The low supply ups and downs of this mom, any possibility these could be due 
to hormone fluctuations re menses or ovulation?  I noted she'd become pregnant 
while nursing two of her children so this thought occurred to me.  I remember 
a not so distant post about use of a calcium/magnesium supplement for moms 
with decreasing supply during menses, might this help?  I had my dd  try these 
to increase supply (even tho she has no menses yet) and initially it did boost 
her supply by a few oz/day (her baby then about 10 mos).

I would be interested in knowing what her dose of domperidone was?  Again, dd 
at one point upped her domperidone to 20, 20, 40, 60 and this helped 
noticeably--never a side effect (except better milk supply!).  Also she'd been 
instructed to take 1/2 hr before bf/pumping which also helped.

Other suggestions, Mechell Turner has a nice letdown remedy on her site, milk 
thistle may be good to switch to, and also Mechell has homeopathic tinctures 
that may be useful.  The long term use of herbals can cause a lessening of 
their efficacy,  the body gets used to them and no longer responds as before, so 
a week or two off with different herbs being used can be helpful.  The 
recommendation from one LC/MD to discontinue domperidone for 2 weeks or so and then 
re-starting might help and follows the same principle as the herbs.  Again my 
dd had been instructed to do this but was so afraid of losing her marginal 
supply that she never tried it until one time she'd run out of domperidone, had 
been taking less until it was all gone and was without for less than a week, and 
when she got her domperidone she took her usual doses and her supply did 
increase.

Hope these suggestions and anecdotes are of some help to this mom.

Barbara Latterner, BSN, RN, IBCLC, RLC




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