Although I am a member of the Academy of Breastfeeding Medicine, I cannot say I manage my breastfeeding patients with low milk supply according to the ABM protocol.
I use herbs and  domperidone very, very often, and metoclopramide occasionally but reluctantly.
From my experience, they make a huge difference for many mothers, but not all.
I try to avoid the herbal combinations because I don't think they work as well. I feel that there is too little of each herb in each dose, at least in terms of how they are marketed. 
However, I appreciate the protocol's emphasis on behavioral management, since throwing herbs at a mom with low supply in and of itself won't help.
For example, the phone advice given to moms to take fenugreek, when no one has looked at the whole picture, ie breast fullness, baby's mouth, latch, and her pump use, etc, is insufficient management/advice for mom. 
I don't know re the rest of you, but I see a great deal of low supply due to inadequate pump use. I find that correcting pump use (ie for moms separated from baby due to work or prematurity) is often more helpful than herbs.

Anne


Anne Eglash MD, IBCLC, FABM
Clinical Professor, Dept of Family Medicine
University of Wisconsin School of Medicine and Public Health
Medical Director of UW Health Lactation Services
Co- Medical Director, Mothers Milk Bank of the Western Great Lakes
608-437-3064
600 N. 8th St.
Mt. Horeb, WI 53593
Breastfeeding is Nature’s Health Plan

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