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Mom, trim, very fit. History of 7 miscarriages (one at 15 weeks), one older child (2 yrs) and a 26-day old boy, 9 lb 6 oz at birth. Took progesterone during first trimester with both live births and the 15 week pregnancy. Mom’s breasts were always a small A cup, now a fuller A cup, symmetrical, not far set. Large, long nipples. No fullness or engorgement after either birth. Mom grew up on an apple orchard with exposure to farming chemicals.  Older child has unrevised lip tie, mom nursed, pumped with hospital grade pump for at least 4 months, pumping 10-12 oz per day at most, baby stopped nursing at 9 months. Little boy nurses every 3 hours, for one hour and takes in 1 oz at breast, then about 2 oz of formula/expressed milk by bottle, paced feeds, within 10 – 15 minutes. Mom pumped with consumer grade pump post-feeds getting about .5 oz. She is now on day 11 of a 14 day course of reglan, seeking a script for domperidone. Also, taking MotherLove’s More Milk Special Blend tincture. Baby had his lip tie and posterior tongue tie revised 4 days ago, beginning CST today. Also, beginning today, pumping with hospital grade pump every 90-120 minutes, feeding baby on cue with supplement and ‘finishing’ at the breast.

For a hormonal panel, is this what we should look at?

Androgen
Estrogen
Progesterone
Prolactin – pre and post drainage
Testosterone
Thyroid

Is there anything else we should look at? Thank you for any input or suggestions.

Best regards,
Laura McCormick, IBCLC

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