Jen, I agree we don't know what to expect until there is a baby.  BUT,  when 
a mom is sitting before you, and you examine her breasts and feel there is  
very little there but fatty tissue, and the baby is transferring zero at the  
breast and still losing weight on day 7, well, something is up.  It is not  
about small breasts vs big breasts either.  I have felt breasts that from  all 
appearances should have been leaking!  But, weren't.  Now, for  many there are 
other issues involved.  And, for some, there may have been  'just enough' there 
in the first place, but poor management of breastfeeding in  the early weeks 
dropped their supply and whatever happened, their bodies would  not pick back 
up for them.  
 
One mom I was working just yesterday had very small breasts, elongated  
areaolas and her supply was never full.  If I just went by a picture, I  would say 
she fit the photo in Breastfeeding Atlas for breasts with impaired  milk 
supply, but 'impaired' does not mean 'none'.  Her pediatrician made  some bad 
choices, gave her some bad information, and set her up to not have the  best first 
week.  Yes, there was a problem, her baby was losing weight,  though not 
enough for what his intervention was:  Immediately stop  breastfeeding, formula 
feed only, and pump once or twice a day.  She didn't  know any better, she 
listened.  By the time she contacted me, her breasts  that may have had limited 
glandular tissue now also had a lack of  stimulation.  For many reasons, she was 
doing the best she could  within her own personal situation...pumping with a 
hand pump and nursing and  supplementing.  For awhile she was making about 6 
ounces a day.  With  a lot of work and a decent pump, we got that up to 14 oz but 
the baby was no  longer at her breast much.  When she finally came to see me 
with her almost  5 month old baby, he was able to take less than an ounce from 
her nursing, but  she says she can usually express about that too.  In the 
mornings she can  get about 2 maybe 2 and a half after several hours of not 
expressing, and it  goes down from there to less than an ounce each time. When I 
felt her  breasts, there is only one quadrant that has any glandular areas, the 
rest is  just not there.  When she felt for herself, she said it made sense, 
because  that is the area that feels firm sometimes, but the rest of her 
breast never  does.  So, for her, the amount of functioning tissue she has may not 
be  full, but what she has is working as much as it can.  

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