Dear Cindy, Two of us IBCLCs here have had several situations like your mom this summer. It seems that these ladies have a breast reduction surgery and can pump really well but baby can not remove the milk well. Test weights showed 1/2 to 1.5 oz removal, depending on the baby. The one baby did well on weight gain until he got big enough to need more and then dropped off the charts. This mom could pump 6-7 oz out with either a Lactina or a Purely Yours. We theorize that some moms have had their areola tissue stretched too tightly when sewed back on which makes it difficult for the baby to get the nipple far enough back into his mouth to effectively remove lots of milk. Or somehow this tissue is "damaged" and doesn't function properly in baby's mouth but pumping works better. I would want to verify exactly how much milk this baby can remove/transfer on his own by having mom do test weights at most feeding over 48 hours. Good luck to this mom, Kathy Eng, BSW, IBCLC

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