First of all, you could use more fenugreek. I routinely suggest 2 capsules 4 times a day. You could also suggest the mother add blessed thistle (same dose as the fenugreek). If that doesn't make it, then you can add metoclopramide. I have had mothers on all three without any increase in side effects. Have you tried breast compression? See url: http://www.erols.com/cindyrn/drjack0.htm or http://www.bflrc.com/jn_arts.htm Jack Newman, MD, FRCPC