Hello, from Helena, MT.  This is my first request for help from all of you.  I am actually posting for a friend who works for an intern.  She is working with a woman who attempted to nurse her baby and had to give it up at 3 mos. when the baby was not getting enough milk.  I recall only a few details of the process of my OB supervisor doing a lactation consult on her for 2-3 visits and it seemed that the primary problem was inadequate weight gain. I don't recall if there were problems with change in breast size during the pregnancy.  Latch was worked on and I believe that pumping augmentation was utilized, but to no avail.  I apologize for having so little information on the breastfeeding consult part of this story.  My friend called today actually wanting to know of any references or articles that would make this woman feel better about the failure.  She is East Indian and breastfeeding is a strong cultural belief for her.  That the first loss of self esteem she is suffering from.  The other stems from the fact that the child, now 10 months, is still having "feeding problems" .  My friend described a course of one OT consult to look for "swallowing problems", nothing found and baby on Tagamet currently.  Baby also has thalassemia.  The feeding problem that the baby has right now is that it won't swallow any food put in it's mouth, just lets it sit there, no matter what it is-other than formula. Developmental milestones are appropriate and my friend says is "neurologically intact.   Friend thought a control issue by baby and a possible parent/child interaction problem.  I was at an excellent workshop this weekend on "Feeding and Swallowing Disorders in Infants" by Lynn Wolfe and Robyn Glass.  My thoughts are that a 10 mo. old  probably is not a control freak nor has the forethought to play it out enough to warrant OT consults.  The workshop this weekend has me thinking that this baby needs further evaluation depending on what was done with the first OT consult.  Perhaps some sort of suck-swallow problems brought on the lactation failure to begin with and the mother really was not at fault.  Diagnosis of a suck-swallow problem would then not only help the baby (paramount to this case) but would also serve to allay the mother's guilt feelings as well.  Anyone thoughts on this part would be interesting to hear.  The request by my friend is for any articles or references that we could recommend to this mother to get her on the road to recovery of her feelings.  I apologize for the length of this, but needed to give you what I had as information.  Thanking all in advance-Faylene Nelson,RNC,IBCLC.