The problem with making generalizations about gastric by-passes is that so
often these surgeries are done on morbidly obese patients who may have other
issues that may be more key to the bfg issues than the surgery itself.
Often these women have some sort of insulin resistence problem, or have the
obsesity secondarily to conditions such as PCOS.  Both insulin resistence
and PCOS have been implicated in primary low milk production.

 Additionally, some morbidly obese patients have eating disorders.  Too
often the by-pass is done without addressing (through behavioral therapy, 12
step programs or additional treatment of some kind) the underlying
psychological disorder.

Finally, and I am not saying that this is pervasively a problem, but I have
worked with two grossly overweight mothers with very thin girl babies.  In
both these cases, it was my impression that in some manner (perhaps due to
their own body image issues) the mothers preferred that these baby girls be
low weight.  Both had very distorted impressions of their baby's situation.
They essentially defied any suggestions by their physicians or by me to help
the babies gain weight.  One baby was identified as FTT and hospitalized a
few months later for supervised feeding.  She was so thin that she was very
susceptible to lots of illness, and was repeatedly  hospitalized for
respiratory infections.  Her mother's comments when the baby's weight was
discussed was that the baby was "built just like her [skinny] father."

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com
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