Dianne Sounds like things in the history may have contributed to low milk supply: <<recovering from a flu that had lasted for some weeks>> Was she vomiting and having diarrhea? Dehydrated? How sick? <<history of severe anemia>> Can be linked to low milk. <<Fatigue had precipitated giving supplemental bottles>> If this was about at one month old this could have contributed further to the downward spiral before her milk supply was well established. <<first saw this mom, the baby was not latching well, with pursed mouth and clicking>> Was this the "cause" of low milk or the "result" of low milk.?? <<two lumpectomies in the years since she nursed her last baby>> Maybe caused some damage too? Not high on my list actually, though not seeing where they were done and how the scars look. near the areola or far away? <<Baby was, and continues to gain fairly well (4 ounces per week, on average)>> This may be fine, but if you first saw her in March and now it is May, baby maybe could be gaining better. I hesitate to bring up the mom's age, but some anecdotal reports indicate that some "older" moms may have low milk. Was she perimenopausal with some hormonal fluctuations? [realize I have nursed a child in my 40's so I am not biased against older bf'ers]. Advice - the usual increase your milk protocols: feed the baby, maximize milk production; check thyroid (hx fatigue), correct anemia if still present, breast compression, express what she can manage with hosp grade double pump, and give in nursing supplementer ("may" need supplemental donor or artificial milk), herbs, domperidone - she can get from mexico herself if willing w/o prescription, cosleeping, emotional support. Good luck to all. Laurie Wheeler, RN, MN, IBCLC Violet Louisiana, s.e. USA ________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html