Dear Brenda,

Was there a visible difference between the breasts during pregnancy and/or post-partum?  Is there anything in her history (injury, illness, radiation treatment, etc.) which would have affected one breast more than the other?  Has the low-producing side always been that way?  If there was milk in the beginning that then diminished over time, it may be that the other breast may need a different size flange to be effective.  She may find that hand expression is more productive with the other breast - I would use a lot of hand expression/massage anyways right now in addition to pumping to help get things going.  Has she tried a hospital-grade pump?  Perhaps that side needed more frequent pumping than the other in order to maintain a supply.  Has she switched breasts while pumping to make sure that both sides are getting similar amounts of suction?  It may be that she is one of those women who does have one breast that produces poorly, for unknown reasons.  Since a single breast is capable of sustaining a baby, it may be that she does not really have a problem.  If all else fails, Increasing the amount of pumping/expressing on the good side should produce plenty of milk for the baby.  Have her add hand expression to the beginning and ending of each pumping session, if she is not doing so already.


Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
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