I've been reading with interest all the discussion about this problem, and I
agree with so much of what has been written---BUT---I have found also that
the mother's lifestyle as others have written has so much to do with it.
Mothers of 4-5 month olds are no longer resting. Why should they?  They feel
completely recovered from the birth now.  But this mother is producting milk
for perhaps a 15 to 20 lb baby.  I learned, once upon a time, that it took
more calories from the mother to produce milk for a baby this size than it
took to be 9 months pregnant.  When the baby was born she was providing
nourishment for a newborn baby.  She had help and was waited on.  Naps were
encouraged and expected.  But now at 4 months is anyone helping her?  What do
people think if she takes a nap?  Lazy?  But when would she find the time
anyway with all she has to do and carpool the other kids, school conferences,
church activities.  Most mothers are back in full swing by 4 months and are
so shocked when I suggest they take a few naps. I have had tremendous success
with the following "perscription" for the 4-5 month "blahs"  I usually call
it "The Wall" because they feel like they have hit one:
1.  Mom to give this plan 2 weeks and then report (I have almost universal
success)
2.  Mom to cancell everything possible in her life, and only do things
absolutely necessary.  She is also to tell everyone she thinks she may be
coming down with something (who knows she might be?) and needs to spend a few
days in hibernation at home.  Donot tell everyone what she is doing--don't
need any stress here.
3.  Mom to sleep as much as possible.  All these moms tell me they are tired.
 She should take daily naps, with baby of course, the 1st week if possible
and at least every other day the 2nd week.  MUST go to bed early each night
and not stay up doing stuff.  Often mom is up late as she is trying to "catch
up" on all the stuff she neglected during pregnancy and early baby phase.
4.  Vitamins!  Many moms have stopped their prenatal vitamins at this point.
 If so I tell her to restart, and if she has continued I tell her to increase
her vitamins, maybe with a nonprescription daily vitamin as an extra boost.
5.  Nurse lots and lots.  If baby is using pacifier--put it in the drawer, or
if he is sucking his fingers all day, pull them out and nurse every time she
can.  Many mothers have inadvertently let the pacifier or finger sucking get
in the way. It is so convenient and works too well. Noone ever told them the
baby's sucking instinct is to produce milk in mom!  Mom often doesn't realize
what is happening until the baby starts pulling away from the breast and low
milk is painfully obvious.
6.  If mom is scheduling feeds and worried this will ruin "the schedule"  I
ask her to just do this "treatment" for 2 weeks then she can resume her
schedule.  Sometimes they are so impressed by the results and happy with the
increased milk they don't go back to the strict schedule.  If I told them
they couldn't have the schedule they would reject all my advice.
7.  I also suggest some "Mother's Milk Tea" as this is easy to obtain, not
too wierd for those not into herbs, and it makes the mom believe she is doing
something, which I believe it does, but the rest and nursing are the major
cures here.
8.  Working moms--this is when they need to take a "milk vacation" and
hibernate all weekend, or even take sick days to stay home and nurse and
snooze.
Now comes my "easy keeper -- hard keeper" story.  I'll post that separately.
Jane Bradshaw RN, BSN, IBCLC
Private Practice in Lynchburg, VA