Hasn't anyone considered removing the baby from that breast for say, 30
seconds after let-down occurs, and then putting him back on?  I had such a
strong letdown that Amanda (this is 18 years ago and I still remember) would
gasp and choke and I finally learned to remove her from the breast when I
felt the letdown, wait a few seconds, until the milk stopped spraying, and
put her back on.  Isn't it a shame that all the HCP's think of are
interventions instead of solutions.
Mary Kay Smith