A couple of thoughts on this:

2 oz at a pumping sounds ok to me. Not super abundant, but I would not be 
thinking retained placenta. A mother with very large breasts does not always 
feel the fullness of lactogenesis II.

The baby may not be able to access the right spot to elicit the MER. Perhaps 
mother can elicit MER first. Make sure mother is using a rental pump and a 
flange with a large enough opening. Perhaps try all sizes at different times 
to see which yields the most. In my opinion, ANY MOTHER HAVING CONTINUING BF 
PROBLEMS SHOULD BE USING A RENTAL-GRADE PUMP if at all financially possible, 
until baby is breastfeeding ALL FEEDS WELL. Any thing less is to risk the 
milk supply.

One other thing, baby can feel smothered by the pressure of a very heavy 
breast on his chest, particularly if using the football (clutch) hold, which 
is often easier to use than the cradle or cross cradle for large moms. So it 
may be that you have to adjust the baby or support the breast so that he 
doesn't feel lke someone is laying on top of him. This could be very 
uncomfortable and/or scary.

Laurie Wheeler, IBCLC, MN, RN
n.e Mississippi, s.e. USA

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