layer of pressure.

7) Write About It
I had to laugh when I wrote in my journal, “How much more obvious can it be? I am having a hard time with flow.” And going with the flow is what it is all about. I had read advice about imagining fountains. Ha. Might work for you. Didn’t work for me. But it did work to realize that I had built my own walls and that I might be the one to tear them down, too.

8) Become a Creature of Habit
The body has muscle memory. Rely on it. Pick a place for breastfeeding and go back to it again and again. Sing the same song. Hold your hand the same way. Eventually the body associates the place and posture with nursing and kicks into gear out of habit.

Making Peace with What Is
It took a few months before I felt fully confident about nursing. I wondered each time I’d raise her to my breast if the milk would come out. And it did. And it did. And it has for six months. I am grateful that I stuck with my commitment to breastfeeding, though I know that if we’d gone to bottle feeding, that would have been okay, too. Bottom line is that I know I am able to care for my baby, to give her love and meet her needs. And that is what a mother does.