I really appreciated Jeanne Mitchell's vivid and horrifying descriptions of the tragedy of the Guatemala earthquake. Stress such as this, which results from intense, sudden, and very frightening episodes has, of course, been identified in the literature for a long time as a cause for losing ones milk. There is a very early case report of a "coaching accident" where a stage coach carrying a nursing lady over-turned, and the woman immediately lost her milk. However, in the normal course of events, we seldom see such violent and immediate trauma. Everybody has a certain amount of stress after the birth of a baby, and there are admittedly incidents of family violence which people can be awfully clever about masking. But even in cases where I have suspected or mothers have let me know about such circumstances, they have been producing milk. Maybe less than normal, but something. The interesting and striking fact of this woman's situation is the total absence of any secretion at all -- no post-partum breast changes, no drops. Not from a pump, not with hand expression, and no intake during test weights. This in a woman with a happy history of bfg with the previous child. In the case I am reporting about, there is no observable stress, nor reported stress, nor even inferred stress. I can only trust my own perceptions and the word of the mother. She's not that stressed. In some ways, calling up the specter of stress (in the absence of earth quakes) is kind of a blame the victim thing. I think that the failure of to lactate following an uncomplicated delivery is a medical symptom, and I can't for the life of me see why her MD isn't more excited about it. Barbara Barbara Wilson-Clay BSEd., IBCLC Private Practice, Austin Texas Visit the "LactNews-On-Line" Web Page http://www.jump.net/~bwc/lactnews.html