Hi, wise members.  A colleague and I were discussing the use of Reglan
(metoclopromide) used to increase milk supply by boosting the prolactin
levels.  I also have recently been in touch (via email only) with two
separate women who have recently had good results with using Reglan.  One
woman had a doccumented case (by breast tissue biopsy at her own request!)
of hypoplastic ducts, but she has noticed an increase in supply with the
Reglan.  I understand (I think) the mechanism of the Reglan/ prolactin on
supply, but after searching the archives I haven't found much about what
happens after the medication is tapered off?  How does the milk supply stay
elevated?  I remember Dr. Newman mentioning that he has seen some women
stay on long-term Reglan, but that is not the norm.  Specifically, the
questions posed to me are:

>>One thing that still puzzles me - maybe you can help? When a baby goes
through a growth spurt and feeds a lot more frequently, that induces
hypothalamic prolactin release and increases milk production, right? So
then the baby goes back to eating every 3 hrs or whatever and its
increased needs are met by the increased basal rate of milk secretion.
Yeah? So, my question is, what sustains this increased rate? Does
prolactin keep being released at the increased level despite the
back-to-normal suckling? Or, do the breasts make more milk in response
to the usual levels of prolactin, this increased synthesis having been
triggered by the little prolactin burst caused by the baby's increased
feeding during the growth spurt?
The reason I ask is, I was wondering why Reglan is tailed off again
after 3 weeks. How is the milk supply kept at that high level? <<<

This writer is really keeping me on my toes, but I sure know where to turn
for help!!! So...?
Nancy Holtzman RN BSN MOM
Great Beginnings New Mothers Groups
Boston, MA