Barb, below is a post that I have sent to Lactnet in the past.  I still 
find the protocol useful for such cases as you are describing.

Pat Gima
_____________________________________________________________________________
For some women (I was one) there is a drop in milk supply beginning about a 
week before a menstrual period and continuing a few days into the period. I 
researched this when my babies were feeding and found that from mid-cycle 
until a couple of days into the period, there is a steady decrease in blood 
calcium levels.  Obviously the decrease varies among women, as some women 
never experience this drop in milk. This lower blood calcium level is also 
the cause of uterine cramping before and in the first days of the period.

I began to take a calcium/magnesium supplement from mid-cycle until 3 days 
into my period. The milk supply was maintained. When my daughters began 
menstruating, I had them follow the same plan and they were able to have 
little or no uterine cramping.

A breastfeeding mother needs 1500mg of calcium a day. There is calcium in 
many foods so she doesn't have to take the entire amount in supplement even 
if she is on a dairy-free diet.

I recommend supplementation for mothers who call me with a supply problem 
before and in the early days of menses. The amount of added ca/mag is 
variable, of course.  I suggest that she add 500mg-1000mg a day . The more 
meat that we eat the more Ca/Mag we need. Usually it takes the higher doses 
to accomplish the desired goal. Vegetarians could begin with the 500mg 
dose. The added ca/mag has resolved the problem in all of my clients who 
have tried it.

It can even be effective if they call me with the decrease in supply and 
say that a period is due.  I suggest that they begin immediately with 
1000mg of ca/mag. and there is usually an increase in supply within 24 hours.

One problem is to determine when "mid-cycle" is with a mother just resuming 
menses.  I suggest that she take the supplement throughout the month until 
she sees a pattern of cycling.

One shouldn't take calcium without magnesium in a 2/1 ratio (the ratio that 
is found in foods and is usually found in supplements). And disuade 
someone's taking Tums for their calcium.  It is not an adequate dietary 
supplement and it is an antacid, while calcium needs an acidic gastric 
environment for assimilation. She could end up with less available calcium 
than if she did nothing.

Patricia Gima, IBCLC
Milwaukee, Wisconsin, USA

 >Also, frenotomy planned on an infant with an exceptionally tight frenulum -
 >keep me in your thoughts that this baby goes to breast and nurses like a
 >trouper and mom has no pain.

I do hope all goes well. How old is the baby. The older ones need a bit of 
re-training in correct suckling.
 >When do you leave for ILCA?

Alison and I leave at 6:00am (!) on Tuesday. Since it is an international 
flight we are supposed to be there a couple of hours early--say 4:00am. We 
might as well go there on Monday night and sleep on the couches.

I really need some time away. I have broken my rules and have not had a day 
off in 3 weeks. I've been working 12 hour days this past week.

Did you have a lot of babies last week with the full moon?

I'm looking forward to lounging in the fancy resort for a week. THen when I 
return on Monday the 23rd I have a lot of things going on that week, so I'm 
not returning to work until the 30th.

Pat
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