Most of us have had this situation, and I'm sure there have been many posts, but... I saw a mom in the hospital today, with her second baby, via C/S, 3 days post op, getting drops of milk/colostrum by hospital pump after nursing.  Now I know 3 days is too early, but with her last baby her milk never came in, so this is a deja-vou.  She breastfed, pumped and used the SNS and finally gave up at 1 month.  She was devastated and had a significant postpartum depression. She had 'general hormone' tests that showed nothing.  She experienced lots of breast changes with both pregnancys, but none afterwards last time, nor so far this time, takes no meds, has had no breast surgery or trauma and has moderately large symetric breasts that  are not widely spaced. 
Her baby has a wide gape and is eager to nurse, but gets pokey with the decreased flow (pre and postfeed wt.6cc in 40 min.). He cup feeds formula supplement,  and has her genetic disorder "spherocytosis" (her first son also had this, and both of them have had the spleen removed). 
She is reliving her grief, "why does my body do this?  why won't it make milk for my babies?"  Her emotions are raw, and her thinking negative. She feels like a failure as a mother if she can grow her babies but not nourish them.  She doesn't want anything less than nearly full breastfeeding.  Her definition of success is all or nothing.  She will not use the SNS or any other device while nursing. She wants to know if breast ultrasound would tell her anything.  Is there anyway to know why this happens to her?  
Meanwhile she is 'treading water' by nursing 8+ /24 hours, using breast compression (which did help a bit), and pumping.  Last time she also took reglan and some herbs. I've encouraged her to visualize her milk flowing and give her body more time.  But I also don't want to minimize her concerns. 
TIA for your responses,
Bettina Pearson RN, IBCLC

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