Thanks for all the responses to my dilemma. I have spoken with the mother 
and we have brainstormed some ideas. Her thyroid level just came back as 
normal and we've pretty much ruled out anemia, poor fluid and food intake, 
transfer issues, pump and flange problems and issues with contraception. She 
is using no hormonal birth control methods, but interestingly has had two 
periods in spite of her insistance that she never is not pumping or feeding for 
longer than 2-3 hours day and night. Could it be a hormonal issue and, if so, is 
there really any reliable testing for it? (I've heard the ranges of normal for 
prolactin, for instance, are so varied that testing is of little help). We 
discussed the normality of reverse cycle nursing for some babies, but she 
doesn't feel able to handle it and have a life during the day. For now, she is 
going to try the More Milk Plus and Goats Rue and supplement at bedtime 
(after feeding), and see how it goes. She knows her supply may drop further, 
but she needs some rest and perspective. She also just shared with me that 
her doc suggested cereal (at 4 months) to help him sleep better at night---
this at a facility that is having it's on-site inspection for Baby-Friendly in June. 
I have work to do....must go!  Thanks again.




I have permission to post. I am working with a second time mom that is 
exclusively breastfeeding her second child (4 months old)--she didn't 
breastfeed her first. She nurses and/or pumps with a medela double electric 
pump every 2 hours, but still has had a tenuous supply since the baby has 
been about 6 weeks old. She works at a hospital two days a week and uses 
the hospital-grade pump there every two hours while working or leaves to 
nurse the baby. She's been taking fenugreek with some results, but we finally 
tried Reglan for two weeks and it worked like a charm. However, when she 
went off, her supply dropped dramatically again. We tried another two weeks 
a couple of weeks later, but she says it barely worked the second time. She's 
currently drinking mother's milk tea and breastfeeding all night. The baby's 
needs are met as he is gaining weight (nothing spectacular, but WNL's) and 
peeing and pooping well. He receives nothing else but her breast milk. I've 
suggested More Milk Plus and Goat's Rue, but she hasn't tried them yet. We 
just had her TSH level drawn and are awaiting results. No s/s or concern 
related to PCOS, breasts look normal. Mom very rarely feels let down or 
fullness anymore and is weeping in my office this morning because she can't 
continue to breastfeed every hour all night and doesn't want to resort to 
formula. I'm beseeching the wisdom of the women on this site--am I missing 
anything that may help?

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