1.)  I wonder if this mom's prolactin levels were measured with the baby on one breast and a pump on the other,  if they might be higher.   

Also, if the baby is not getting sufficient milk and needs supplementation, I would suggest a nursing supplementer.  The Starter SNS would be fine, to start with.  If only they would make one with the tube molded as a single piece with the cap, and not stuck onto it, I would not say for starters.   

I would stress to the mom that there are important benefits to partial breast milk feeding, with supplementation, and that a feeding tube device can be used, rather than bottles, so mom's breasts keep getting the stimulation they need.  Lactation professionals often seem to stress the benefits of a partial milk supply, and/or supplementation at the breast,  in an adoption situation, but not think of it with a mom who gave birth to her baby.  I belong to a Facebook group called "At the breast supplementing support".  At least half of the members are bio mothers with chronic breast milk insufficiency, who want to preserve their nursing relationship and provide a much breast milk as they can, while ensuring that their babies will be sufficiently fed.  

2.) I found it interesting that Julie Tardos asked why gut issues lead to oversupply.  Julie, is that just something you have observed, or is that commonly accepted?  Most of the moms I work with (online) are adoptive moms and prospective adoptive moms.  About three-fourths of them take domperidone and most of them report a significant increase in bowel activity, especially during the early weeks.  It makes, sense, since the drug is used for GI problems and the increase in prolactin in a side effect.  I had always thought the two things were unrelated, but, since reading Julie's question, it sounds like maybe the stimulation of the pituitary to produce more prolactin is actually secondary to the increase in bowel activity.  I hope more comes of this discussion, because it might also shed some light on how drugs like domperidone and metaclopramide (which I strongly discourage adoptive moms to take) increase prolactin levels.  
 		 	   		  
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