Jane, 
I've seen this a handful of times. The first mom was a long time ago and had
the same kind of history. The only thing that worked was a pharmaceutical
galactogogue-- first sulpiride, then metoclopramide. She had side-effects
with each and sought out domperidone.  

A year or two ago I had a primip whose history and pregnancy and breast
tissue were textbook perfect. Milk came in great and then proceeded to drop
off regardless of great management, then pumping and galactogogues, until
she was down to drops by 4-6 wks. A prolactin test showed her to be the very
low side of non-lactating. We had an answer as to *what* happened, but not
*why.* I surmised that she must have had prolactin from the pregnancy in the
beginning (necessary to initiate lactation), but perhaps a failure of the
surges postpartum resulted in a precipitous drop of prolactin and consequent
milk production. She would have been a good candidate for the prolactin
replacement study that was going on at the time in Boston (now on hold due
to inability to obtain more recombinant prolactin). 

It seems apparent that something hormonal is going on with your mom and my
mothers. I would like to track prolactin in one of my case moms during
another pregnancy to see what her prolactin curve is for pregnancy and
postpartum. We might learn something by such an experiment. You could check
her thyroid as well, though I suspect that isn't an issue for your case.

Lisa Marasco
Santa Maria, CA

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