Since Catherine asked me to comment on domperidone and goat's rue for
hypoplasia....

Rule #1 about hypoplasia is that it is always worth trying a treatment.
Huggins, Petok and Mireles did indeed find that most of the mothers with
hypoplasia tended to produce more milk over time if they continued frequent,
adequate stimulation/milk removal, though the severity of hypoplasia was
somewhat predictive of the results. The hardest thing I find is that many
babies just shut down after a bit when the milk flow is not there. If a baby
can suckle vigorously that is ideal; otherwise, a pump is almost always
needed. 

Domperidone raises prolactin and almost always gets more milk out of a
mother, though if she doubles her output of 10mls to 20mls, she is not
usually satisfied. If it is an option, probably worth a try.

I've been working with goat's rue, which comes from the same family as
fenugreek and has the reputation not only of being a galactogogue, but also
of stimulating breast tissue growth. There is no research to support this,
but when used over time some mothers have reported this increase. The key
word is "time," and there is also the question of the underlying cause.  My
philosophy is to tell mothers all their options, including this one, and let
the decide how far they would like to go.

Lisa

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