Barbara & Virginia,
 
Thank you for your suggestions.  I really do appreciate the thought  that 
has gone into them.  Couple of things to keep in mind -- this is her  second 
baby (second boy), first one she nursed nearly a year with no difficulty  (I 
suppose we could possibly explore the "I really wanted a girl and got a boy 
 instead, issue).  So I don't think sexual abuse is a concern at this  
point.  Secondly, this only started two weeks ago, and is only during the  
evening feeds when the milk is more depleted.  Morning and early afternoon  feeds 
are fine -- quick and easy MER.  As were the evening feeds up until 2  
weeks ago.  And she can't think of anything that would have triggered the  issue 
two weeks ago -- we talked about that.
 
I agree that the baby is a better trigger for MER than the pump, however,  
the baby isn't interested in hanging out and nursing for 30 minutes to 
elicit  the MER which is why she started using the pump.  He gets  restless and 
wants FOOD.  Most 6 month old babies of my acquaintance aren't  interested in 
nursing for long periods of time when they are hungry --  especially when 
they are used to quick MERs....
 
Have suggested CST and bodywork, and sent handouts on breast massage and  
RPS.  
 
She is not supplementing with a bottle, he's never had one, and she never  
pumped until the MER problem came up.  She knows she has the milk --  it's 
just getting it to flow that is the issue.  And why only in the  evening?  
Does it have to do with the fullness of the breast stimulating  the oxytocin 
receptors?  
 
I will suggest the skin to skin and cobathing at night.  How realistic  
that is going to be with a toddler in the house is anyone's guess.  And, of  
course, this is a squirmy 6 month old...not a newborn.  
 
I've also suggested Rescue Remedy which she is going to get today.  
 
Acupuncture has been suggested as well, so I'm going to give her that as an 
 option.
 
Thanks for everyone's help -- truly a sisterhood of wise women here!
 
Jan Barger, RN, MA, IBCLC, FILCA
Wheaton IL
 
 
 



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