I am so glad that this woman is going for a second opinion. It infuriates me though that she has to do this. In cases like this, a prolactin level is certainly indicated as is an ultrasound. In our area, Riordan and Auerbach is referred to all the time by the physicians and nurses and as far as I know, that's the only reference on the subject. I also recall this physician saying that he/she has references to the contrary-what references!? I hope whatever is found is reported to her first physician. I don't mean to be doctor-bashing, but for any health care professional, ignorance is no excuse for poor care! Yet we see it everyday with lactation related issues. Perhaps we should channel our energies so if there's nothing in the literature to support this then perhaps our collective minds on the list should change that! Thanks for keeping us posted. Maurenne Griese, RNC, BSN, CCE, CBE Birth and Breastfeeding Resources http://www.childbirth.org/bbfr Manhattan, KS USA [log in to unmask]