Well, it is always difficult without seeing the mom actually pump...but can you try a 36 or 40mm flange? These situations are very frustrating. We see them once in a while...I can think of a handful in the past 6 years, most of whom just nursed on one breast. We have two women currently who had previous lumpectomies with periareolar incisions from about 1:00-4:00 who are getting very little milk from that breast, and are from the other one. But at least we have something to theoretically blame in those cases. There is so much we do not know. Kathy Leeper, MD, IBCLC MilkWorks- Lincoln, NE The contents of this message may be privileged and confidential. Therefore, if this message has been received in error, please delete it without reading it. Your receipt of this message is not intended to waive any applicable privilege. Please do not disseminate this message without the permission of the author. *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET email list is powered by LISTSERV (R). There is only one LISTSERV. To learn more, visit: http://www.lsoft.com/LISTSERV-powered.html