Jan, wou;ldn't it be easier and more effective if, instead of getting out a 
pump, this mother did some massage and nipple stimulation and hand 
expression? There is some useful information on Russian breast massage in 
the August 2013 issue of JHL. I'm thinking that, if she isn't having a MER 
in response to her baby, placing a plastic funnel on her breast/s is going 
to be more impersonal. I recall discussion about mothers' lack of affection 
for their pumps in a book published by Demeter Press (Toronto) in or about 
2011.

Of course, another line of thought is the opposite. Her baby is over 6 
months. If the mother is a survivor of past sexual abuse, coping with a 
little baby may have been okay for her, but an older, more active baby, 
showing active enjoyment at the breast (patting, pinching, twiddling 
nipples) might trigger unwanted memories, consciously or unconsciously. If 
the baby happens to be a boy, in that circumstance it would be part of the 
picture. Years ago i saw a mother who never did make heaps of milk with her 
first baby and needed lots of support to keep going. Something didn't add 
up, until, after she'd gotten through the first six months, she told me her 
baby had been the wrong gender (boy), but now she was okay about that and 
loved him dearly. (He'd never missed out, as she'd been diligent about being 
interactive with him.)  She didn't disclose a past history and I knew her 
well enough to believe she didn't want to be asked. Next baby was a girl - 
and she let down her milk easily to her daughter.

So, there are two quite different sets of ideas for you, and for the 
archives.

Virginia

Virginia Thorley, OAM, PhD, IBCLC, FILCA
Lactation Consultant (original cohort of 1985).
Brisbane, Queensland, Australia.
Website: www.virginiathorley.com
[log in to unmask]

----- Original Message ----- 
From: "Jan Barger" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, October 29, 2013 11:01 AM
Subject: Delayed MER


> Dear Wise Women (and men)
>
> Cross posting:    PTP....a mom -- unable to see her, but talked  w/ her by
> phone.  Baby a bit over six months old, gaining well, has begun  solids 
> but
> was until 6 months breastfeeding exclusively.  About two weeks  ago she
> noticed that during the evening feeding, the MER was delayed -- slowly  at
> first, 10 minutes, to 15 to 20....now she pumps to stimulate the MER, but 
> it  is
> taking 30 minutes of pumping.  Once it comes, baby latches, has a 
> wonderful
> feed, and is completely satisfied, so she doesn't think it is a milk
> supply issue.  Feedings in the morning and afternoon are fine, though she 
> has
> now noticed that it is happening at the second to last feed and sometimes
> even into the middle of the day feeds.  I asked her about orgasm, and she 
> said
> though they have resumed sexual relations, there is no orgasm.
>
> Ideas?  I'm thinking something's up with the oxytocin -- obviously --  but
> in all my years, I've never had one that started this late in the game, 
> and
> only in the evening when her breasts are somewhat depleted.  Ideas?
> Wondering if oxytocin nasal spray might give it a kick start.  Have 
> encouraged
> her to rent a hospital pump as she is currently using a Swing single  --  
> so
> perhaps double stimulation might help.  She says that hand expression 
> isn't
> getting her anywhere.  This is second baby -- first she nursed for  nearly 
> a
> year.
>
> Does anyone have a "recipe" for oxytocin nasal spray?  Her OB is  willing
> to prescribe it, but says he's never done it and wants some  guidance.
>
> I explored the stress issue, but she said no, there is none.  She is  an
> advanced practice nurse in pediatrics -- is well read and researched.
>
>
> Jan  Barger, RN, MA, IBCLC, FILCA
> Wheaton IL
>
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