There is no published research literature on the effectiveness or safety of
fenugreek or blessed thistle with full term, let alone preterm infants.  I
have used fenugreek for mom's in the NICU for over 10 years without any
recognized adverse effects in either mom or infant (any gestational age).
Remind MD that mom and milk may smell like maple syrup!  There IS published
info re Reglan use in preterm infants (for GER) and use as a galactogogue for
moms.  See my 2 referenced articles (parent and prof) in our web site
www.breastfeeding.org.  I can understand your Neonatologist's reluctance to
use a substance that is not "approved" for use in premies, and not
standardized.  I have no experience with blessed thistle.
Nancy Wight MD, FAAP, IBCLC
San Diego CA