I also wanted to chime in. I just took the IBCLC exam and in my preparation I came across two relevant points. One, oxytocin secretion can be inhibited by stress (explaining her difficulty to let down, given her infant's medical issues and her family situation), and two, Riordan/Wambach (Breastfeeding and Human Lactation, 4th ed.) note on page 406 that "Some mothers find the use of synthetic oxytocin nasal spray helpful in eliciting the milk-ejection reflex. While it may not increase overall volume of milk pumped (Fewtrell et al., 2006), its use may help individual mothers overcome delayed milk ejection and reduce pumping time. This preparation can be obtained by prescription from a compounding pharmacy".

Hope that helps,
Patricia, CLC (hopefully IBCLC by October)  

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