I am mostly seeing patients well after delivery but i do see that some women cannot express a drop of milk. We watch them and baby closely. I see many Asian mothers and there is a belief that their colostrum levels are low. I would say it is not consistent among that population and it varies widely.  I also see that drop in production and i counsel on it. If i see the mother in the first 6 hours of life and i am able to get a good quantity while I’m teaching mom i remind her that milk production is cyclical and there are high tides and low tides. Keep practicing and we get what we get and we don’t get upset!  That way when they try later and their technique may be the problem they have been forewarned that volumes may be lower. 

I see dense breast tissue as being sometimes more difficult to get milk out of but not consistently. 
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