Hello,  I think that unless her T4 levels are elevated that this part of her history is a red herring. Although if in fact, the T4 levels are elevated then based on animal research oxytocin may be particularly helpful in 

 hyperthyroid women.  But, based on your mom's TSH levels she is not. 




From your mom's history is seems more likely the supply problem is an effect of poor suckling and milk transfer early on.  In this case, some reglan and fenugreek would be helpful.  A plan where by she 

limits feeds to 10 minutes each side then she pumps and bottle-feeds will give her enough time to still get the baby to practice and allow her pumping time.  Oxytocin may still be helpful but it is expensive and the reglan is probably more effective.  If she is willing to use a supplementer and the infant can transfer the entire amount in 30 minutes this might improve her work load.  




Is she hands-free pumping?  This will allow her to multi-task.  ALso when moms are making this little, I have them place the flange and bottle in the refrigerator between pumpings so she can just pull the whole thing 

out quickly, connect and pump some more.  I suggest they thoroughly clean the pumping equipment  ONCE a day and rinse it between bottle changes. I suggest this thorough cleaning be done at bedtime

so that at the first nighttime pumping they can set the milk on the bedside table until the next pumping when they can then place it in the refrigerat
or.  This minimizes the nighttime disruption. 

 I only suggest this with babies who are at home not those in NICU's. There is no research to back it up.  But, my moms are more likely to pump 6-8 times per day.  NOne have become ill with diarrhea's.   




If she is not making more in a week or so then I would check her HcG, prolactin and testosterone levels  to rule out other hormonal problems that can interfere with lactation.  I give reglan 10mg tid for one month

and refill as needed.  I find that a 10-12 day cycle has never been enough.  She has several weeks left to increase supply. Christine Betzold NP CLC MSN















 




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