Well, now that so much excellent research information and anecdotal
experience on pumping has been shared, could we go on to Domperidone?

(The mother in question has two separate issues. Baby is still clamping
despite one CST last week, and today, at 15 days old, is due for another.
But the insufficient glandular tissue issue is requiring supplement by
Dr. Jack's feeding tube method, and I am told baby is taking 2-3 ounces
from it, at times.

At last weight check Friday, he had gained 5 ounces, which just now puts
him about up to birth weight. He is definitely not satisfied just at
breast, and now that the supplementer is being used at breast, is not
willing to continue stimulating her breast after he gets his calories
from the supplementer. Which is sort of understandable, to me.

She has been able to work in 3-4 pumpings per day. This was definitely
one mom whom I have encouraged to work it in "when she can" because her
ideals and goals and hopes were so high that I perceive perfectionism
might lead her to get overwhelmed in the long run trying to do everything
"just right".)

Another practitioner told me that pumping would be the better option and
that there was no point in using Domperidone if the prolactin levels were
"ok". Well, in several cases in the past, for curiosity's sake, at my own
expense, I have drawn serial prolactin levels (before and after feeding
or pumping) and by golly, they ain't cheap.

So, my question was "Has anyone published research on this?" Without
running serial prolactin levels at the appropriate times in relation to
meals, etc. how would one really know whether prolactin levels are "ok"
or not?

Understanding that milk removal by adequate suckling or regular pumping,
has to be the first approach to increasing supply, I felt that informing
the family of the existence and ways to get domperidone were meeting
their needs to try everything that was at all possible. Since inside the
skin of the breast, especially one that seems to be borderline
insufficient glandular tissue (2 " space between breasts, no enlargement
in first trimester and now noticeable engorgement on day 5), on can never
tell exactly how much actual glandular tissue there actually is, I was
hoping Domperidone might help, and I felt it certainly couldn't harm
anything to try. I've not read any information that stimulating prolactin
levels even more could be harmful, at least for the short term. Does
anyone know about this?

Thus far, from reading Dr. Jack and Teresa'a book, they have obtained
fenugreek and fennel tea. I'm going to look up Pat's posts on goat's rue,
but I guess my nursing background shows when I say that I feel more
comfortable encouraging domperidone.

Experiences of others??? Opinions???Advice???

Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA


Jean

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