Dear Jan, how distressing this must be for both of you! The first thoughts I had were to make sure the breast flanges were large enough for your daughter's nipples. I see a lot of women that need the largest flanges and pump greater quantities with them. I would say maybe half my WIC clients with premature babies need the bigger flanges (and the Ameda standard flanges we use are larger than the Medela standard ones). Also, someone needs to check her Classic pump with vacuum gauges just to make sure it is working properly. Is baby at breast at all? If yes, some test weights before and after nursing would help solve this puzzle. I've seen too many babies who just could not transfer milk properly -- tongue tied or formerly tongue tied especially (due to what I think are baby's physical oral motor limitations). Best wishes to you, Kathy Eng, BSW, IBCLC

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