Besides appearance, it seems like the couple of moms that I have seen, with
baby number 2 not doing well either, is spotty engorgement...very spotty,
and to go along with a previous post, there isn't a whole lot of palpable
ductwork. Some milk but very little even with what seems to be good
technique by baby and regular pumping by mom.

I'll come back to my favorite question that some of you have responded to
previously...What about the mom who doesn't seem to be one that has the
insufficient glandular development, in fact some have nursed other babies
very well, whose *milk never comes in*!!!!!  What can be our very objective
tests to perform that can give us more info into why no lactogenesis?  (Can
you tell I just got another mom in this situation..32 weeks, abrupted
placenta,now 12 days post partum, no engorgement, gets about 1/4 ounce with
diligent pumping. Just came back from the NICU out of town and called...)

Karen Foard, IBCLC, State College, PA
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