Hi,
Milk letdown is one of those things that is a bodily relex - it really always works. However, the sensation women experience is very different. About 30% of women never feel a letdown and yet their baby grows and thrives - it's working. When you are anxious and stressed it is easy to overthink it. The milk you express into the shield at the start of the feed would probably be milk you can express before your milk lets down - so it's a bit harder to get out - it comes more easily with practice. How is the pain level now? Could it be time to ditch the nipple shields? Nipples generally heal pretty quickly. What is baby's output like? Tell me about the wet and dirty nappies - colour and quantity? Feed your baby all the time - whenever he looks sideways - don't worry too much about the letdown. It's working. You'll be back on track very shortly
Thanks Barb!
Milk let down seems to have improved a bit. She has put on 210g in 5 days. Her poo seems to be getting thicker and an "Dijon mustard" colour. She has a lot of wind though, not colicky just unsettled. I've finished the antibiotics last thursday, but it looks like the mastitis has returned today in the right breast instead. so I might have to start another dose. Nipples aren't fully recovered but I will start trying her without the shields occasionally so she gets used to it again.

It seems I either have too much milk or not enough!