Renee, I was always taught people feel letdowns differently and lots of 
mothers don't feel them at all.  I find it to be true.  Plus, Dr. Hartmann 
et al. have been saying that mothers in their studies typically had 2-3 
letdowns in a particular nursing session but only felt the first one -- 
never the later ones.  I teach mothers to recognize the letdown by changes 
in the baby.

When I have a mother who is tense because of pain or anxiety, and starting 
to nurse the baby, I don't walk out after the baby is latched on well.  I 
sit right down and we start to chat.  She asks a question or two, I make a 
joke or two, and after a little while two or three things usually happen: 
the mother smiles or chuckles; the baby starts to swallow differently and 
relax; and the mother says that nursing is getting more comfortable.  A 
minute or two later I point out to her what has been happening and show her 
how different the baby is now.  I also ask if her feet feel warm, and I 
notice and point out to her if she's getting dozy, as these also can signal 
the letdown response.  I want her to understand that she often gets a nap 
as a reward for nursing.  (I make sure she's set up so she can't drop the 
baby.)

I'm also asking the nurses at the Birthing Center to not set up a mom with 
the *pump* and walk out on her.  (Of course, if the mother is pumping 
there's something the matter, and she's uptight.)  The nurse needs to stay 
throughout the whole pumping session, coach the mother how to hold the 
flanges so they aren't digging into her breasts too deeply, help her play 
around with pump speed/suction levels, answer questions, and engage the 
mother's attention *and eye contact*.  Otherwise the mother is left by 
herself staring at empty bottles...and they stay empty!  I think we should 
tape pictures of spraying milk onto the containers, so moms can't see if 
they're getting anything yet.  When the nurse is there (or I am) she can 
comment admiringly after a while "look at that colostrum/milk pouring 
out!"  One nurse did comment recently that she could see staying made a 
difference.

Elise
LLLL, IBCLC, RLC
New Hampshire for another week or two...

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

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html