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Uneventful homebirth, great post-partum care.  Dedicated, lovely parents.

Mom has very little milk.

On palpation she does not have very much milk production tissue in her breasts, very little veining, breasts are wide spaced, asymetric.  She has been feeding her baby at the breast with an SNS for the past two weeks.  Mostly donated breast milk.  Her sister has a history of PCOS so I asked her to get some basic labs drawn.  I think this is a case of insufficient glandular tissue, but wanted to cover all of the bases.

here are her labs-

Thyroid Panel
TSH 2.15 normal range .45-4.5
T4 10.5 normal range 4.5-12.0
T3Uptake 26 normal range 24-39
Free Thyroxine Index 2.7 normal range 1.2-4.9
Testosterone 25 normal range 6-82
Prolactin (b4 feeding) 215.7 normal for postpartum
HCG 22 normal for postpartum
Prolactin (after feeding) 240.4 

 the base prolactin level was drawn two hours after nursing, the second one 30 minutes after nursing.  I usually see more of a rise than that but the level seems more than adequate.

The HCG level is higher than what I would expect after two weeks post-partum, but I don't have a lot of experience with labs for that time period.

Any thoughts???

Warmly,

Charity

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