Darillyn Starr wrote:

 I have been interested in the posts about metoclopramide.

 My experience with it is only with adoptive mothers, myself included.
 In the survey I've been conducting, every mother who had used
 metoclopramide reported having symptoms of depression or anxiety.
 Although everyone felt that it improved their milk production to some
extent, none had stayed on it very long because of the side-effects.

 I personally have had a very difficult time taking it. For me, the
 depression occurs almost immediately and just gets worse if I keep
taking it.  I can tell that it does help my milk production, so I have
tried to take it many different times, each time hoping that something
will be differrent and I will not have the depression. I did get by with
taking a very low dose with my fourth child, but have not been able to
function when I have taken it with the last two.

 I think there are several reasons that could explain why adoptive
mothers may be more likely to have trouble with this than bio moms.  For
one thing, our hormones are not the same. Perhaps there is something
about the effects of pregnancy on the pituitary that helps counteract
the dopamine antagonist effects of the metoclopramide.

 There is also alot of emotional stress that comes with adoption.  Many
 emotions come into play that do not exist for the mother who gives
 birth.  Both the infertility that usually precedes it and having to be
scrutinized by social workers to determine their fitness to parent can
be very hard on one's self-esteem and confidence.  Frequently, there are
worries such as whether or not the birth mother will change her  mind
about placement, worry for the birth mother's welfare, and guilt over
the grief the birth mother experiences when she gives up her baby.
There is also mourning of the loss of the highly desired pregnancy,
birth, opportunity of sharing the child's life right from birth, and
ability to provide colostrum and sufficient breastmilk.  On top of all
of that, the effects of metoclopramide may be more noticable.

 Adoptive mothers do not often admit to being depressed or sad over
these things, for fear of being considered ungrateful or unappreciative
of the baby or the sacrifice of the birth mother.  Quite often, people
around them tell them how lucky they are that they did it the "easy" way
and didn't have to go through any pain at all.

 The idea of women using this drug, especially with other hormones and
 pumping, prior to the birth of a baby that they hope to be able to
 adopt  concerns me.  It is not uncommon for a birth mother to get to
the point of delivery and find that she really cannot go through with
it. This would be difficult for the hopeful adoptive mother at any rate,
but could be much moreso if she has gone tp extremes to bring in a milk
supply, including taking something known to increase the likelihood of
depression.

 I feel really strongly that no adoptive mother should ever be given
this drug unless the possibility of depression is explained to her.  In
cases where a woman has a history of clinical depression already, I
really doubt that it should be used at all, especially not before a baby
has actually been relinquished by the birth mother.

 Adoptive mothers also need to understand that, despite what the study
 from New Guinea said, taking metoclopramide does not usually make
enough difference to eliminate the need for long-term supplementation.

 I hope this doesn't sound too negative, but I am very protective of
adoptive mothers.  Most have been through h*ll already, trying to give
birth to a baby and really need, and deserve, to be able to have a as
happy an experience as possible with an adopted baby.

 Aloha,
 Darillyn