Hello...a quick reintroduction as it has been a long time since I have
posted.  I am an IBCLC working in a hospital setting.  I see both inpatient
and outpatient moms.

I am currently working with a mom whom I first saw almost 6 years ago with
her first baby.  She has now had her third baby who is 2 months old.  She
has a history of early return to menses which is soon followed by a drop in
her milk supply.  With her first baby her period returned at 6 weeks, with
her 2nd, her period returned at 4 months.  She was tandem nursing at that
time.  This time her period returned at 8 weeks.  She co-sleeps with her
babies, demand feeds and does not use a pacifier.  She is a very small lady
who is happy if she can keep her weight above 100 pounds while she is
breastfeeding. She has not had any fertility problems. Her babies gain
weight well in the first few weeks, but then after her period returns the
weight gain really drops off and the babies start to become fussy at the
breast particularly while she is on her period. We have done several test
weighs that have confirmed a low milk transfer.  With the other two babies
she has started solids early at the urging of her pediatrician, but this
was only done after the milk supply dropped off.  It is very typical for
her babies to feed every hour or less.

She has tried fenugreek, it did not make a difference.  She tried reglan,
which she felt did cause an increase but quit taking it after one week as
it made her nauseous.

My question is this...what is it that causes the early return to menses?
(This has not occurred with other women in her family who have breastfed.)
Is there anything that can be done to counteract the drop in milk supply
that typically follows?

Thanks so much for any thoughts...

Beth Seidel,BA,IBCLC
Pekin, IL

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