Hannah wrote, "Do genuine cases of milk insufficiency exist?"   The piece
you quote is interesting and logic would demand that there are wide
variations in breast size/shape/glandular tissue, although questions of milk
"quality" leave me a little sceptical.  My observation is that, yes, there
are genuine cases of milk insufficiency.  I have occasionally worked with
mothers right from the beginning who did all the right things, had no
history of haemorrhage or Sx of retained placental fragments, were taking no
meds that could suppress lactation, were nursing long and often, their
babies were breastfeeding effectively and yet, with the highest motivation
and effort, they simply did not produce enough milk.  I find it baffling and
heart-breaking when this happens.  Many are motivated to continue
breastfeeding while they provide supplements to maintain adequate weight
gain for their babies.  I agree that these cases are very few and far
between, and it takes a fair while and lots of follow-up to be quite sure,
but I do believe that genuine breastmilk insufficiency can happen because I
have seen it.

Pamela, Zimbabwe (who currently has a client who, at 2 full days postpartum,
and for no "cause" that I can see, is not producing even a glisten of
colostrum - HATE these cases!  Just seen Opal's message on this, very much
liked the protocol, but am concerned if *I* can't express colostrum at this
stage.)