This is a case where I would very likely suggest mom use syntocinon nasal spray for one-two weeks. It works very well under the right circumstances. As I said in an earlier post, I do look at the whole story including mom's labors and mom's ability to experience orgasm. I had one mom who had seen a couple of other LCs who kept suggesting new galactogogues and with each one, her breasts got full, but she got little milk and then she down-regulated. The nasal spray improved things dramatically. We also used a feeding tube to supplement at breast. Also, look at her history and her overall health and nutrition. I think we drastically underestimate the importance, especially where there is pain. I would also use homeopathy (need more info)--send her to a homeopath--and definitely a chiropractic adjustment. I have a friend--former LLLL who could not get a let-down after birth until she got adjusted. Worked like a charm.
Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network, LLC
Date: Sun, 11 Jul 2010 04:03:32 -0400
From: Riva Weissfish <[log in to unmask]>
Subject: slow or absent let down
I am working with a mom with her second baby who cannot seem to to let down the
milk she has. Initially she experienced fullness and fed with great amount of
pain, the baby was not gaining so she started to pump and got only small amount
despite her feeling very full. Her supply then down regulated.(This actually was
the same scenario after her first birth, which ended with full formula feeding
by 1 month) We are , now, trying to build it up again with regular pumping and
motilium. She felt a definite increase in fullness - after 4 days on the
motilium - but cannot get more that 50cc for her almost 3 week old baby and she
feels that since she is not removing milk she is already down regulating again.
Another issue she is dealing with though seems to have improved somewhat, is an
unexplainable exquiste pain in the area of the areola when pressure is applied.
The milk does not ever spray and seems to just dribble out for the 15 minutes
she can stand to double pump. Expressing by hand and /or compression does not
seem to improve the situation- ineffective and extremely painful. She denies any
surgery or injuries, takes no medication(except the motilium, of course).
Doesn't seem to have had any traumatic experiences or abuse in her past and came
to breastfeeding with complete confidence that is meant to work "as it did for
her Mom, sisters and sil's". Dad is very supportive but w/o pressure. We have
tried relaxation techniques and guided imagery - to no avail.
This week we are going to try to add goat's rue, and see what happens but will
that effect let down?
She is about to give up, but if I had any reasonable suggestion I know she would
be willing to try.
Any ideas?!!
Riva Weissfish BA,CCE, IBCLC
-
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