I am posting this on behalf of a colleague of mine, who is seeking
additional ideas and input:
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 I have a patient with a normal baseline prolactin
level but an abnormal rise after 30 minutes.  Her baseline was 125, her
rise
was 150.  Does Reglan help in a situation like this?  Anything  else?

She came to see me 1 week post partum with no milk (2cc pumped in 20
minutes).
She seems not to respond to pumping very well.  Responds much better to
her
baby.  Over the last couple of weeks she has test weighed in at 1,  1 1/2
and 2
oz. in various feeds.  Her baby is over 12 pounds and she is supplementing
15oz./day (down from 26, then 20).  She is using Fenugreek, Blessed
Thistle,
and Brewer's Yeast 2x/day.  At this point she is only pumping
occasionally.
She has suffered from sore nipples - her breasts are very round and it is
hard
for her to achieve a good latch, especially when she feels fuller.

Any help you could give would be appreciated.  This mom is a real trooper
and
has hung in for 9 weeks now.
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Please respond privately as well as to the list, so that I can forward
the answers. Thank you!

-Lisa Marasco, BA, IBCLC