Today I received a request for help from a 35 yr. old mom of 3.  Her 8 week
old woke up at 4am today to nurse and after about 30min of nursing, mom
reported she was unable to have a letdown.  Mom stated that this prob occurred
at 4 weeks of age when family was in Fl. for vacation and also baby had "the
sniffles" so mom just chalked it up to changes in schedule and added stress.
After 48 hours of pumping and giving EBM via bottle after nursing attempts,
finally was able to have letdown again.  No probs since then until this
morning.  According to mom, these have been the only bottles baby has
received.  Mom denies all meds except Tylenol d/t sinus pain last 2 days.  Non
smoker, breastfed other kids about 1yr each.  Mom reports that her nipples
have been more tender and sore with this baby than the others and that by the
end of the first day of birth, her nipples had blood blisters.  Most soreness
resolved with time but nipples still "tender"  (her words).  Also reports that
nipples look white after feeds.  States that baby opens very wide for feedings
and I encouraged her to make sure as much breast tissue as possible gets in
baby's mouth and mom states she does.

I searched archives and only found references to heavy smokers, possible
Ibuprofen interefering with letdown and overall milk supply problems.  Mom
stated that this am her gown was soaked and other side leaked during the
nursing this am but baby still frustrated at breast, pulling, moving head side
to side which is making mom even more sore.  Is it possible that this baby is
having latch on difficulties after 8 successful weeks of nursing?  Mom denies
no recent changes in schedule, illness, etc.  I am stumped.  Any help would be
greatly appreciated.

I recommended mom feed baby about 1oz of milk before next feed to see if she
would nurse a little more gently therefore reducing mom's pain level.
However, I still am wondering if it is a latch problem.  Mom has always felt
letdowns up till now and I think is pretty up tight about this problem
(sounded that way) although she says she is trying to relax.  Is using warm
compresses, warm showers, etc. to no avail.

TIA
Amanda Copeland, IBCLC
Griffin, GA