It is difficult to advise a mother how long, because there are so many variables.  In my experience, personal and professional, the mom who has no breast increase, the physical appearance of inadequate development, and no engorgement when milk comes in, is at highest risk for inadequate supply.  When she "does everything" for two to three weeks and sees no increase in supply, I rarely find it improves.  This person may pump 1/2 to 1 ounce maximum even if the baby has not fed for a couple of hours.  There are others where the baby is not gaining, but she has a much greater supply.  These women may continue to improve with continued stimulation.
    The other big thing I have noted anecdotally is that young mothers (teens to twenty-five or so) usually have milk come in no matter how their breasts look and in spite of no changes in pregnancy.  Has anyone else seen this?  We are wondering if there is a time-sensitive period for glandular tissue to develop if it did not adequately do so at pueberty or early pregnancy.  Love to hear if others notice this.
Judi Hall, RNC, IBCLC

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