I've been working with a 1st time mom (1st pregnancy) who was induced due to high blood pressure at 37 weeks. She was given misoprostol as a prostaglandin to induce labor. She ended up with a C-section 22 hours later. Blood pressure took several days to drop and stablize. I saw mom and baby on day five and baby was 19 oz below birth weigh and jaundiced. Mom thought breastfeeding was going fine as baby latched and would stay at breast 45 minutes or more. Test weigh revealed baby to transfere only 4cc after 20 minutes at breast with breast massage and compressions. My first thought was baby was just too weak to do an effective job at breast. Started mom pumping with hospital grade pump. Only got 10 cc both breast. Started baby on formula via finger feeding. Mom has been pumping for a week now and taking fenugreek (due to history of depression, she did not want to try Reglan). Supply has not come up at all, she pumps between 15-20 cc every 3 hours. She is very motivated to breastfeed and has really worked at the pumping. She has had thyroid test done in recent past. Is there a possibility that the misoprostol effected her hormones or prolactin levels. Should I suggest prolactin levels be done? Any suggestions are welcome. Pat Lindsey,IBCLC