>My questions is about moms with history of pcos and milk that is 
>slow to come in.  At what point should we refer these women to have 
>prolactin levels checked.


I am no expert on hormones at all, but I have never understood why 
prolactin checks would be ordered at any stage.

I understand that prolactin levels vary a lot between women, and at 
varying stages of the day and night, and in relation to the 
start-middle-end of a feed.  How would you know *when* to take a 
reading? What baseline would you be comparing it to?

In addition, levels fall anyway after the first week or so, and 
continue to fall over the next few months, again with a range showing 
individual variation.

>What would be an acceptable milk output on Day 5 through day 10.


Again this is so variable - with effective breastfeeding and a 
healthy baby, the answer is 'an acceptable level of output is one 
that is consistent with the growth, health and development and 
satisfaction of the baby' which is not measurable in mls :)

The research we have on this - outputs - shows that women differ 
widely in how much they can produce. So again, what would we be 
measuring?

To help a mother in this situation,  she might need to experiment 
with hand expressing, with different pumps, and look at technique - 
rather than look at the clock and judge 15 mins as an accepted 
session, she should be watching how her breasts respond. We encourage 
mothers to observe what her breasts are doing and to swap sides when 
the flow dwindles to a trickle, and then swap back again, and then 
again....in practice this usually means a session of 20-30 mins with 
each breast pumped twice.  Some people have found good results with 
traditional galactogogues to add to this regime.

Good luck to this mother!

Heather Welford Neil
NCT bfc, tutor, UK
-- 
http://www.heatherwelford.co.uk

http://heatherwelford.posterous.com

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