I would certainly suspect stress in this case. When I was pumping for 
full-time work, any worry at all about the amount I was pumping would stop a 
let-down flat in its tracks. My first approach would be to reassure the mom 
that she has plenty of milk (if she doesn't, this can be addressed later), 
and advise her to NEVER watch the bottles when she is pumping. Consider the 
pumping just as "practice", with no emphasis on quantity, and try to find 
out what will help her relax with nursing. With good counseling, she may 
feel the return of her let-down. If this turns out not to be the case, you 
can start to follow the "Low Supply" pathway, but my suspicion at this point 
is that starting to treat her as if she has low supply (with her worries 
about returning to work) could actually make the situation worse.

Good luck to this mom, and steer her to www.workandpump.com (my website, but 
I have no financial interest, as I'm paying for it out of pocket!) for more 
pointers about going back to work.

Kirsten Berggren, PhD, CLC

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