In response to Kathleen Huggins question, my experience has been as follows:
1)these mothers give no history of breast changes during puberty OR
pregnancy, 2) usually have some underlying hormonal insufficiency
(hypothyroidism is a common one.....mom may even be on Synthroid or some
other replacement hormone), 3) failure to produce enough milk with previous
babies, 4) double pumping q3hrs from the get go failed to produce any
significant amounts, 5) breasts are often tubular in shape, flaccid, with
little or no "veining" present.  I have seen it happen on more than one
occasion.
     I am an IBCLC on staff at the Lactation Center at Northside Hospital in
Atlanta. We have the dubious honor of being the busiest hospital in the
country averaging close to 1100 deliveries /month.  We currently have 15
IBCLC'S on staff with another 20 Lactation educators (RN's) in our department
currently in the process of obtaining their IBCLC staus. It's a great job. We
have a 90% breastfeeding rate in house, god only knows what the fall off rate
is, but at least we give them a good start. Needless to say, I've seen about
everything there is to see nad then some. Much more than when I was in
private practice 10 years ago.
If we can be of any assistance, please let us know!
 Sandey Arrowsmith, RN, IBCLC
P.S. You can e-mail me privately at: [log in to unmask]