I'd love to hear from anyone experienced with using oxytocin nasal spray
and can give some documented guidelines for use - soon!
The Mom I'm working with (hospital setting) is in her first week of
breastfeeding her second baby.  Her first baby had a poor weight gain and
although this Mom pumped frequently for five weeks and used an "SNS" at the
breast, was never able to produce more than one ounce by pumping, and
eventually gave up.  We had her start pumping occasionally soon after birth
in addition to her baby feeding on cue, but in spite of baby having a good
suck from the beginning, at a four day f/u visit, the baby only transferred
6 ccs. after 20 minutes of feeding.  There were other indicators of
insufficient intake.  Mom's milk had "come in" the third day and was
palpable at the fourth day visit, but obviously wasn't being transferred
either by baby or by pump (she is only pumping about 10 ccs. from both
breasts at most, after her milk came in).  It was concluded that she must
have ineffective let-down.  This Mom has a very high tension level and I
wonder if she is a good candidate for oxytocin nasal spray to stimulate let-
down.  We have never used this therapy and I'm finding resistance from our
OB unit director and fellow LC's.  They say it is not approved for this
use, that it is unconventional and too risky.  Her family practice M.D. is
willing to let her try it and I've found a nearby compounding Pharmacy
who's able to supply us with the med.
    My question is this.  Where can I obtain documentation for guidelines
for safe administration, what are the legal ramifications, what are the
likely side effects to watch for (Hale's book lists some pretty forboding
ones), and clinically, how risky is this treatment, really?

                    Grace Pommerening RN, IBCLC
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