Dianne,

Two risk factors for producing less milk that I noted in your post were
"minimal changes in pregnancy" to her breasts, and the thoracic surgery she
had.  Does she have good sensation in her nipples?  It is possible that the
nerves to her nipples/breast were damaged during the surgery, and as a
result she is not getting the positive feedback from nipple stimulation to
produce and then eject milk.  Also, ETS affects the autonomic nervous system
responses, so I imagine this could also affect lactation.

-- 
Sharon Craig Economides, LM, CPM, MMid, IBCLC

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