In my role as hospital LC, I am working with a woman who is coming-in
this evening to be induced for delivery of her 8th child.  For 3 or 4
children in the middle of her family she used the pitocin nasal spray
that is no longer available.  She got one 15cc bottle of the spray each
time, and that lasted her for the first few weeks.

I am planning to have her use Pitocin 10 units/ml, draw 0.5ml into a TB
syringe, and sniff half of this into each nostril 3-5 minutes before
breastfeeding.

Questions:  Is this the doseage and administration others have seen
used?  Will she need to use it for the first feeds?  I expect she will
be given a pitocin injection after delivery to contract her uterus, so
told her she would not need it for the first breastfeeding after birth.
But should she start using it in the first 24 hours?  How long should
she continue to use it--24-48 hours, few days, regularly (before every
feeding) or as needed?  If she needs it for an extended time that could
mean she would need a prescription for several vials of pitocin as one
vial will cover only two feedings.

Thanks for your help.

Barbara Berges BS, RN, IBCLC
Rochester, New York