Sunny California seems to be suffering from an epidemic of low milk supply
moms.  I am beginning to feel there is some physiological process happening
that we have yet to document.

Standard wisdom in the clinic I work at is that milk supply will be
permanently impaired if breasts improperly stimulated in first 48-72 hours.
 But I see plenty of exceptions to this rule.  (Why do some mothers respond
to insufficient breast emptying with engorgement day 3 and others with
delayed and low lactogenesis?)

On the other hand I see moms who have no suspicious history, no birth trauma,
no health issues and who have managed breastfeeding in a textbook fashion
since hour 1 but make less than 10 oz q24h.  No emotional issues either that
I can determine.

I, and others locally, are seeing enough of these women that we are going to
attempt to document them more formally as a group.  There simply are too many
unexplained cases of low milk currently.  Anybody else similarly frustrated?
 Or is it something in the water locally?!

Joanna Koch, IBCLC in Los Altos, CA