>>Previously breastfed two older children but weaned early due to excessive
supplementation.  Mother has been pumping with double pedal pump and after 1
0 - 15 minutes has not seen even drops of milk.  Hand expression by LC
yielded only dampness at the opening on one duct.  Mother is heavy-set.<<

Linda-- I believe that your clues lie in the above quote. I would like to
know when the mother noticed her milk coming in with her first two babies.
Is this a similar experience, or different? Did mom supplement for similar
problems, or by choice? I had a mom a year ago who apparently had no
colostrum whatsoever, and it took longer than usual for milk to come in.
Once it came, however, things were fine.

If milk is not in by day 7, then an in-depth evaluation is in order--- blood
panel for TSH (pp hypothyroid?) and prolactin. I do wonder about the mom
being heavy-set; any hx of diabetes, high cholesterol, adult acne,
hirsutism? My concern would be excess testosterone. Ask about her mother,
aunts, sisters, etc, for their reproductive and breastfeeding histories for
any additional clues.

I know you'll be following this mom closely; keep us posted!

Lisa Marasco