I also just had a mom present at WIC with apparent failure of lactogenesis
II. She was two weeks postpartum and had given up pumping two days prior to
our appointment. Her history was quite messy. Lovely primip Hispanic mother,
age 34, regular cycles and good health but took 2 years to conceive.
Reported only very modest breast changes during pregnancy. Was diagnosed
hypothyroid during the pregnancy (they do not usually test when there is no
prior history, so I do not know what the red flag was). Delivery was induced
@ 39wks because they estimated baby was at least 10lbs, but was only 7#10.
Mom had disseminated intravascular coagulation after the delivery and ended
up in the ICU for 5 days. Did not begin pumping until after 3 days, then
started pumping every hour. I do not know for how long she pumped every hour
(language/communication issues) but she was insistent that she pumped a lot
and said that nothing ever came out. Anything. I checked her breasts; they
looked normal in appearance with some veining, but very flaccid; I was not
sure how much glandular tissue I was palpating. I expressed half a drop of a
clear yellowish liquid on one side and nothing on the other side. 

At this point mom had decided just to formula feed. I talked with her OB
office and suggested they test her further regardless because obviously
something is not working right in her body, but because she doesn't have it
in her to try any longer, it will not be urgent testing. Was it the
fertility issue? Or was a pre-existing thyroid problem the cause of the
infertility and now the lactation problem? How about the DIC situation?
Didn't even get to retained placenta.  She told us that she was RH- and that
the doctor at the hospital told her she probably should not have another
baby because 1) it might die, 2) it might be deformed, or 3) something else
horrible. The nurse in her OB's office told me this was not true and I'm
thinking that maybe she misunderstood info about the Rhogam shot, but the
mother insists she was told this. Wish I could have dug into this one more,
but it was such a train wreck and the mom already so traumatized.

~Lisa

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