Kim,  I have worked with Moms in the Neonatal Intensive Care fitting the 
dscription you describe.!  We take a detailed history on mom, and when 
there is a history of little to no breast changes with invitro for low 
hormones (we have several invitro clinics in our area), a warning flag 
goes up.  Unfortunately, many of these moms deliver early and rely on 
exculsive pumping.  These moms do seem to struggle with there supply and 
one that is of advanced maternal age (I hate that phrase) does seem to 
compound the challenge.  
Since your mom will be delivering a term baby, her success may be much 
better-I would follow her closely and investigate some herbals if she is 
open.  Also, her physician may be willing to draw labs to confirm her 
hormone levels if her milk does not seem to come in despite the best 
breastfeeding management.  I have found many moms feel better knowing why 
breastfeeding did not work out when they truly did all they could. An SNS 
may be helpful for this mom if you see them getting off to a slow start.  
Keep us posted!
Catherine Katz RN,IBCLC,RLC 

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