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Thread: Please help! No letdown in middle of the night

  1. #1

    Default Please help! No letdown in middle of the night

    I have a 4.5 mo LO and have had letdown issues since she was 6 wks. I know the letdown reflex is usually connected to stress, but I honestly don't think that is the problem. I'll have had a great week and suddenly my letdown will get very slow out of nowhere. It will last for a couple days and then get better for a week or so and happen again.

    The slow letdown really seems to come out of nowhere. I'm a SAHM and don't think my stress/anxiety is particularly high. I have had some PPD and just started zoloft 2 weeks ago though -- could PPD be the cause? The zoloft seemed to be helping but the last 2 days or so I've felt gloomy again and my letdown got all screwy again. The past 2 days it literally will not let down in the middle of the night. LO will nurse for 20 minutes and I know she's getting something, but it never lets down. It doesn't makes sense -- I nurse in bed lying down and am very relaxed -- I've just woken up for God's sake! How much more relaxed can your body get?

    I mainly look for that change in suck pattern or gulping b/c I know you can't always feel it (although I usually do) -- but I know letdown hasn't happened in the middle of the night the past 2 nights. She'll go back to sleep for maybe an hour and a half and be up again hungry. Can anyone help me figure out how to fix my letdown? A LC I talked to suggested maybe my oxytocin was low, and I've tried more skin-to-skin and other things but nothing seems to work. I'm SO tired of this. I now have to pump first before almost every feeding during the day to get the milk to let down first or my LO won't wait for it. She's had to wait 4-5 mintues before in the past and I think she's gotten frustrated. My supply seems to be fine, at least she is gaining weight well. She's 15 pounds at 4.5 mo.

    Thanks for any help you can give me. This has been such an emotional roller coaster that I'm ready to give up. And I REALLY want to nurse -- I nursed my first 2 kids for 18 mo. each, so I can't fathom putting this baby on formula. But I can't keep doing what I'm doing -- pumping before every feeding, dealing with letdown issues, etc.

  2. #2
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    Default Re: Please help! No letdown in middle of the night

    Hi momma,
    So sorry you have to deal with PPD. Although i have the same problem with letdown since her birth, I never thought it's stress related. I usually experience delayed letdown in the middle of the night before my period, it returned very early post partum in my case and with it came back the good ol' pms. I had it when my LO was going through 4MO fussies too, but I was clearly stressed and annoyed at that time. Since you mention mood swings, my guess would be that it could be either Zoloft side effect or something hormonal. But I don't know if zoloft alone can cause delayed let down, someone more experienced will hopefully reply to this. How's LO doing, is she latching and unlatching nervously when you try to nurse? Is the number of wet diapers okay during these days when you have delayed letdown?

  3. #3
    Join Date
    Jan 2013
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    NY
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    Default Re: Please help! No letdown in middle of the night

    Mama, are you thinking that the likelihood that you've had a letdown in the middle of the night is low just because of the frequent night waking/feeding? You say you can tell she's getting "something" but you still don't feel like you've let down--if baby is getting milk, then it sounds like you actually have letdown. The frequent wakings don't necessarily mean anything on this front. Lots of 4.5 month olds begin waking and feeding much more frequently than they previously had been. It doesn't necessarily mean you have a problem!

    4 months is also a time when babies get notoriously fussy at the breast. A lot of times this is because of a very normal adjustment in mom's supply at around this time to more precisely match the infant's needs. So a baby who once had a very easy time getting out the necessary milk may suddenly find herself having to work just a little bit harder to get the same amount of milk, which can bring on some fussy behavior. I'm wondering if this too is what you are experiencing during the day, and it just happened to coincide with you starting your PPD treatment.

    In short, if baby is gaining well and having appropriate diaper output, I think everything is likely okay--and that baby just needs to get used to working a little bit for those letdowns.
    Apologies for the short responses! I'm usually responding one-handed on my smartphone!

  4. #4
    Join Date
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    Default Re: Please help! No letdown in middle of the night

    I would suggest calling infant risk to see if they have any more information regarding Zoloft and let down. If you do and online search for infantrisk you should find it easily.

    Did you say you saw an LC? Did she mention taking the herb fennel? My understanding is this is a galactagogue that can help specifically with letdown issues. But I don't know all that much about it. Overall, increasing your milk production a bit with a galactagogue would probably help anyway?

    If pumping prior to nursing is a chore, and I can see that it definitely would be, have you tried hand expression instead?

