Sue:
If I'm reading you correctly, this mom habitually and exclusively breastfed
5 times a day during the first four months? And then the supply dropped, her
period returned, and she desperately picked up the feeding frequency to try
to bring things back while adding supplements?

I doubt that hormones are the issue (any official dx for the infertility?);
I suspect that the return of her cycle was indicative of the situation
falling apart, and not the cause.

Combining DeCarvalho's and Woolridge's works, I would theorize that this mom
simply did not develop adequate prolactin receptors, and when her lactation
hormones dropped enough, this became evident by the decreased supply. I've
also worked with a mom who initially started off very successfully but
averaged only 6-8 times a day the first few months, and we were unable to
bring her supply back with any of the normal regimes. I can only surmise
that we can resurrect some mom's supplies, but not others.

Of course, if you want to chase the hormone issue a bit more, you could have
her prolactin levels taken (baseline and spike)and compare her levels to the
chart in Ruth Lawrence's book. In the meantime, reglan or domperidone may be
the only choices left to try.

Lisa Marasco, BA, IBCLC
Santa Maria, CA