Did mom have infertility issues?  Did she have breast enlargement during the 
pregnancy?  Do her breasts appear hypoplastic?

She deserves to have some labwork if she has not already.  Prolactin hormone 
before and 1/2 hour after nursing (or at least one random value), thyroid 
panel and testosterone.  I normally get a HCG, but if she had a D and C the 
retained placental fragment should be ruled out.

If the testosterone is high, she may have a theca-lutein cyst, and her 
supply should come up as that fades out over several weeks provided she 
keeps removing what is there.  If the thyroid is abnormal, that can be 
treated and hopefully improve her supply, but if she did not have breast 
changes during pregnancy (implying lack of development of the milk-making 
tissue) there may not be much you can do.

Kathy Leeper, MD, IBCLC
MilkWorks- Lincoln, NE

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