I wonder if this is a "plumbing" issue, i.e. ducts not fully patent? It's unusual, but possible, in humans though I'd expect it to be unilateral. The case I was shown was a cow - before I became a mother and began my interest in all matters lactational.
Even if duct openings that are loo narrow or closed is not the whole story, it may be a contributor.

Virginia
in Brisbane, Queensland

Date:    Tue, 26 Feb 2013 09:47:42 -0500
From:    Lea Rivera Todaro <>
Subject: 
Am curious PTP -- a mother  with 35 week twins 3 days old.  History of IVF (premature ovarian failure) and Crohns Disease.  Twins are second pregnancy.  2 year old sibling.  Mom states she pumps regularly, and feels milk (I feel decent mammary development)- got engorged with baby #1 -  but never gets it to come out even with direct breastfeeding. 

Anyone have an idea of root cause? Could it be the infertility? Could it be Crohns?  

Thanks in advance for your ideas. Mom will be buying donor milk (YAY!) and feeding newborns with whatever she can pump plus donor milk, so they are doing fine.  We are just trying to trouble shoot what her challenge is so others can learn too.

Lea Rivera Todaro

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