I actually see this fairly frequently (because problems get attracted to all
of us). Even when the mother's are not pumping, and everything seems fine.
We discussed this a couple of years ago.  Many said the problem was a growth
spurt.  But I don't believe it.  For some reason, some mothers have a
definite drop in their milk supplies around 3 to 4 months after birth.  This
is not a question of babies just wanting to nurse more frequently.  They
actually are unhappy on the breast, they pull at the breast and they often
stop gaining or the start losing.

A two or three week treatment with domperidone does wonders.  If you can
only use metoclopramide, then it can be used as well, though it would not be
my first choice.

Jack Newman, MD, FRCPC