Jan, I have no great words of wisdom about your daughter's milk supply but would like to share some experiences I've had with exclusively pumping women. The conventional wisdom is if they don't have that initial surge of milk it won't happen. I've had mothers in the NICU, however, exclusively pumping for premature babies who've taken up to 6 weeks to get a full milk supply. One recently, pumped with a Classic, followed guidelines to pump 8 times in 24 hr., took Reglan, etc. but only very, very slowly increased milk supply to about 15 oz. per 24 hr. at 6 weeks. Once her premie went on to nurse on a fairly regular basis her supply increased to meet his demand. I've had other mothers who have very slowly increased supply over that first 6 weeks to make the 20 oz. per 24 hr. which I consider the minimal amount they need to breastfeed a premie. In each case I was surprised to see this happen. There was never a surge of milk only a very slow, gradual increase in supply. I would pursue retained placenta and thyroid issues but if these don't pan out I wouldn't give up hope yet. I've also had excellent results with 15 Fenugreek caps per day--I generally recommend moms take 3-5 caps with each meal just to help them remember to take it. Also lots of skin to skin.

Oh, one other thought--we've seen increases in milk supply among our pumping mothers when we've changed flange sizes.

This must be so tough on all of you. I wish your daughter and grandbaby the best. They are so lucky to have your support.

Kathy Boggs, RN, IBCLC