Patricia, for the mom who won't/can't let down, I have worked with *one* mom
(with a newborn, I admit) whose doctor agreed to prescribe buccal Pitocin to
assist letdown.  Mom placed the tablet under her tongue, waited for the
let-down then spat it out, repeated as necessary.  It worked to resolve
severe engorgement.  It sounds like you and mom have tried just about
everything else. Just a couple more thoughts - could the heavy bleed have
been a miscarriage?  Could there be some retained products of conception?
Could there be any connection with a low Hb level following the bleed?   Any
connection with oral contraceptives or injectibles?  Menstruation at three
months while "happily nursing" sounds unusual to me.  Keep us posted.

Pamela Morrison IBCLC, Zimbabwe