Well, the mother I wrote about on 9/8 never did get more of a milk supply. She didn't go all out to do everything that might have given her a little more, but after seeing her again at 19 days PP my best guess is insufficient glandular tissue. She was not interested in using the SNS; we'd used the starter SNS during the time baby was hospitalized and she didn't wish to continue; she also never filled the prescription for metoclopramide. Linda Smith's point about "milk removal not stimulation" was well taken--I *will* be more careful about my wording in the future! Baby appeared to be suckling effectively when I saw him at the breast at one day of age; as soon as baby was admitted on day 5 mom began pumping after feeds with a big electric pump and continued the pumping q3h for about 5 days without seeing an increase. She remembers a change in her breasts at 3-4 days PP, described feeling a "lump." When I palpated her breasts on day 6, they were primarily soft with only a small area in each that felt firm; on day 19 they felt essentially the same. (There is more firm tissue in my definitely dried-up "old boobs"!) The report I was given about her age was incorrect; she's only 32, not 38 as I originally thought. Surprisingly, baby is still willing to latch on and nurse for about 10 minutes each side before the bottle is given (for a grand total of 6cc during this last visit). Mom is going back to work in 3 more weeks, so will continue as is for as long as baby is willing. Thanks to Jan B. and Linda for their input. Becky Krumwiede, RN, IBCLC, Wisconsin [log in to unmask] [log in to unmask]