Lisa, I might suggest some other things. Starting pumping or nursing on 
day 3 is a red flag for causing low supply. The pump she may have been 
using might not have worked properly or if it was a computer pump, might 
not have cycled correctly for her. Her flanges may have been too small 
or she did not know how to use the machine properly.

The fertility question is also valid. The illness and stay in the ICU 
could have something to do with this problem.

When she stopped pumping is also important as she may have just pumped 
in the hospital and quit upon discharge.

I find that moms who get long term mag sulfate or even one day of it 
often have low supplies (you don't mention this drug but I see this so 
often I mention it here).
Could they have given her depo?

When I have helped moms with very flacid or "empty" looking breasts in 
the first two weeks, I do not see them making a full milk supply even 
when using galatogogues and a good rental quality breastpump.

You don't mention if she ever got engorged?

The reality is that we need to help mom achieve her goal and it sounds 
like her goal is to formula feed at this time. There is not a solution 
to every problem unfortunately.

Kathy Eng, BSW, IBCLC

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