Hello,

I have a mother with a history of low milk production (permission to post)
with her other children and is seeing me with baby #3. She is pumping after
feeds, power pumping, and feeding at the breast and milk production has not
budged.

Hx of GDM, pregnancy-induced hypothyroid (not with this pregnancy), IVF x 2
(although this pregnancy was spontaneous), irregular menses

She is NOT pumping around the clock, but is nursing. Baby's latch and
feeding look wonderful and while there is a possibility of feeding
difficulty her history of low supply is suspicious.

I have more details that I am happy to share, but there is nothing that
stands out except the below, which is what I was hoping to get insight on.

We had her labs checked per Marasco's book.

Prolactin: 294.5 (~30 minutes after pumping)
Thyroid panel (TSH, T4, antibodies) wnl
Electrolyte panel wnl except BUN/Creatinine ratio 22.2 (high)
A1C 5.2
Total testosterone was 49, flagged as high by her provider
HCG 7

Thanks so much!

-- 
Theresa M. Moutafis, MA, RD, LDN, CDCES, IBCLC
Nutrition and Wellness Consultant
Lactation Consultant
(315) 730-1858
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