Joy,

 Interesting case ! From this distance it would seem that emotional factors
might play a large part in this mother's low milk supply. Pain, and fear (of
the baby starving) would inhibit the MER. This mother must also be feeling
very angry, disappointed and out of control about having a c-sec when a home
birth was planned .At age 41, this may be her "one and only", so it had to be
perfect. Talking with her about these feelings and letting her vent might
help. A professional massage might also relieve her tension. Use of
syntocinon at a couple of feedings might stimulate the MER and give her the
confidence to release and make more milk.(Derrick Jelliffe said
"Breastfeeding is a confidence game").

Let us know the outcome of this case !

Beverley Rae, MSW CSW iBCLC
Manhasset, NY (formerly from Melbourne, Australia)