All these messages on this topic have come at *just* the right time for me -
thanks people!  I'm working with a mother of a month-old baby, both father
*and* mother had infertility problems - however it is the mother's hormones
which are obviously important to BF.  Prior to conception mother did not
ovulate, had a progesterone level of 10 instead of 2000 apparently (don't
know what units - do we have an endocrinologist who can explain?), was
treated with a "double-dose" of Clomid, baby conceived by artificial
insemination, problem pregnancy, induced labour and finally a C-section.
Now reports minimal breast changes prior to menstruation or during
pregnancy.  No history of breast fullness/engorgement after delivery.  My
first contact with her was at 4 days postpartum, baby had lost 16% of
birthweight and was passing brick-dust urine, no stools since the second
day.  On my advice she commenced supplements, which have gradually crept up
to 250ml per day.  Baby is now gaining at a "normal" rate - 28g/day and is
looking pink, alert, healthy.  This baby is so precious, *exactly* as you
described Pat, and mother wants so much to breastfeed.  She is taking
sulpiride which will enhance prolactin levels, and she is breastfeeding
often to maximize breastmilk production.  Supplements are offered after
BFing, 30 ml 3 hourly in the day and 50ml twice during the night.

My question for those of you with experience with these sad cases - assuming
mom continues to maintain frequent and thorough breast drainage, can we
expect the breastmilk supply to increase over time, or do you find that
formula supplements need to increase?  If the mother is taking medication
which can be expected to increase prolactin levels, does this have a
beneficial effect on breastmilk production over time, by increasing
prolactin-receptors, so that she could at some time in the future be weaned
off the sulpiride and still continue to produce the same amount of
breastmilk?  Should we be testing prolactin levels?  If so, what level is
"normal"?  I'd appreciate any thoughts or opinions - thanks!

Pamela, Zimbabwe