I'd recommend a nursing supplementer for this mom, so her baby is 
protected and they can establish a breastfeeding relationship apart from 
any milk transfer; and maximize the baby's motivation to work at the 
breast to improve milk production if mom is able to make milk. The fact 
that she could get pregnant means at least her GNRH is working, but that 
doesn't necessarily mean she will produce prolactin. Testing her 
prolactin levels is a good idea. Domperidone will only cause secretion 
of any prolactin that has been made in her hypothallamus and released 
into her pituitary, so if she isn't making it or the pituitary is unable 
to secrete it, domperidone would not be helpful. And if she was not 
making prolactin through the pregnancy, breast development will be 
impacted. Did she experience breast changes?

Catherine Watson Genna BS, IBCLC  NYC  www.cwgenna.com

On 10/26/2017 3:56 AM, Riva Weissfish wrote:
> PTP. I have a client with panhypopituitarism. She was told that she would not be able to have more children since her diagnosis. 3 children later (!) - she is not breastfeeding as she has been told that she cannot produce milk. I don't want to give her unrealistic expectations but would like to encourage her to try. I thought to first have prolactin levels checked (so we know what we are dealing with) and start motilium (obviously with endochrinologist's approval) and pumping - her baby is a week old.
> Does that sound appropriate? What would you suggest in such a case?
> My lactnet account is on a email I cannot access so please respond to [log in to unmask]
> Thank you very much for any insight or experience you might have,
> Riva Weissfish
>
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