Julie,

Given that all other normal factors were appropriately screened for, I
have seen this twice before. On mom in particular would lose her milk
right at the 7-8 wk mark, despite doing *everything* right. With her
first baby she did make the mistake of scheduling. Number 2 she
breastfed ala LLL, but still had the same problem. Galactogogue herbs
did not make a difference when added. With #3, mom was put on reglan
when the drop started, and this worked, but she then developed
depression and had to be taken off of reglan and wean because she was
then put on anti-depressants. With #4, when it happened again despite
super frequent nursings, the pediatrician put her on thorazine. This
worked well, except that she had side effects. She stopped and started
the med a couple of times, got through the next couple of months, and by
5/6 mos her supply seemed to stabilize and meds were no longer
necessary. Mom was so thrilled to finally get to breastfeed a baby
longer term! I had suggested domperidone, but there was less info a few
years ago and she and her husband were not secure about trying it.

My best guess was that she had an unusual hormonal threshhold that she
would drop below around 2 mos that was not responsive to even very
frequent, round-the-clock feeds from day 1. Definitely puzzling! One
interesting side note: after the fact, mom wrote to me that she thought
that perhaps her last baby had a better suck than her first three; she
thought she felt some difference. She lives across the country so I
never saw her in person, only counseled online and via phone. I had to
rely on the other LCs she had seen in person before contacting me that
everything else was normal. Was it possible that the first three babies
had suck issues, but not the fourth? Or was she just grasping at straws
to make sense of an enigmatic situation? Given that all of her babies
initially thrived and grew quickly (milk supply abundant at start), I
doubt that three babies in a row would have suck problems. But, I'll
never know for sure...

Comment on growth spurt: I wonder how your ped mom determined that it
was at growth spurt time that the problems set in. I suspect that
"growth spurt" might have been defined as onset of increased hunger, and
if so, might have been the result of decreasing supply, and not growth
hunger.

Lisa Marasco MA IBCLC

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