I also had a very puzzling case of a mother who failed to produce milk.
This mother was treated for pregnancy induced hypertension with
magnesium sulfate for two days after birth.

 She began pumping with a hospital grade double electric pump on day 2.
 She was initially only pumping 4 times a day.  On day 6 she was not
feeling any engorgement or other signs of milk production.  She then
increased pumping to every 2 1/2 to 3 hours including once at night. On
day 12 she was still only producing drips despite double pumping every
3 hours.  She reported that there never were any changes in her
breasts after delivery.  They were both very soft.  The most milk she
ever pumped at one time was 10 cc on day 4-5.

I wondered about retained placental fragments, prolactin levels and the
effects of magnesium sulfate.  The mother did have a history of
hypothyroidism but was not currently on any medication.  The baby was
born via C-sect at 35 weeks due to failure to progress and fetal
bradycardia (baby actually had an undiagnosed cardiac defect requiring
immediate surgery).

Mom went back to her OB at 15 days.  OB said everything looked fine but
agreed to check prolactin levels which are still pending.  Mom took
fenugreek for 48 hours beginning on day 16 with absolutely no increase
in production.  We even had the baby to breast on day 16 in hopes that
the skin to skin would stimulate hormone production.

Today is day 19.  Mom stopped pumping yesterday and baby is receiving
abm by bottle and feeding tube.  Mom is disappointed but ready to move
on.  Very puzzling situation!

Rachelle Lessen, RD, IBCLC
Children's Hospital of Philadelphia