Hi Anne, 
Thank you so much for taking the time to share your thoughts.  There is no overt indication of insulin resistance, mom has a very low BMI (which I know does not preclude IR), and is not taking a SSRI.  Mom is a highly active, very fit, well educated (veterinarian) caucasian woman in her early 30's.  The question re: prolctin levels vs prolactin receptors being available is a good one.  Given this, maybe doing a baseline prolactin level blood work check would be helpful to tease this out?  My understanding is that this number can range quite a bit...Riordan and Wombach text suggests 200-400ng/ml at term...if we get a number significantly lower than this range, potentially the pharmaceutical galactagogues would be more appropriate.  I appreciate you helping me think through this.
Warmly, 
Bonny

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