Hi Jessica, Breast trauma can induce mastitis in a non-lactating breast, which could concievably produce damage that could explain the lower production in the injured breast. Other possibilities to look at in this case: The unequal breast consistency could be caused by an unusual distribution of glandular tissue in the breast. Did you palpate for milk glands, and if so, did it feel like the usual amount and fairly even distribution (it is typical for there to be more glandular tissue in the lateral and lower quadrants of the breast than the medial and upper ones.) When there is unusual distribution, it can be a sign of glandular hypoplasia, whatever the size of the breast. Baby could have headache from vacuum extractor, try positions which put no pressure on baby's head, vacuum does not predispose a baby to either happiness or proper sucking. If baby does a poor job stimulating the milk supply initially, it can take mom time to increase her supply in the second week. Watch mom pump, to make sure her breast fits well in the pump. Medela kits have a comparatively narrow nipple tunnel. If mom's nipple is being entrapped, it will turn either beet red or white soon after she starts pumping. Either way, a wider nipple tunnel will help her get more milk. Medela does sell "personal fit" flanges that are wider. Barbara Wilson Clay finds that if mom's nipples are the diameter of a US nickel or greater, they need wider flanges. -- Catherine Watson Genna, IBCLC New York City mailto:[log in to unmask] *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html