I have mother's permission to post this request.  The mother is exclusively 
breastfeeding her 3rd child, who is six months old and 21 pounds. She nursed 
her previous 2 kids for 18 months each.   Until last week, she has had no 
problems.  Mysteriously and unpredictably, over the past week, her baby has 
not be able to evoke a let down, nor has she been able to do it manually.   
She's got a good milk supply, and feels full when this happens.  When it's time 
to feed the baby, only dribbles of milk drip from the breast.  She feels no 
physical symptoms of a let down, which she usually does.  Nursing sessions 
have lasted 30-40 minutes and still no MER.  The baby is happy to stay at the 
breast and NNS, though.  After the unsuccessful feed and before the next, 
she feels full and somewhat uncomfortable. But, she has no plugged ducts, no 
signs of mastitis, no blebs, and no real pain. After the event, the baby returns 
to the breast for the next feed, and the MER and the feed is normal.  She 
says it's not an issue of stress or emotional upheaval, everything is normal and 
fine at home.  She's happy other than this odd situation. She's able to feed 
without problems most times, and has done so at public places like the zoo, 
when her other little ones are being kids, etc.  This is happening at home, but 
at different times of the day, and even when she's in a comfy chair, dark 
room, totally relaxed.  She's tried music, massage, showers, deep breathing, 
all the tricks. But it happened twice yesterday, so now she's getting a little 
more concerned.  She's thinks that there  might be dietary reason, but I 
couldn't think of any. She's well nourished and hydrated.  She's being checked 
for thyroid levels tomorrow.  Since it's not a chronic problem (at least not 
yet), I'm leary of going down the intranasal oxytocin by a compounding 
pharmacy route, but might this be a time to use it?  The only thing others 
have been able to suggest is to try to relax -- they say she's stressed, but 
she's convinced that's not it.  In speaking with her, I don't think it is.  But I 
don't have any other ideas, either.  I'd appreciate any ideas you all might 
have.

Thanks,
Barbara Ash, IBCLC
Burke, VA

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