VERY slow letdown, anxiety

[@llli*dvs208]

I am more looking for support than any concrete advice here - I've already spoken with two lactation consultants and a personal therapist about this. Of course, any new insight will be welcomed, but I'm more interested to learn if others have weathered similar challenges and come out okay.

My daughter is about 5.5 months old. I returned to work full time when she was 3 months. She's bottle-fed during the day, and while there were no dramatic problems off the bat, she did seem to get more fussy and frustrated with breastfeeding after a few days of daytime bottles. We always regrouped over the weekend though. Thing is, she's not great with the bottle either - she's just a very fussy eater in general.

Over the past 2.5 weeks, however, things have gotten really bad. I do NOT think this is a nursing strike - she acts really interested in nursing, roots around and latches on like a champ, but gets frustrated after just a few seconds. I've gotten so anxious and stressed about this that it's almost impossible for me to let down now. I can pretty much only feed her "successfully" in her sleep, and it can take anywhere from 3-20 minutes for me to let down (she would never, never stand for that while alert!). Pumping while I'm at work is going okay, but when I've tried pumping at home to stimulate a letdown and then popping her on, I have the same anxiety and don't let down then either.

I've tried relaxation, visualization, singing, walking around rocking her, looking at a magazine, and nothing has worked reliably. It might sound ridiculous, but has anyone heard of hypnosis for this? I'm willing to try ANYTHING.

I do still feel my letdowns, while I nurse her in her sleep and when I pump at night. It's also fairly easy for me to tell based on her sucking pattern. So I really don't think the issue is that I'm feeling them less.

I think she's getting enough to eat - during the week, this is really only an issue for a few feedings. I think this is way more my problem than hers, so far anyway.

I have tried bumping up my supply - I take fenugreek supplements (as much as I'm "allowed" according to the packaging) and am drinking Mother's Milk tea. I think that did help a little bit but just for a few days ... not sure if there's anything else I can try instead of or in addition to this? I've just recently been trying to read about fennel, but am confused and worried that there are possible dangers/side effects involved?

I'm extremely depressed now, which I know doesn't help. I am so adamantly against giving up breastfeeding, but I don't know if there's a point where I should just give up to get that horrible decision out of the way, mourn, and move on. I keep thinking things could get better - "successful" waking feedings are not unheard of, we have them once every few days, but I'm such an anxious person by nature that I can't help worrying that this cumulative stress, cumulative frustration and negative conditioning for her, all of it is going to build up and not resolve.

I feel like I'm totally failing her here. Breastfeeding isn't a comfort, it's a stressor. Working full time, I am desperate to hold onto that bond. I wish I had appreciated nursing more during the times I was so clearly taking it for granted.

Has anyone heard stories about instances similar to mine, where the baby seems eager to nurse but the mom is suffering from MAJOR performance anxiety and simply can't let down? I think I spend every minute of my day thinking about this, and start getting nervous up to an hour before when I anticipate she'll be hungry. I'm so angry with my body for failing me.

I'm sorry this is so long; I hope some people made it all the way through!

[@llli*mommal]

Welcome, mama, and congratulations on making it this far despite the stress and anxiety. I once read a paper about letdown reflex in cow's. When cows are stressed or scared, their milk often won't flow. Apparently adrenaline inhibits the milk ejection reflex. Maybe that is the problem for you? (And please don't be offended that I'm sort of comparing you to a cow- it's just that a lot of what is known about lactation comes from the dairy industry...)

One thing that might help would be an oxytocin nasal spray. I have heard of that working for women who have trouble with letdowns.

[@llli*worknpump]

So sorry this is happening. It feels like a never-ending cycle, I'm sure. She gets fussy, which makes you more anxious, which slows the letdown, which makes her more fussy, etc. I had a little of this with DS and am also kind of an anxious person by nature. Seemed like a lot of things could interfere with my letdown. To answer your question about hypnosis - I've not heard about hypnosis benig used specifically for this purpose but I'm sure it can be applied, as could biofeedback (a form of behavioral conditioning related to your heart rate's response to the stressor and then learning to control your heart rate). I've used both hypnosis and biofeedback for a variety of anxiety-related issues over the years with success.

