I have a few comments to make on this subject.  Often, I see these moms can 
actually spritz a line of milk quite easily, but it seems whatever few cc's 
are available are right at the front, and then there is nothing afterwards. 
But to the mother, she thinks, wow, if I can spritz, I must be doing great.
Second, I think they often get a feeling of fullness when in actuality what 
is in there is very small.  Let's say they spritz out that 3cc, when they 
really get full, and say they feel engorged, it seems there is more like 
10-15 cc inside.  This is just my clinical experience.
On the other issue, we have a duty to inform the mother.
Years ago, I helped a mother on her 9th (!) child.  Each time was traumatic 
for her, because people told her if she would just try harder, nurse longer, 
be more calm. etc that this time would be different.  Well, each time she 
had a starving, miserable baby.
I explained to her the situation of her breasts, and she burst into tears. 
I of course stepped into the whole counseling mode, of this is not your 
fault, etc. and she turned to me and said "These our tears of happiness. 
Thank you so much for telling me.  Noone ever told me there may be a 
problem, and I blame myself each and every time>"
So, mothers deserve to know the realities.
Jessica Billowitz, IBCLC
Israel 

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