Milk let down is not happening, is it low milk supply?

[@llli*aeli.james]

Hello! I am currently nursing my 6 month old, and in the last 3 weeks, I have been having difficulty in my milk letting down. It first started in the middle of the night only. Seeing as she only nurses once at night, I didn't think it was that critical. I would still try to nurse for 10 minutes before finally giving up and putting her back to bed. But in the last week, I have been having the same problem during the day now. I will sit there and try to nurse her for a half hour, and still no milk let down. The worst part is, she won't take formula in the meantime. She HATES it. So now I am worried that she will starve to death soon if I don't do something quickly. I have a sneaky suspicion the reason may be due to a decrease in my milk supply. I am not sure why my milk supply has decreased, but it is enough that my milk is having trouble letting down. I am a stay at home mother, but I have begun pumping to try and increase supply, and I have always been really good at staying hydrated. She nurses every 3 hours. However, even pumping doesn't cause my milk to let down anymore. The only thing I can think of that might have caused my decrease in milk supply is my recent progestin IUD implant. It finally regulated itself a few weeks ago, and it also seems that is when my milk let down troubles started. Does anyone have any insight as to why this is happening, and if it is perhaps the IUD causing my decreased milk supply? Anything I can take that will increase my supply? I have already contacted my doctors, but unfortunately, they were not much help. I need to do something fast, so any help is much appreciated, thank you!

[@llli*mommal]

Welcome to the forum!

In general, as long as the baby is having sufficient wet diapers and is being nursed on demand, there's nothing to worry about. Letdown sensation often decreases or vanishes as time goes on, usually when supply adjusts to meet demand very precisely without a lot of milk left over. Many moms freak out at this point, mistaking normal, adequate supply for low supply.

However, since your perception of a decreased/vanished letdown coincides with you getting the IUD, it seems very likely that the IUD is the cause. The progestin IUD is less likely to cause harm to supply than combination estrogen-progestin birth control like the pill or patch, but some moms still experience significant supply reduction when using progestin-only contraception. Personally, if it were me I'd make an appointment to get rid of the IUD. All barrier methods (condoms, diaphragm, sponge, etc) are safe for breastfeeding, and the copper IUD (ParaGard) is as well.

Until you can get the IUD removed, nursing more frequently, pumping, and taking some fenugreek and eating some oatmeal may help you through.

[@llli*aeli.james]

Unfortunately, it has now begun to affect her. She is no longer having sufficient wet diapers. When I changed her this morning is was barely wet at all. So now I am really worried. Once again I could not feed her again. The let down problem seems to happen every other feeding now. I can tell she isn't getting enough because she gets really fussy after a minute of eating and then it all goes downhill from there. I was on the low dose progestin pills before with my first, and I remember having the same problem I am having now. So I think you may be right about getting it removed. The one thing that really bothers me besides her decreased wet diapers is the fact that when I am having my let down problems, it doesn't matter if my breasts feel normal or if they're really full first thing in the morning after not feeding all night. Regardless of how full or empty they feel, I still have no let down. I just don't understand it. Anyone else ever had let down issues???

[@llli*mommal]

Possible explanations for what you're experiencing, WRT letdown:
- You are letting down, but not feeling it. Decreased or absent letdown sensation is normal as time goes on and supply adjusts to meet demand very precisely. Some moms never feel letdowns, but can learn to identify them by watching their babies: frequent swallowing sounds, or a change to a "suck-swallow-breathe, suck-swallow-breathe" pattern usually indicates that letdown is taking place.
- Anxiety is inhibiting your letdown. Adrenaline production will actually stop letdown from occurring.
- Baby is not nursing effectively, and is not stimulating letdowns. This would be unusual in an older baby who should be a good nurser, but can happen during teething or nursing strikes.

[@llli*aeli.james]

I am not experiencing any high levels of anxiety, nothing in life that is stressing me out or anything, except for this of course. But this was happening before I started getting stressed about it yesterday. I just stay calm, quiet and just do breathing exercises. She is teething, so that may be part of it, but the fact that it's gotten acutely worse to the point of dry diapers just doesn't warrant to write that off and let the situation go. I can definitely feel when I let down, and like I said before, after a minute she is crying and not staying latched on because nothing is coming out. I watch very closely to see that change in her sucking and breathing, but it never happens. She just continues to suck frantically trying to get it out I am guessing she is only getting minute amounts of foremilk and then that's it. No let down, nothing else. And I'm only getting drops when pumping after and in between feedings. I am getting the IUD out today, so I am praying that will be the solution. In the meantime, I will also start taking that fenugreek and eat oatmeal. Thank you so much for helping me, I really appreciate it. Unfortunately I haven't even been able to get a hold of the local lactation group here for help, so your support is like the light at the end of the tunnel for me!

[@llli*mommal]

I hope getting the IUD removed will be the solution to all your problems. You're so smart to be pumping and taking fenugreek and oatmeal in addition to nursing- hopefully that will help your supply rebound faster. What sort of pump are you using? If you're using anything less than a very good double electric, you may want to rent a hospital-grade pump and see if that helps during this trying period.

Just one additional thought: babies often fuss and pull off the breast when mom's supply dips. Babies get used to one particular flow speed, they get used to having a certain duration of nursing stimulate a letdown- and when all of a sudden things change, they get really upset. But it's a learning experience for the baby- if you just let baby nurse all. day. long. she should eventually get sufficient milk, and discover how to encourage the maximum flow despite the current short supply.

[@llli*aeli.james]

That makes a lot of sense, that's exactly what she does, and would explain why she keeps doing that. I'm only using a high quality manual pump. I do want to invest in an electric pump though. I will start looking into that! On another note, my supply is starting to come back!! My let down is happening at almost every feeding now, and sometimes faster than usual too. I think the IUD was the culprit! I am so happy I went proactive and got it removed right away. I am going to continue the pumping, and look into an electric one of some sort. I need to start pumping anyways since nursing school is starting back up shortly. Thanks so much for your help!