Time, Time, Time......I personally have helped some large family moms (Amish & English) and have found that they are not nursing (actually sitting and nursing, definitely not lying) these more than #3 babies 10 to 12 times in 24 hours.  They are usually trying to get the baby to sleep at night and definitely not waking up a "good baby".  If they are a mom that just supplies "enough" for one baby and are not a big milk producer these babies sometimes are failure to thrive until 8 weeks or more. Suddenly the baby gets to a point the he can hold his own and starts growing.  My first thought would be to forget the "tubular breasts" and ask the basics.  Have the mom actually keep a breastfeeding chart, make sure the baby is really nursing, and get HELP for the house and kids for 6 weeks. (this is well done in Amish community).   Karen Graham IBCLC, LLL (30 years)  PS last year had Amish women with #12 who REALLY wanted to nurse (this was going to be her last).  Nursed #1 and #2 then failed on 3,4,5,6,7,8,9,10,11 and gave cow milk straight.  This gem of a woman did everything I told her to do,  really did have a supply issue, so hand pumped, took some herbal tea and it still took 3 months. She is nursing her toddler now.  I had to get her to promise not to hand milk cows for a couple of weeks!   

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