----- Original Message ----- 
From: Beth McMillan  
Sent: Monday, January 21, 2008 1:13 PM
Subject: domperidone and stress


Hello everyone
I need some wisdom and I need it fairly quickly - this one has me stumped.
I spoke to a woman over the phone today about milk supply (permission to post).  Her 5wk baby has just been moved to a "highly monitored" ward bed from the ICU at our children's hosp.  The babe is on a feeding tube and mom is pumping.  Baby was only 1wk when she got sick (not sure what the diagnosis is but they have long term issues ahead of them - will talk to her more later) and mom felt that she was just getting a handle on nursing when the rug was pulled out from under her.  She has been very sporadic with her pumping as she has been focused on just getting by.  The "pumping room" is not near her daughter's bed so she has been getting there infrequently (this hosp has no dedicated LC on staff and only a few nurses certified but not necessarily on that floor) to make matters worse she noticed that if she waited for several hours between pumping that she got "more" milk than if she pumped every 2 or 3 hours so she has been spacing out pumping too.  Of course talked to her about the how's and why's of frequent, regular pumping at her daughter's beside (she has a double electric pump of her own as well as access to the hospital's pump) and to be happy for every bit she could get to give her daughter instead of beating herself up for not having a full supply. :(  

OK that's the history - now the question:  She asked me what else she could do and I discussed the other options that may be used in conjunction with frequent milk removal such as Domperidone and herbals.  She had already asked her doc about Domperidone and the doc told her she really discourages using it but especially in her case since she is under so much stress it would be to hard on her pituitary gland.  What?  This mom does take an anti anxiety med (I believe it is a low dose of clonazepam) for panic attacks.  Is this doc just biased against domperidone - we are in Canada so it is available and fairly commonly used - or is there some justification for this?  The doc is an OB but I don't know her.  I need evidence to have on hand for this mom in case she wants to pursue this or see another doc.  I'm looking on my end but if any of you can come up with something that would be great!
I've already "contradicted" a Ped today so I'm on a roll - I really want to give this mom some good info. 
Thanks
Beth 
LLL and IBCLC

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