My questions is about moms with history of pcos and milk that is slow to come in.  At what point should we refer these women to have prolactin levels checked.  What would be an acceptable milk output on Day 5 through day 10.  This mom I am thinking of had a premature delivery(34 weeks) after an early rupture at 33 weeks. Her breasts were rounded and dense but she was unsure if they enlarged during pregnancy.  Her milk came in sometime on Day 5 but volumes seem slow to increase.  No engorgement or dramatic changes experienced even with 4 hour stretches at night.  She is pumping with hospital grade pump and appropriate size phlanges and is collecting about 15-25 mll a session at least 8 times a day for 15 minutes.  I know we would like Mom to be expressing 600-800 ml by the end of the second week.  But what about before that.  Her milk supply seems to be lagging on day 6-7. Is anything we can be doing to ensure best possible outcome.  I am aware and advised on pumping, relaxation and massage.  I appreciate any input I might get.  I am a newer LC and trying to get a handle of hormonal problems and milk supply issues so i can better educate my patients.  Thank you in advance for your time.  

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