This is something that was discussed many months ago.  I mentioned that
sometimes around 3 or 4 months after birth some mothers had a dramatic
decrease in their milk supplies and that this was *not* just a growth spurt.
It was not related to going on the pill (though this question should be
asked), and the baby was not wanting just to nurse more, but in fact in some
cases lost weight and was obviously not getting much milk when I observed
the feeding.

I have no idea why this happens, but it happens.  This is a good place to
use domperidone.  It works quickly and dramatically and within 2 or 3 weeks,
the mother finds she can wean herself from the drug.  I think that the same
could be done with metoclopramide (Reglan).

The other option is to add solids (not mutually exclusive with the
metoclopramide), and this will make the baby happier, but, of course, it
does nothing for the milk supply.  On the other hand, it might allow the
baby to wait a little longer before wanting to breastfeed, which will allow
the mother to be "fuller" and the baby might be less fussy at the breast
(because babies respond to milk flow, not what's in the breast).

Jack Newman, MD, FRCPC