Diana, I have worked with a few women who had oddly shaped breasts that 
do not look "full" or normal. Most did not make enough milk but a few 
did. What really needs to happen is someone needs to take a full 
lactation history. Maybe you already did this. But really delve into 
what happened from birth. How was baby fed from the beginning? Any 
bottles? How was the birth? Earlier than 39 weeks, prolonged epidural, 
etc. in which the baby might be very sleepy and not suck actively in the 
early days? C-sections with epidurals in for 2 days after birth can also 
make the baby too drugged to suckle effectively. Any history of birth 
control pills or shots? Medications or birth problems, such as getting 
mag sulfate which seems to lower the milk supply for some women. I would 
want to know what test weights showed for both of these babies, too. 
What can baby remove vs what can mom pump out? If mom starts pumping on 
a  rental or hospital quality pump with large enough flanges, can she 
improve her milk supply? I have seen many babies with oral motor 
problems that have caused mom to now have a low low milk supply. And we 
can not get the milk supply back. These would be easy to say it is mom's 
fault but with test weights and oral motor assessment, we see it is the 
baby. I have also worked with many women who have NICU babies and who 
don't get started pumping early enough and then don't make a full milk 
supply. I have seen women get started pumping on day 5 and make only 8 
ounces a day. I have had women pump 2-3 times for the first four to five 
days and then never get up to full supply after they begin to pump often 
enough (8-10X in 24 hours) later on. The red flags you mentioned 
certainly could be a factor but I would want to look at other things as 
well just to make sure. Every mother with low supply blames her self  or 
so I find. Even when the baby is tongue tied and it is obviously the 
baby not the mom! Well that is the things that came to my mind after 
reading your post. Best, Kathy Eng, BSW, IBCLC, and LLL Leader
PS: Yes, I also find things go in cycles. Lots of tongue tied babies for 
a while, etc.

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