Saw a mother at request of ped because baby was still loosing weight at 6 day f/u. At 7 day's mother denied feeling transitional milk coming, breast were very soft still and it had been 2,5 hours since last feeding session. Baby transferred 20mls (pre/post feeding weight) after 25 minutes of nursing. I did some labs. I thought I would find low prolactin levels but instead I found normal prolactin levels for 7 day's post-partum. 

I need some help. My thoughts are running around the line of: Her body is producing normal prolactin (evident by serum prolactin level) but she either doesn't have enough prolactin receptor sites or something else it going into or blocking the prolactin receptor sites so that the prolactin isn't able to make it in their. 

Other labs I drew:
TSH - lower end of normal but within normal range for this mother
HCG - wasn't thinking clearly I did a qualitative and quantitative and of course it was positive (by the way can someone lead me to a reference which has normal quantitative levels)
Testosterone  - normal 


Idea's, thoughts would be appreciated

Jessica RN, IBCLC
NC, USA

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