I had a call from a mom that has me a bit stumped.  I know I'm missing
something but I can't figure out what it is and I'd appreciate your input
and knowledge.  I have mom's permission to post.

This mom is a teacher and is experiencing dropping milk supply.  She has a
six month old baby that is a solid 22 pounds that has been fully breastfed
until quite recently.  As a teacher she has only one short break to pump
each day.  She's been back to work since mid-January and was pumping 8oz per
pumping that has slowly dimished over time until she finds herself with
about 1oz per pumping now.  She has used More Milk Plus by Motherlove and
did see an increase of about 1oz for a week or so.  Then that diminished,
too.  She is not taking any medication except for a multivitamin.  She has
had one period and did notice a slight drop in supply that was temporary and
her supply rebounded (this was about a month ago).

We've checked over her pump which seems to operate fine and now she has
rented a hospital grade pump.  No difference.  She did report drinking an
excessive amount of water.  I encouraged her to drink to thirst.  She is
pumping on the weekend also, is trying to find a way to sleep with her baby,
and has stopped More Milk Plus but is trying fenugreek and blessed thistle
capsules.  She is highly motivated for the summer but needs to get through
the next month.  She does have some stress in her life but seems to be very
focused on getting breastfeeding right for her.  Currently her son is
supplemented with 16 oz a formula and 8 oz of breastmilk while she's at work
and is breastfed when she's home.  She told me that when she went back to
work she had 8 gallons of breastmilk in her freezer!

I'm stumped.  Could her daycare provider be overfeeding formula during the
day and giving her baby to her so full he isn't really breastfeeding much at
 night?  Or is this a percieved and not actual milk supply problem?  Maybe
she had an oversupply that has adjusted?  Her baby seems to wake a lot at
night but he is also learning to sit up and wants to crawl so I'm not sure
that's anything more than one of those normal baby things.  My head is so
full of details that I know I must be missing something here.  

Thanks in advance!

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