Good to check TSH levels.  If normal, consider that 10 hour sleep period at
night - when did this start?  Did her first two children do same?  Women
vary in prolactin/estrogen ratios.  Study was done in 3rd tri of pregnancy
to check this ratio and relate it to timing of return of menses.  Those
women who had higher levels of prolactin relative to esrogen had that
typical delay of return and those who were less so had early return.  I
suggest a hypothesis that those women with lower ratio of prolactin to
estrogen may be more prone to loss of milk when infant sleeps thru
especially if from early age.  We all know moms whose babies sleep thru from
6 weeks w/o any impact on milk supply, but I've definitely met a good number
of moms where this "good" sleep has been the only possible explanation for
the supply to tumble, abruptly and around 4 months. Pumping at night may be
the solution if so. 

Joanna Koch, IBCLC 


 Date:    Sat, 16 Oct 2010 22:45:51 -0400
From:    Malke Joselevitz <[log in to unmask]>
Subject: sudden loss of supply at 4 months.

A 30 year old mom, exclusively breastfed her previous 2 children and doing
fine with her 4 month old baby.  3 days ago her breast started  feeling
empty.  the baby was nursing every 3 hrs. during the day, and slept 10 hours
at night.  Now nursing every hour and a half day and night, and gets angry
while breastfeeding.  She doesn't hear him swallow much.  She is nursing on
demand, drinking lots of water and started taking fenugreek.  Her breast not
only feels empty of milk she says it looks hanging like an "old woman's
breast"  She can see some milk but not much.  Before this happend, she had
an overactive letdown.  Any ideas?  Thank you.

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