Hi all,
I am working with the mother of a 3 month old, who is returning to work in 
two weeks and plans to formula feed while at work and breastfeed while at 
home. Pumping at work is not an option. Last week, she removed first one 
daytime feed  and then another one, and unfortunately switched her birth 
control pills to an estrogen containing pill. She feels that there was an almost 
immediate drop in supply, baby fussy at the breast and hungry following and 
between feeds. She has stopped taking the birth control pills.

I have 2 questions. She is considering the Paragard IUD,  a copper containing 
device, - does anyone have an opinion on this and breastfeeding, I searched 
the archives and the only concerns I could find seemed to be connected to a 
possible thinning of the uterine wall due to breastfeeding, leading to potential  
complications.

Second question - have the hormones and weaning thrown her body into such 
a state of confusion that she will need to relactate, use galactogogues etc.
or will stimulation alone bring back her supply, if she stays off the pills? Or do 
we just try stimulation and if that doesn't work, move on to something like 
Domperidone. I suggested taking Fenugreek right now, but I have to say that 
I am unclear as to whether it (or Domperidone)  will be helpful if the mammary 
gland has already involuted. Will it maximize whatever function is left?
Thanks,
Kathy Lilleskov RN IBCLC

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