Karyn-grace,

Pumping during pregnancy does stimulate the nipples a bit more than nursing
does, and therefore releases more oxytocin.  However, unless this particular
pregnant uterus is already at risk for pre-term labor (is sensitive and
receptive to oxytocin -- mother would probably be on "pelvic rest" or a
no-sex sentence if so), pumping may or may not affect that mother.  My guess
would be that as the pregnancy progresses, the risk increases as the uterus
is preparing to receive the oxytocin rushes of labor.  In my personal case,
nursing my toddler started bringing on contractions about a month before my
"due date" but pumping was unbearable from the start of the pregnancy (my
baby was only 13 months old at the time and I was pumping once at work).
Maybe this mother has to see for herself whether she feels any contractions
from pumping.  Also watch for vaginal bleeding, any sign that things aren't
"right" would of course be an indication to stop pumping.

I'm not sure that pumping during the pregnancy would help a mother with
insufficient glandular tissue, because the hormone set that's in place for
pregnancy is different from that which is in place for lactation (I could be
very wrong on this one and I hope for correction if I am).  The fact that
she's breastfed a child (even partially) and worked to bring in milk
production will serve her body very well as it attempts to lactate again
this time.  More important than during the pregnancy is what this mother
does postpartum -- optimize the birth experience for mother and baby to
preserve that natural oxytocin rush, get that baby latched on properly as
soon as possible and as often as possible, ensure baby's suck is strong and
there are no oral issues for baby, offer any supplemental feedings at the
breast (and always FEED THE BABY especially in those early weeks!  A
lethargic baby isn't going to do anything to help mom bring in more milk.)

Most of the galactagogues you listed won't do anything during pregnancy
because they work to enhance lactation that has already started.  I hope
someone more knowledgable on the subject chimes in here, but I'd guess that
goats' rue would be the only herbal to take during pregnancy (again, just a
guess here) because it acts on the breast tissue itself.  There is at least
one study that confirms that suplemental progesterone in the first trimester
is helpful, too, especially for mothers with luteal phase issues or problems
getting/staying pregnant.  I have also heard that progesterone in the weeks
before the birth may be helpful, as it is the precipitous drop in
progesterone after the delivery that helps kick-start lactation -- so in a
mother whose pregnant progesterone levels aren't super-high, the supplement
may be beneficial.  

I know for sure that Domperidone won't help until at least after the first
week postpartum, because it works to block dopamine, a neurotransmitter that
can interfere with prolactin.  Blocking dopamine during the pregnancy would
be of no use because the prolactin doesn't recover from the birth and
normalize until around a week postpartum.

Again, this is only a partial answer and mostly hunches, I hope someone
answers you more fully so I can learn, too!

--Diana in NY 

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