I am presently working with a mother who has low milk production despite all
efforts to improve it--She has been using a feeding tube device at her breast
for 3 weeks, the baby is well positioned with a normal , nutritive suckle,
and was approaching failure to thrive before we began the supplemental
devise.  Mother has also been pumping and can only produce about less than
half of what baby needs in one day.  Mother had normal breast changes in
pregnancy, is 37 years old and reports 1 year of attempting pregnancy before
succeeding.  this is first pregnancy.  She is on no medication. My question
to the group is--If I want to do prolactin levels on her do I need to do a
pre, during and post nursing levels?  Should I even bother with prolactin
levels since her baby is now close to 6 weeks old?  I will try a course of
reglan and check thyroid function tests.(She reports thyroiditis at age 7 or
8)  Anything else I might be missing?  She and I are not ready to chalk this
up to insufficient glandular tissue and bottlefeed!!!!! ( besides,it's rare
to get a patient who is willing to go this far)   Thanks, donna norris R.N.
IBCLC