Hi Jen
Thanks for the update on the case. I would be inclined to recommend 
continued use of reglan because it may take some time to get the thyroid 
situation under control. Repeat lab testing will likely be necessary until 
the situation stabilizes. More importantly, though, seems to be the fact 
that the baby is transferring very littlle milk. So mother should continue 
expressing with a hospital grade pump.
I would also refer this mother to a primary hcp or endocrine doc for 
continued follow-up.
This mother is at risk for continued low milk production due to early 
factors, confusing weights, etc, as early milk volumes seem to predict later 
volumes. I would clue her in to avoid as many factors as possible that tend 
to decrease supply such as birth control hormones, certain medications, 
scheduled feeds, long interfeed intervals, baby sleeping all nite etc.

<<<The most milk she has measured at one time was 68 grams but there are
still nursings where just 6-8 grams of milk are transferred...>>>
<<<  should the mom continue on the usually course of Reglan?>>>
<<<went to urgent care.....should she find a specialist or GP to for follow 
up? >>>

Laurie Wheeler, IBCLC, MN, RN
Mississippi, s.e. USA

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