Hi All:

I could use some help.  I have a client who has had to use oxytocin nasal
spray with her last 3 children, and was successful with it.  She had her last
child before it was taken off the market.  She was able to get nasal drops
this time, which have not been effective.  We have one more resource here in
the Denver area for the nasal spray that as yet we have not been able to
reach due to the holiday weekend. She tried putting the drops in a nasal
sprayer, with no success--different concentrations possibly??? She was told
by the pharmacist that perhaps she had become "immune" to the oxytocin
(drops) which was why it was not working for her.  My thought is that the
drops (which she says just drip down her throat) just do not have the same
distribution as the spray. She is 5 days out, had been engorged, breasts now
softer, obtaining about 5 cc q 3 hours with large hospital grade pump.  She
has tried all the usual methods (heat, pumping, massage, etc) to get a let
down without success.  She called me today saying baby was now refusing the
breast so we used an SNS to get baby to stay on the breast has been somewhat
successful, (i.e., baby will now stay on breast for feedings) but still no
major letdown.   (FYI, no hx of smoking, excessive alcohol intake, meds,
caffiene, emotional crisis--besides this!, etc.)  I'm of course concerned
that breasts are starting to get soft In any case, my questions are as
follows:

1) Are there any other resources out there to obtain the Syntocinon nasal
spray?
2) Could it be true that she has built up a tolerance to this (last child is
now 3).
3) If #2 is true, does this mom have any other options?

I'd appreciate any assistance from out there in Lactnet Land!

Thanks,
Theresa Chambliss, RN, CLE
Denver, CO