Dear Donna:  Used to feel I could get milk out of any nipple (pride before a
fall...) but have several times seen day 3 breasts out of which nothing will
come.  Look normal.  Good growth during pregnancy.  Unremarkable history all
around.  C... pump doesn't work.  Hand expression nets nothing at all.  Not a
drop from the nipple.  But a drop or two of milk appears on the areolae -- I
didn't notice if this is from montgomery glands as you described.

Mom then becomes horrendously engorged.  Cabbage leaves, etc.  I see mom on
day 5 and NOW I can express slow flow of milk and mom can pump  perhaps 20 cc
each breast.  Flow still too slow to satisfy baby.

Do wish we still had Syntocinon (the discontinued oxytocin nasal spray) as
perhaps lack of oxytocin is the root cause.  It's obvious in these cases that
mom can make it -- she just can't get it out.

Have to add that on two very recent occasions (after not seeing this in
months) both moms were quite emotional and gave mixed signals about
commitment to breastfeeding:  "I really want to breastfeed but..."   The
focus seems to be concern for self, not baby.  Could there be a psychological
inhibition at work?

Joanna Koch, IBCLC