HI,

I'm working with a woman who delivered her 2nd child on 5/13.  She had a cxsn with her first and for compounding reasons never had a full supply and used domperidone with exclusive pumping (2 oz in 24 hrs was her peak supply).  That said, she is doing everything that is humanly possible this time around and is again showing signs that she will not have a full supply.  This baby was a vbac and is much more interested in nursing than her first.  She is pumping and breastfeeding, but still needing to supplement due to weight loss and jaundice.  She wants to just start on domperidone again.  I thought would be prudent to do some labs this time since they weren't done the first time around.  Besides a prolactin and thyroid (TSH  and free T4), I also thought it would be helpful to do testosterone, progesterone and estrogren.  Her OB is open to ordering, but never has before.  What do you order?  Any thoughts are appreciated.  Didn't have gestational diabetes and does not have PCOS...

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