Answers and comments follow:

Medication amounts:  I am taking 20mg of domperidone 4x a day.  Lately
(within the last week), I have been taking capsules of fenugreek, blessed
thistle, alfalfa and fennel - 4 capsules each, 3x a day.  Fenugreek and BT
are always taken, usually in that amount or else 3 capsules, 3x a day (on a
"good" day).  I haven't taken goat's rue or the MM+ in over a month, but I
still have some and could certainly try that again.  One person mentioned
that her daughter "upped her domperidone to 20, 20, 40, 60" - does this mean
that in one day, 140mg was taken?  Or is that a daily progression?  With
baby #2, I tried to alternate my herbs (fenugreek and BT for a week, alfalfa
and marshmallow for a week, always with domperidone); it didn't seem to make
a difference in the variability.  I have not tried Ca/Mg; I think I took
that for vasospasm with my son - I'm not averse to trying it again to see if
it helps for this problem.  One thing:  I didn't know that milk thistle was
a galactagogue.  Is it?

Baby's disdain for eating solid food:  I should have mentioned that both of
my older children also refused most solid food until they were 11-12 months
old.  All three were very gaggy with solids until then, and baby is just now
approaching that age.  She does occasionally swallow a bit of solid food,
but mostly, she spits it out.  I could check to see if the oral-motor
therapist who did the original assessment and training would be willing to
see her again; this person was a Beckman-trained oral-motor therapist with
experience in infant feeding problems.

Bloodwork levels:  I had levels done with baby #2, but of course, they
didn't include some of the more in-depth panels that some have mentioned.
Of the ones that were done, they were all within normal ranges for the
testing lab except, of course, my prolactin, as I was taking 80mg of
domperidone then, too.  Unrelated to my supply issues, I did once have my
IgG-antibodies tested (about 3 years ago) as we suspected my son had celiac
disease.  Turns out he didn't (negative endoscopy), and my results were
negative.  Of course, that is probably the least reliable of the blood tests
for celiac; I wouldn't be opposed to having more specific tests run just in
case.  Truly, I suspect some sort of hormonal problem, and I appreciate Lisa
Marasco's suggested list of levels to check.  I, too, have thought that
testing these levels at high and low supply times would be useful; it'd be a
wonderful thing if I could find a local endocrinologist here in Orlando who
would agree to do that.

Supply variations:  No records kept, though I realize, in hindsight, that
they would be very useful.  Unlike with baby #2, this time it seems that my
supply is up or down for longer periods of time (down 2 weeks, up 10 days vs
down 2 days, up 3, down 1, etc.)  I sense that it's shifting toward more
"down" days and fewer up days.  Oddly, to show how hard it would be to track
that - I had very full breasts this morning, and baby nursed well last
night, but tonight, she has struggled to get a letdown at all and seems
unsatisfied, as she keeps waking to nurse (but not really getting anything).

Menses and ovulation:  I have not been tracking my cycle/ovulation; I just
assumed that the reason menses hasn't returned in three months is due to the
elevated prolactin level from the domperidone.  I am definitely not
pregnant.

Clarifications:  The supply problems I experienced with baby #2 were just as
bad as it has been this time, except that with that baby, we started out
with some oral aversion issues and she did not regain her birthweight by 2
weeks.  My ped at the time threatened to hospitalize baby if she didn't gain
weight; it was at that point that I began pumping with my PIS.  Also with
that baby, I eventually rented a Medela Classic (for six months) and would
pump after *every* feeding, in case she wasn't adequately emptying the
breasts.  Just as often as not, I would have a day where I could pump 1-4 oz
AFTER she nursed (each side, each time) and then, the next day, get
nothing - I mean, barely cover the bottom of the bottles.  Still, during the
good times, I built up quite a frozen stash, none of which she would take as
she, too, refused bottles.  I even tried a Lact-aid with her, but not until
she was 7 months old and she wouldn't latch if she realized it was there.

I think that covers everything.  I deeply appreciate all of the responses
and suggestions; it does sound like I need to locate an endocrinologist here
in Orlando who is familiar with levels for a lactating woman and who would
be willing to run tests for me.

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