Many mothers find it difficult to express milk with a pump at least partially because they are anxious about the amount of milk coming out. They really want/need to express milk and so come to the process a bit tense, they watch the bottles and see little milk coming out and they remain tense...and so release of oxytocin is inhibited and the fear becomes a reality. 
Where a mother has had significant challenges with breastfeeding I can see how the MER might similarly be affected by her strong desire that breastfeeding work and her fear that it won't. Maybe that's at least part of the story here. Maybe working on forgetting about the milk and just focussing on her baby will help? Maybe some guided meditation??
Karleen Gribble
Australia
On 28/05/2015, at 9:54 AM, Attie Sandink wrote:

> Pamela
> I have been following the let down situation that Beth described. I have had experience with mother who have been sexually abused in their past but have never come close to the scenario you described but it so totally makes sense. These a re the kinds of case studies we really need to share or be aware of. I have had moms who choose only to pump for those reasons but have never had a client with a lack of letdown at the breast, especially with a feeding tube unless the suck is otherwise compromised. Beth you will have to give us an update. I wonder if the mother even knows she was abused. I have had several mothers who while breastfeeding  first chid and when asked permission to touch their breast say that it brought intense feelings later noted as past abuse they had repressed, but it was verified in both cases by their mothers. They felt is was the asking of permission to touch that was the safe trigger. At the time I was very surprised but now does not really come as a surpirse.
> please keep us posted Beth
> 
> Attie Sandink, Ontario, Canada
> 
>             ***********************************************
> 
> Archives: http://community.lsoft.com/archives/LACTNET.html
> To reach list owners: [log in to unmask]
> Mail all list management commands to: [log in to unmask]
> COMMANDS:
> 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
> 2. To start it again: set lactnet mail
> 3. To unsubscribe: unsubscribe lactnet
> 4. To get a comprehensive list of rules and directions: get lactnet welcome

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome