Heleen,
 
I would consider suggesting to mom that she work on building breast tissue  
(milk producing cells) during her pregnancy and definitely have PCOS ruled  
out.  My daughter who is due to birth her second child soon and has PCOS  
that was only diagnosed after the birth of her first child, has had a  
significantly different pregnancy this time being on metformin, progesterone  
until this last month, and goat's rue last several weeks.  (important to  note 
is that my daughter's PCOS/insulin resistance did not show up in laboratory  
findings nor cystic ovaries, but was diagnosed by Dr Gabbay by 
symptomology).  This pregnancy she has had noticeable breast changes and can manually 
express  colostrum none of which she had in her previous pregnancy and these 
changes  occurred before her 34 the week which is when her first child was 
born.  In  fact at one point, her midwives who were unfamiliar with 
progesterone use past  first trimester, had her go off it and within days her breasts 
actually  "deflated," that is became flaccid and less dense.  She quickly 
resumed and  actually then went on weekly progesterone injections.  I am 
grateful for  the guidance of Lisa Marasco for my daughter and hopeful, no 
positive, that  she'll breastfeed with a normal milk supply this time.
 
It seems worth looking into what she might do even before she's pregnant as 
 what you describe breast-wise and milk supply-wise is quite similar to my  
daughter's first experience as she provided about 1/2 of the milk my 
grandson  needed for his first 2 yrs).
 
Barbara Latterner, BSN, RN, IBCLC
 
 
 
Mother has hypoplastic tubular breasts and went through quite some trouble  
to nurse her first
3 children. She used high doses of domperidon and needed  about 300 ml 
donormilk in a SNS to feed her children adequately. Baby would lose  interest in 
breast if she didn't supplement with SNS because of low  milkflow.

She is planning to try to conceive later this year and is not  looking 
forward to using domperidon again because it makes her hungry all the  time and 
she gains lots of weight as well (from eating more).

She is  wondering if there is another way to stimulate prolactine, apart 
from  domperidon. 

--
Heleen Hayes,  http://www.xs4all.nl/~hhayes

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