I absolutely agree on breastfeeding management first.  But there ARE available tests for prolactin levels that can be done well which can give an idea if there is sufficient prolactin being manufactured or if we are seeing the normal doubling after breast stimulation.  Domperidone doesn't cross the blood brain level - it works as a dopamine inhibitor, I believe, which allows greater transmission of prolactin across the cellular membrane.  That's why it was used with Parkinson's patients for increasing gastric motility, like metoclopramide, but is safer than metoclopromaide because it doesn't cross the blood brain barrier.   

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of stillberatung bremen
Sent: Friday, July 03, 2009 4:33 PM
Subject: Re: LACTNET Digest - 2 Jul 2009 to 3 Jul 2009 - Special issue (#2009-662)

hi all,

2009/7/3 Kershaw Jane <[log in to unmask]>:
> But - just to be "devil's advocate" - if we treated lack of milk 
> supply as a serious issue that needs all the full force of  
> investigation and treatment that we apply to - say - erectile 
> dysfunction - rather than patting women on the back and saying formula is almost as good and your baby will be fine because > I was formula fed and I am OBVIOUSLY just fine - should we not be able to discuss all options for moms, if we are truly lactation consultants and not just breastfeeding cheerleaders?

sure, but we need to differentiate carefully if there is really a lack, before we start popping out pills, don't you think?
suggesting drugs like domperidone, before for example the "breastfeeding management" has been checked and improved, is like taking antibiotics for a simple cold.
ok, i know there are people who do that. but i don't consider it a good idea.

nina

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