Pam,

First, I am wondering what day postpartum the prolactin was drawn, and
when in relation to breastfeeding (near a feed/pump, or with no
stimulation for a couple of hours?).   Also, has anyone checked mom's
testosterone levels? Any signs of adrogenization?

I am also wondering if this mom might possibly have PCOS. Many women
with PCOS have hypothyroid problems, and hyperprolactinemia may occur
within PCOS as well (the experts don't all agree). On top of this is the
gestational diabetes, which indicates insulin resistance at least during
the pregnancy, if not before. With or without a PCOS dx, I am wondering
if it might be worth trying metformin. Mona Gabbay MD has used
metformin, sometimes in conjunction with domperidone, in women with
supply problems who also are insulin resistant; her case studies were
reported at the ABM conference a few months ago. This might be worth
pursuing.

On the herbal end, if goat's rue is an acceptable option, it is
considered a galactogogue plus it may have properties that reduce
insulin resistance (not to be confused with directly affecting insulin),
given that it is the precursor to phenformin, which was the precursor to
metformin.

~Lisa Marasco

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