Hi everyone,

I have permission to post.

I recently received a call from a mother who said she was suddenly unable to let down for her baby.

She nursed her 2-year-old daughter through this pregnancy.

Had a son, no problems with delivery reported, did have IV.

Baby nursing well, gaining weight. On day 9 at 2 a.m. she reports suddenly not being able to let down for her son, who became very frustrated after about a half-hour latched.

When I spoke to her 12 hours later, she'd managed to let down for her daughter and for the pump once, and after more (in her view) unsuccessful latching gave in and gave pumped milk in the bottle.

She said this had happened to her once before (with first baby) due to a 'very traumatic' event but since her daughter was on solids at the time she was less concerned then and it resolved after a couple of days.

Everyone she talked to tried to tell her she just wasn't feeling the letdown, but she says she knows the difference, and she can see that the baby's not doing suck/swallows.

She generally has a very quick, forceful letdown and abundant supply, with baby sometimes having to work to keep up.

I saw her in person 24 hours after our first conversation, and the situation had pretty much resolved. I observed a nursing and everything looked good - a textbook feeding :)
No pain with latch, tongue-tie or other obvious physical issue.

She already is using Bach Rescue Remedy, takes Vitamin D (4000 IU daily) and fish oil as well as a multivitamin. 

Her mother is there helping her with chores and the 2-year-old.

Now, a week later, she says it's happening again, but thanks to the Stanford videos on hand expression/breast compression, she's able to use breast compression so baby gets enough even without a letdown. 

The suggestions I had included using the sister or pump to stimulate letdown, trying reverse pressure softening. I even mentioned that someone on LACTNET suggested stretching out the nipples to elicit a letdown.

We're talking through her expectations/understanding of how letdowns and milk removal work and talking about her anxiety (which is unusually high in my assessment). I demonstrated using laid-back positioning to get completely relaxed. She's extremely worried about having something go wrong where she loses her supply. I'm guessing it's her anxiety which is the key to the issue.

I'm just wondering if there's something else that could be a contributing factor? I haven't run across a mom with this issue before where it wasn't low supply or a baby clamping due to oversupply, and where things went well until day 9.
Also, any other tips for eliciting a letdown?
TIA,
Marcia in MN

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