Here is another confounding situation that may speak to the possibility of the prolactin receptor theory. I have worked with women who have had bad bleeds during and following delivery, and women who have been very ill with infections. Several times they have been old clients whose families called me almost immed. for advice, so I was able to initiate early interventions. My standard protocol in these situations is to tell them that the mother may not experience any notable engorgement at the normal time, and that it may look as if her milk does not 'come in'. However, they are to rent a pump and help her pump at 3-4 hr intervals (more if possible) in order to hold open the option to breastfeed. They are not to worry if no milk issues forth during pumping. I have explained it by saying things like: "Imagine the breasts are rooms with many light switches on the walls. The power plant is off-line due to a storm (the illness, loss of blood, etc). If you keep the switches on, when the power comes back on, there will be light in those rooms. Pumping keeps the switches in the "on" position." The women (if they have not hx of other hormonal issues) typically recover slowly, and their milk supplies increase gradually to normal levels. The worst bleed I've seen (just short of Sheehans's) resulted in a two month delay until return of full lactation. There was no apparant inhibition from FIL as there was never any early breast fullness, just increasing levels of milk production over time. Barbara Wilson-Clay BSEd, IBCLC Austin Lactation Associates http://www.lactnews.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