<< I have a question re: the effects of infertility on breastfeeding.  If a
 woman has a history of infertility or a difficult time getting pregnant
 (with this baby), can her milk supply be deficient in some way?  Less supply
 even though she does everything the "right way". >>

I have seen this anecdotally in my practice.  It is one of the questions I
always ask in a history taking.  Generally speaking, it doesn't seem to be an
issue with moms who have just needed a boost with Clomid or Pergonal or one
of the other drugs, but it seems to be a bigger issue with moms who have
undergone IVF or GIFT or one of the more esoteric infertility treatments.
 And even then, it doesn't happen with everyone of them.  Some of the moms
produce lots of milk -- some produce none.  I've had prolactin levels tested
on a couple of them that didn't produce any milk (or very little), and they
have been subnormal.  I suspect then that it may be a hormonal system that is
screwed up; that they either didn't have enough progesterone or prolactin to
produce the milk making alveoli in the first place -- I don't know.  I've
also had OBs who have scoffed at me saying there was absolutely no connection
whatsoever.  This is something that wouldn't have been studied in the past
necessarily because if a woman didn't get pregnant, she obviously wasn't
lactating.  Except for those few that tried adoptive nursing.

Let's put it this way -- it's one of my "red flags" and I watch these moms
extra closely until I know all is well and I heave a sigh of relief.  And no,
I don't tell them why I'm asking, and most of them don't ask.  I'm not into
self-fullfilling prophesies here.  Unless she doesn't produce milk, and then
we talk about it.

Jan B
Wheaton, IL