Someone requested references for use of Reglan (metoclopramide) as a
galactagogue, to boost prolactin levels. Here is an edited posting of
references I have collected and keep available, all these are available on
Medline.
Nancy Holtzman RN BSN MOM
Great Beginnings New Mothers Groups
Boston MA
[log in to unmask]
Title
Metoclopramide effect on faltering milk production by mothers of
premature infants.
Author
Ehrenkranz RA; Ackerman BA
Source
Pediatrics, 1986 Oct, 78:4, 614-20
Abstract
Metoclopramide treatment has been shown to augment milk production
by stimulating prolactin secretion in women in whom lactational
insufficiency develops after a full-term pregnancy. The effect of
metoclopramide therapy in 23 women who were delivered of premature
infants (birth weight 1,314 +/- 115 g, gestational age 30.4 +/- 0.7
weeks)
and who were having difficulty maintaining milk production with milk
expression was evaluated. Each woman had noted a gradual decrease in
the total daily volume of expressed milk during the first several
weeks of
lactation. Maternal metoclopramide therapy was started at a mean of
32.0 +/- 3.7 days postpartum, after a review of diet and milk expression
technique and an increase in the number of expressions per day failed to
increase milk production. Daily milk production increased significantly
from 93.3 +/- 18.0 mL/d to 197.4 +/- 32.3 mL/d between the first and
seventh day of therapy. This increase was associated with significantly
increased basal serum prolactin levels, from 18.1 +/- 3.3 ng/mL to 121.8
+/- 21.5 ng/mL. Although milk expression resulted in a variable increase
in serum prolactin levels prior to metoclopramide treatment, milk
expression did not produce any additional prolactin response in the
treated women, with mean basal levels of 157.8 +/- 15.4 ng/mL v mean
peak levels of 144.5 +/- 12.2 ng/mL. No major side effects were
reported by the women, and no untoward effects were noted in the infants
fed milk expressed while their mothers were being treated with
metoclopramide.(ABSTRACT TRUNCATED AT 250 WORDS)
Language of Publication
English
Unique Identifier
87016068
Title
A dose response relation between improved lactation and
metoclopramide.
Author
Kauppila A; Kivinen S; Ylikorkala O
Source
Lancet, 1981 May 30, 1:8231, 1175-7
Abstract
In a placebo-controlled, cross-over study, thirty-seven puerperal women
with inadequate production of breast-milk were treated with 5, 10, or 15
mg of metoclopramide three times a day for 2 weeks. Doses of 10 or 15
mg significantly raised maternal serum prolactin; they also increased
breast-milk secretion by 42.5 +/- 34.7 (SD) ml and 50.0 + 35.9 ml per
feed, respectively. This effect was unrelated to the phase of the
puerperium during which treatment was started. The increase in milk
secretion was associated with a decreased need for supplementary feeds,
and 33% of the infants of these mothers needed no supplementary feeds
during treatment. 5 mg doses did not stimulate prolactin milk secretion.
Although placebo had no objective effect on the milk yield, 24% of the
women judged its effect to be good, and 89% of women on
metoclopramide reported a good effect. Seven women on
metoclopramide and three women on the placebo complained of slight
side-effects. No adverse effects upon the infants were observed.
Metoclopramide therapy may be useful for improving poor lactation.
Language of Publication
English
Unique Identifier
81196365
Title
Metoclopramide and breast milk.
Author
de Gezelle H; Ooghe W; Thiery M; Dhont M
Source
Eur J Obstet Gynecol Reprod Biol, 1983 Apr, 15:1, 31-6
Abstract
Thirteen primiparous nursing mothers participated in this
placebo-controlled double blind trial of metoclopramide. Therapy was
started on the first postpartum day and continued for 8 days. Seven
women received metoclopramide (10 mg, 3 X dd). Serum prolactin and
milk yield were measured during the trial. The breast milk composition
was analysed during the trial and weekly for 3 wk after the trial. A
detailed analysis of the amino acid content was performed on the 6th and
21st postpartum days. During the early puerperium the total milk yield
was ca. 50% greater in the metoclopramide-treated group compared to
the control group. The evolution of the breast milk composition was
similar for both groups, except for the amino acid content. The shift in
amino acid composition occurred earlier in the treatment group indicating
that metoclopramide enhances the rate of transition from colostrum to
mature milk.
Language of Publication
English
Unique Identifier
83288025
Title
The relationship between metoclopramide and milk secretion in
puerperium.
Author
Tolino A; Tedeschi A; Farace R; Granata P
Source
Clin Exp Obstet Gynecol, 1981, 8:3, 93-5
Abstract
The Authors administered Metoclopramide to women in puerperium with
poor lactation. An increased lactation and high serum prolactin levels
were noted. The administration of this medicine did not provoke any
variations in serum T3, T4 and TSh levels. thyroid screening of the
treated
mothers' babies resulted negative.
Language of Publication
English
Unique Identifier
82184950
Title
Metoclopramide challenge: a measure of human lactotroph activity.
Author
Martin RH
Source
Obstet Gynecol, 1983 Dec, 62:6, 691-5
Abstract
Prolactin response to an intravenous injection of 5 mg of metoclopramide
was monitored in 1) normal subjects during the follicular and luteal
phases
of the menstrual cycle; 2) subjects with known prolactinomas, two of
whom were breast-feeding; 3) subjects with suspected prolactinomas; 4)
normal lactating women; and 5) normal postmenopausal women. The
magnitude of prolactin released was greater in the luteal than in the
follicular phase controls (P less than .001), the estrogen status being
important, as further seen in the postmenopausal group. Comparison of
responses in the prolactinoma and control groups is a useful diagnostic
tool when assessing the possibility of a prolactinoma. Comparison of
physiologically hyperprolactinemic subjects (lactating women) with
pathological ones (prolactinomas) suggests that the main mode of
metoclopramide's prolactin-releasing action is mediated via dopamine
antagonism, though a small direct action on the lactotroph is possible.
Language of Publication
English
Unique Identifier
84040688
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