I must agree emphatically with Barbara's hypothesis that genetics, hormone balance and health at time of delivery are likely high affectors of milk production. I have been amazed at the number of women who have been presenting the past few years with what I assess to be true milk supply problems. I have a local midwife who alone has sent me probably 4 or 5 cases the past couple of years, a rather high rate for a small practice. These women had well-cared for pregnancies and non-medicated, non-induced homebirths. Despite the best of care and a strong positive belief in the birth process, still they experienced a primary failure of lactogenesis II of a significant degree. Many, but not all, have personal or family histories of endocrine problems. In my corner of the world, it sometimes feels like milk supply problems are becoming epidemic. I do not consider this all to be of entirely "natural origins," but of whatever origins that are also causing the inexplicable rising rates of a host of other diseases and ills as well. One thing that I learned through my recent research in this area is the need for compassionate care. Too many of these women have been judged by family or friends or health care practitioners as not having tried "hard enough." I agree that there are probably more cases of incorrectly perceived milk supply problems than anything else, but we must be very careful to automatically made that assumption of every case. Some women have cried tears of relief at being told that the problem they were experiencing was not "their fault." Just yesterday I sat at a small wedding reception, and was approached by a young woman on behalf of another young woman. I had seen the small baby earlier, and I guess someone told them that I was an LC. The problems? They were two-fold: non-latching 15 day old baby, and low supply. Mom had been pumping from the beginning and would see 2oz in the morning (no pumping some hours) and <.5 oz q 2-3hrs the rest of the day. Now I have not done an official consult yet, but the mother reported that her milk came in (or didn't come in) the same way with her first baby, who she didn't try to breast feed. This mom is only 22, and has supportive close family! She also told me that she took a while to get pregnant and didn't experience breast changes during the pregnancy. <BIG SIGH> My guess is that her perceptions are fairly accurate even if her management has not been stellar; we will see. I can't explain this phenomena, I can only describe what I see presently. These women need thorough assessments and compassionate care to help them develop the best attitude for their circumstances. Lisa Marasco MA IBCLC *********************************************** 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