I always appreciate reading the "final chapter" in a query so I thought I'd
post mine.  My original post was around Dec. 9/10.

First of all, I was referring to delayed lactogenesis which I should
have referred to as delayed lactogenesis II.  At 5 days postpartum this
mother was pumping enough to just coat the bottom of the double kit bottles
but had something. The "switch just hadn't turned on yet."

We ruled out PKU, CF, heart defects, thryoid, insufficient mammary tissue,
and retained placenta fragments. Baby seemed happy and alert with many wet
diapers yet scant stool unless rectally probed then copious. Things began to
kick in for this pair at one month postpartum.  Weekly weight gain on the
babe averaged 3 ounces but at 5 weeks there was a 6.5 ounce gain and 12 days
later a 15 ounce gain. Two MDs examined baby for stooling concerns.  Neither
has yet to uncover anything.  We suspected that low caloric intake was the
cause yet now that the weight is so consistantly high, that doesn't follow
through.

In that first month, the midwife and I focused on maternal diet.  I hate to
say this but we even added one of those adult "formulas" to her daily diet.
I had her pump 8 times per 24 hours for a couple of weeks and then wean off
the next two.  The EBM was given back to the baby but the most ever
complimented in one day was 8 ounces (there was some donor milk in that
case).  The compliments were tapered off as well.  Mom gained 5 pounds over
her pre-pregnancy weight of 103 lbs at 5'6" tall.  She had only gained 27-30
pounds during her pregnancy and lost her pregnancy weight almost immediately.

Half of the responses I received said there was no relationship between
maternal weight and delayed lactogenesis II and half said there was.  I felt
that what was causing the maternal low weight to be the key to the problem
yet the thyroid profile was within normal limits.  We did much system support
with herbs to enhance thyroid function and a concentration of protein.
Someone mentioned that these slender mothers may not have enough reserved to
produce milk fast enough for their babies.  Someone also spoke from their own
experience that they were even more slender than this mother with a copoius
milk supply.

I don't mean to imply this we have found the true answer.  I just wanted to
report on the progress.  We think maternal diet played an important role.
Perhaps all the early pumping calibrated Mom's otherwise lacking sufficient
mammary tissue breasts to increase production of the sufficient tissue?
Whatever the case those breasts are making lots of milk now.

We wanted to thank you all for sharing your great minds in such unselfish
ways.

Joanne