Lactnetters and Dr. Hale,

I spoke with a physician  who uses vitamin therapy and he would like to
know if pyridoxal 5 phosphate would have the same effect of inhibiting
prolactin that pyridoxene (B6) does when taken at high doses.  (I only
have the '96 version of Hale at this point).  The question relates to the
following situation.

I saw mother initially at 4 months pp with virtually no milk supply after
3 weeks of bottle supplementing post feed  in treatment of FTT symptoms.
 (Baby taking about 30oz formula/day).   Initially she responded well to
more nursing with the help of an SNS.  Then after one month,  milk supply
just stopped increasing.  (Baby takes about 14-16 oz/24 hr. of formula
supplement now)  Mother was on progesterone mini-pill (micronor) from 3-4
weeks and again at 6-8 weeks postpartum.  She felt it affected her
supply, but baby had slow gain, only quiet swallowing,  and infrequent
stools from birth.   I am convinced the baby is an effective feeder (at
least since my first visit) and this is not the problem.

I have just found out that she is taking 50mg time release B6 supplements
every day. I strongly suspect this may be a piece of the puzzle. (She
didn't indicate she was taking it when I first did the history and she
thinks she may have been trying a brief respite from it then--or just
forgot to mention it...)  Anyway, she has been in pregnancy and is
currently taking it for treatment of carpal tunnel and finds it very
effective.  Missing just one day has symptoms returning.  She is now 6
months postpartum.  (We have also discussed checking thyroid before this
information about the B6 came out)  I have suggested she see a physician
for more traditional treatment or a different alternative treatment so
she can stop the B6 and see if her milk supply improves or not.

And Thanks for any and all suggestions any of you may have!

Natalie Shenk BS IBCLC
Ohio USA