I am working with a mother with a history of low milk supply with a  previous 
child.  We believe it was related to  her hypothyroidism.  However, with this 
pregnancy her values have  been within normal ranges and monitored closely.  
She has implants, but was  able to breastfeed successfully with adequate 
weight gain with her first child  for several months, and then to regain her milk 
after using domperidone after  the thyroid levels were back to normal range.
 
She is now 4 days (in 24 hr increments) postpartum without a substantial  
change in milk volume.  While I realize this could still be just a time  issue, 
she is a determined mom in proactive mode and wants to be sure there is  
nothing being missed and is having an ultrasound to check her ovaries and her  
midwife and ob are supportive and want to provide whatever lab work is needed to  
be sure everything else is on target.  She doesn't want to take a wait and  see 
attitude if there is a chance she can get a jump on anything that is not  
quite right.
 
I know I had this done for myself with my twins 8 years ago, but my denial  
brain will not allow me to remember what all we checked for.   Can  someone who 
works with low milk supply give me exactly what labs need to be run,  how 
they should be done, and what numbers we want to see.  I remember with  my twins 
having blood draws pre feed, 10-15 minutes into feeding and then 30  minutes 
after the feeding to check for the higher base line in the early days,  the 
spike during the feeding, and the drop back to baseline.  If that has  changed, 
let me know that too.  She will go for lab work as soon as I tell  them exactly 
what to screen for.
 
Please reply to me off list and on list so the answer is in the archives  too.

Thanks a bunch,
Pam MazzellaDiBosco, 

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