I would appreciate your wisdom in helping a mother of an almost 5 month old increase her milk supply. The mother has given permission for me to post.
   
  The infant was born 09/02/05 by induced vaginal birth. In the hospital,  the family and nursing staff had concerns about the mother's milk supply from very early on and the baby was supplemented beginning at 3 days and the mother occasionally used a double electric personal breast pump and breastfeeding about 6 times a day. Early breastfeeding management was less than ideal.
   
  I first saw her right before Christmas. She called me because she was concerned that the baby had blood in the stool and the pediatrician told her to give the baby only breast milk. The mother has been pumping with a hospital grade pump since and breastfeeding every 2 to 3 hours. The mother has said she wants to not use a supplemental feeding system and is supplementing with bottle.
   
  In November 2003 she was diagnosed with Hashimoto syndrome. Her thyroid antibodies were signifcantly elevated. She is currently taking 75 mg synthroid. She had blood work to check her thyroid on 01/12/06. The thyroxine is 1.3 ng/dl and the TSH is 0.67 uIU/L. Both of these tests were within normal limits in 11/03 too. She had one miscarriage prior to this pregnancy and was prescribed progesterone suppositories for the first three months of this pregnancy. Her menstrual period resumed 01/10/06.
   
  The mother began taking fenugrek about 2 weeks ago. She is taking  two 610 mg tablets 3 times a day. She has noticed an improvement. Her OB prescribed Reglan 10 mg three times a day beginning January 17. The doctor also suggested a supplement called Optivite supplement and flax seed oil.
   
  The pediatrician has recommended that the baby be supplemented with "as much formula as she will take" after each breastfeeding session because of concerns about the infant's lack of weight gain at 01/15/06 appointment.
   
  Any suggestions for additional measures that can help this mother increase her milk? I will be seeing the dyad this morning for a weight check and follow-up to see if the Reglan is helping.
   
  Thank you in advance for your insight,
  Mary Marine, BA, IBCLC

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