Thanks so much to Cathy B, Diane and Jack for responding to my previous
post.  If a drop in progesterone is the trigger for Lactogenesis II then my
concern was that progesterone taken so soon after delivery could impact
negatively on lactation in the same way that we sometimes see this happen
when the mini-pill is taken in the early weeks.

But anyway, the good news is that today this mom saw her ordinary doctor
(GP) who advised that this med should not be taken by a diabetic, and
prescribed sulpiride instead, which is commonly used for similar situations
(anti-depressant and galactogogue).

Mom is much happier and continues to breastmilk-feed her still-sleepy baby
who she has to wake for every feed - this was 3 hourly, but mom is leaving
the baby for 4 hours now to see if she will wake spontaneously - she
doesn't!  She described to me how she needs to know "how much the baby is
getting" and "can't understand how these moms who just *breastfeed* can
trust that their babies are getting enough."  No amount of explaining how to
keep the baby swallowing, and how to identify swallowing, and to count
urine/stool output seemed to reassure her.  The baby lost 12% of her
birthweight by 3 days of age and I know you don't like these stats Jack, but
it was obvious to all that the baby was not doing well at first. I have to
accept that breastmilk-feeding for the time being is the only way that mom's
confidence can be nurtured and I'm just trusting that the baby will become
"demanding" before too long.  Meanwhile baby's nutrition is being protected
(she weighed only 30g less than her birthweight by 9 days of age), mom is
pumping a full 50% *more* than baby "needs" and building up a huge stash of
frozen EBM and the management of the whole thing is becoming much easier for
her.  Crossing fingers ... and thanking you for your help.

Pamela Morrison IBCLC, Zimbabwe
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