Taffy states she has a client who experiences a very painful MER - only
relief comes from firm pressure on brsts.  Most books talk about MER being a
tingling sensation, or mom may have no awareness other than noticing baby
swallowing steadily.  However, in my experience a few moms will experience a
vice-like pain for a couple of minutes.  The fuller they are the worse it is
- may need to do a little lamaze breathing to get thru it.  Often these moms
have very strong flow. I find they deal with the pain just fine once they
learn to breath thru it (perhaps while folding arms over brsts to provide
pressure), and are reassured there is no underlying pathology. 

If a mom suddenly develops unilateral pain with mer then I would suspect
onset of mastitis. 

By the way, I see that Ruth Lawrence's 2005 Breastfeeding: A guide for the
medical profession refers to "let-down reflex".  I remember MER coming into
favor about 15 years ago.  Is the pendulum swinging back to the original
again?

Joanna Koch, MBA IBCLC, N Ca  

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