I was hoping to see if anyone could help me with this problem. I have 
permission to post. I have been working with a mom and baby girl DOB 3/9/05. Mom 
had a prolactin secreting pituitary tumor resected before she became pregnant. 
Her pituitary is intact. She is hypothyroid on replacement. Baby breastfed 
great from birth. Mom noted sore R nipple only within a day. Latch was good 
without any mouth, tongue or palate issues. Breasts fuller by day 3-4 with less 
soreness and increased swallows. By day 5-6 breasts softer w/ less swallows and 
increased R nipple soreness. Started mom pumping w/ Symphony and baby w/ 
supplements as weight decreasing. Mom got only 10-15 cc's from both breasts. 
Discussed herbs. Now taking fenugreek and blessed thistle. When mom pumps in place of 
feeds she now gets 10cc from R still but 1-1 1/2 oz from L and notes 
increased swallows at breast. I have talked to her about Domperidone. At my suggestion 
she had her thyroid levels and a prolactin level checked. Thyroid is low norm 
but endocrinologist doesn't want to increase replacement as it is a high dose 
already. Her prolactin at 1 hr post feed was 200 at one week. Her prolactin 
when tumor present had been 600. Her R nipple pain is less as she thinks this 
is due to feeling somewhat fuller.
    So my question is this--what is causing her supply to remain low? She had 
breast changes with pregnany but also had same when tumor present.
    Thank you for all words of wisdom. 

Allyson Michaels RN, IBCLC
Charlottesville, VA

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