I am presently working with a mother who has low milk production despite all efforts to improve it--She has been using a feeding tube device at her breast for 3 weeks, the baby is well positioned with a normal , nutritive suckle, and was approaching failure to thrive before we began the supplemental devise. Mother has also been pumping and can only produce about less than half of what baby needs in one day. Mother had normal breast changes in pregnancy, is 37 years old and reports 1 year of attempting pregnancy before succeeding. this is first pregnancy. She is on no medication. My question to the group is--If I want to do prolactin levels on her do I need to do a pre, during and post nursing levels? Should I even bother with prolactin levels since her baby is now close to 6 weeks old? I will try a course of reglan and check thyroid function tests.(She reports thyroiditis at age 7 or 8) Anything else I might be missing? She and I are not ready to chalk this up to insufficient glandular tissue and bottlefeed!!!!! ( besides,it's rare to get a patient who is willing to go this far) Thanks, donna norris R.N. IBCLC