Judy:  It sounds as though this mom's nipples and areola are not being
properly stimulated.  Although I've not had much success with it, some moms
find that the "flexishield" attachment for pumps (Ameda/Egnell) helps with
this. Make sure the mom is not dehydrated.  Also, she might try Fennugreek
and Blessed Thistle before resorting to Reglan. Honestly, there have been a
few cases locally of this situation where moms have borrowed "experienced
nursing babies" to stimulate milk coming in.  This raises all sorts of
health issues, but it worked in every case I've heard about.  Perhaps this
woman's partner would be willing?
Chris

 Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC   email: [log in to unmask]
                HSR & Health Educational Consultant