Thank you for all the responses.  The theories as to why a mother with a prolactinoma has difficulty making enough milk, sound quite plausible.  As mentioned previously, breastfeeding management may very well play a role here, but I wouldn't want to miss another contributing factor. 

 It stands to reason that if there were a reduction in her prolactin receptors, then a) continued breastfeeding and/or pumping could potentially increase the amount of prolactin receptors she has over time or b) b/c her breasts are essentially "tuning out" the prolactin, that she may never be able to get a full supply (??).  And, because this particular mother only BF for 1 week with her first child, and has already stopped BF with this baby (at 2 or 3 weeks), and may very well soon stop pumping altogether, we won't know if her breasts have the capacity to do what they need to do to make more milk!

Anne, have the mothers you worked with (with a diagnosed prolactinoma and milk supply issues) been able to increase their supply with increased BF and/or pumping and galactogogues?

Nina Isaac, MS, CCC-SLP, IBCLC, LLLL

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