Yes---I have seen this situation.  Most commonly something went wrong with 
the thyroid during or before pregnancy that was diagnosed during the 
pregnancy...either too high ot too low, and appeared to mess up the breast 
development. So she should have thyroid testing done now...and while you are 
at it they can check a HCG level and  testosterone level looking for 
retained placenta or ovarian cyst.  Might as well throw in a prolactin 
level, but seems much less likely that would be abnormal after two normal 
lactations.

I would also ask about medications taken during pregnancy.  Ocassionally I 
see someone who took pseudoephedrine either a lot during the pregnancy or 
right at delivery who struggles with milk supply, and I wonder if that 
messed them up.

Finally, did she have infertility issues with this baby?  If so, they may 
have been hormonal, and a subtle hormonal imbalance that persisted during 
pregnancy could have negatively influenced breast development.

That is all I can think of this morning...but I have only had 1/2 cup of 
coffee!

Kathy Leeper, MD, IBCLC
MilkWorks- Lincoln, NE

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