    But I guess I am missing something. I'm confused about what is happening that you would have to give up breast-feeding? If your baby is gaining well this does not seem to be causing any serious problem. Very often babies change their nursing patterns and nurse for very short periods of time, or get fussy at the breast etc. etc. for any number of reasons and it's not usually an issue. As far as needing to pump-do you mean your baby refuses to nurse totally if you don't do this? Would a healthy four-month-old baby get to so impatient that they won't wait for letdown and then starve themselves? Maybe baby just wanted to nurse for a very short amount of time at that moment? Just wanted to give a quick comfort suck and then stop? Thought they wanted to nurse and then realize no that really wasn't what they wanted to do it all? Unless a baby has flow confusion from getting bottles and it doesn't sound like that is the case, I am not sure why the baby would object that strenuously to a slower than average letdown.

    I am not saying you do not have a slow letdown, that is not what I am questioning. I'm questioning if it is as big an issue as you think it is. At this point with a normally gaining baby, do you need to be looking for looking at suck pattern and swallowing? It's just not something you typically would need to even worry about, with a normally gaining baby.

    If you're used to feeling let down, especially if you have experienced a strong letdown sensation, and don't feel it with this baby, or did but don't anymore, or only some of the time, I imagine that would be very alarming even if you know in your mind that it is perfectly normal to not feel let down some or all of the time. If you are not letting down your baby would not be getting anything. if baby is getting something you are letting down.
    In my personal experience with a letdown sensation it is usually although not always more apparent if it has been longer between nursing sessions. If baby is cluster feeding then I am pretty unlikely to feel any letdown. It just occurred to me that I also rarely felt let down at night when sidelying nursing. I wonder if it's possible you feel it less at night due to your nursing position?

  5. #5

    Default Re: Please help! No letdown in middle of the night

    Hi -- thanks for your all your replies. I'm going to go to my GP and see if they can look into the hormonal thing. I get the feeling it is hormonal. She does sometimes wait patiently (if she's falling asleep) for the letdown, but sometimes she gets impatient and yes, will latch and unlatch and fuss and after 2-3 minutes she gives up and won't nurse anymore for awhile. She IS gaining really well, and has plenty of wet diapers, but it's because I've been pumping before nursing more often than not and also pumping and giving bottles the second half of the day for the last few weeks. I experienced a drop in my supply before my period with my other 2, but with this one, I don't have my period back yet. and we've had letdown issues since she was 6 wks old.

    My LC did say that she would be getting something before letdown, but that it wouldn't be very much, like little sips. I can tell that she does, but I can tell when I get letdown because she starts gulping, even if I don't always feel it.

    The reason I say I may have to give up BF is because this has been SUCH an emotional roller coaster ride, and coupled with the PPD, every time I go for a week with no problems and then have slow/no letdown again out of nowhere, I get very upset and can't figure out why my body is doing what it's doing. It makes me a basket case and then I start having to put SO much more work into it, like pumping before every nursing session or pumping all my milk and feeding bottles bc i just can't deal with it. I feel like it's just not a sustainable way to live. I feel like my husband and other 2 kids are a bit neglected. My goal is to make it to 6 months and then if it's not better, I'll seriously consider weaning her. I feel like it just keeps me stuck in this place where the PPD is not going to get better.

    Thanks again for your replies. I'm hoping my GP will have some ideas today. Maybe they need to up the zoloft dose. I'm only on 25 mg right now.
    Last edited by @llli*henderswing; May 7th, 2014 at 11:24 AM.

  6. #6
    Join Date
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    Default Re: Please help! No letdown in middle of the night

    Same thing's happened to me since about 3 months. Baby is 6 months now. But especially at 4.5 months, the same age you pointed out. I'd get random groups of days where letdown took very long to happen, or didn't happen at all. It manifested itself during breastfeeding as well as pumping (where it's really obvious, and even more stressful, in a way!). I considered it to be hormonal because it would come and go and had nothing to do with stress or with baby eating less or whatever - i.e. no real cause for letdown issue that I could think of. Sometimes it was accompanied by extra cervical discharge, which, to me, is always a sign of something hormonal. I have not gotten my period back yet either but I am on the minipill so maybe that plays around with it.

    Btw, I don't think I either get letdowns at night, or very small ones at best. But baby doesn't eat much at night so it never bothered me or him really.

    Mom to Samuel J.
    born 7lb. 10 oz. and 22" tall
    on Saturday, October 19, 2013.

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