I can share one thing that helped me in this situation - although keep in mind that by the time I started having this issue, DS had a serious case of "flow preference" - he had been in daycare for several months and his bottle nipples had too fast of a flow (my fault)and this is also his personality, blah, blah - lots of other factors that don't apply to you. BUT, it's called the "finish at the breast" method and is mainly designed to get babies back to the breast when there are supply or bottle preferance issues which I'm NOT saying is the case with you, but it may help get you both to a calmer place. Basically, during the times of day that I knew were stressful for us in terms of nursing, I would put maybe a half ounce or an ounce of breastmilk in a bottle, feed it to DS, then latch him on. His need for that "immediate gratification" was satisfied, which allowed him to wait more patiently for my let-down. When I knew he wasn't freaking out, I was more relaxed, which facilitated the let-down. Then we would nurse as usual. We had a good deal of success with this. I don't know if this would work in your situation but I just wanted to share my thoughts. I hope you are able to hang in there. Don't be angry with yourself, your body is not failing you. This is just a hump that you both will get over. Be kind to yourself and I wish you the best of luck!

[@llli*dvs208]

Thanks for the suggestions! I don't mind being compared to a cow at all, I've definitely given lots of thoughts to cows when I've tried hand compressing .

Does anyone know how easy it is to find oxytocin nasal spray - could I get it at a drugstore or Whole Foods or something, or would I have to special order it?

I haven't tried "finish at the breast" yet but it's something to consider. I'm not sure how well it will work because she doesn't totally love the bottle, but I don't suppose it would hurt to try. Maybe I'll attempt that this evening.

[@llli*lllmeg]

Well, I think you have a good handle on what is going on-you have a tremendous amount of anxiety, and that anxiety may be inhibiting your letdown.

This is an age where babies typically become distracted when nursing, and that distraction can take many forms and be pretty severe in some babies. In those cases, setting up distraction free places to nurse and gently encouraging nursing are helpful. It sounds like you are doing all you can, keeping your milk supply up, pumping at work, and nursing baby when together. Look the fact is it can be difficult for some moms and/or babies to keep things "flowing" so to speak when mom and baby have regular separations and pumping and bottles are thus neccesary. Sometimes this works out fine, of course. But some moms and babies really struggle afgter mom returns to work-with milk supply, or bottle confusion, or just with the emotional impact of the separations themselves. In those cases, (if working fewer hours or not working are not options) basic remedies are to pump regularly when separated (and make sure pump is always in good working condition) consider using galactagogues, and to nurse/cuddle/enjoy your time with baby as much as possible when together. You could also make sure your baby is being fed in as breastfeeding supportive a way as possible when you are at work. See http://www.llli.org/docs/00000000000...astfedbaby.pdf

I wonder if you have considered treatment for you anxiety. There are many treatments, including medication. There are anti-anxiety meds and anti-depressents that are safe to take when breastfeeding if that is something you and your doctor think would help.

I would also suggest that giving up breastfeeding, especially if a mom feels 'forced" by circumstances outside her control to give up-is often not helpful at all for moms experiencing depression. if this becomes an issue where your baby cannot get enough milk, for example, there are other alternatives, like going to combo feeding (formula + nursing) for example.

[@llli*aprilsmagic]

The oxytocin spray is prescription, and you have to have it compounded.

I would second treatment for anxiety.

[@llli*lovemygirlso1]

I had this problem with my first daughter. I even have an extremely sensitive letdown and OALD and I'd be fine when she was latching on at home but when pumping at work I'd get so anxious that I wouldn't be able to letdown and pump in the time I had to do it and I'd get so anxious that I then WOULDN'T let down. Just like you. I'd try super relaxing and everything you've said. Nothing worked. I second the advise of perhaps getting some medication or therapy for your anxiety. I benefited a lot from Zoloft. Don't worry things resolved for me and they will for you as well Don't give up mama!

[@llli*worknpump]

Just curious - how is this going, mama?

[@llli*newmom1987]

I started nursing my daughter in the side-laying position at about 4 months. And I have noticed when I go to pump, if I raise my arms over my head and hold them there like I do in the side laying position my let down reflex will kick in. However I don't always feel it, usually I don't feel it at all anymore. Just every now and then when I raise my arms over my head. I don't know if this helps you or not. Although stress could be the culprit, don't give up it will get easier. Just try to stay positive hun.