It is normal for you not to feel your let-down as strong as your baby gets older. Some never feel let-down, and some stop feeling the let-down sensation as time goes by. This does not necessarily indicate that let-down is not taking place.

Reliable signs of a healthy, functioning let-down include:
* In the first week or so, feeling uterine cramping during letdown.
* Baby changes sucking pattern from short and quick (like a pacifier suck) at the beginning of the feeding to more long, rhythmic suck a minute or so into the feeding. You’ll start to hear consistent swallowing that sounds like a “uh” or small puff of air. Baby’s jaw will drop lower with the swallow than with sucking
* A feeling of calm, relaxation, sleepiness or drowsiness
* Strong thirst when breastfeeding.
* Occasionally people can experience itching, nausea, headaches, or negative emotions during let down
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It’s quite normal to have a harder time letting down to a pump than to baby. The milk may be in the breast, but the stimulation from the pump may not be enough to trigger the release needed for the milk to flow. Although rare, this can occasionally happen when directly breastfeeding as well.

Many things can be the cause of a slow or inhibited let-down: anxiety, pain, embarrassment, stress, cold, excessive caffeine, smoking, use of alcohol, or certain medications. People with breast surgery or nipple piercing history may have nerve damage that can interfere with let-down. In extreme situations of stress or crisis, the release of extra adrenaline (the “fight or flight” response) can reduce or block the hormones which affect let-down.

Let down can be a conditioned response. Sometimes a cycle is created, where baby fusses and pulls off because the let-down is slow, which makes mom tense up, which makes the let-down even slower, etc. You can use relaxation techniques and let-down cues to break this cycle.

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