Nancy's question asking how breastmilk production is maintained after Reglan
is tapered off is interesting ..  We use another medication, sulpiride,
which I believe is similar to metoclopramide and which seems to be very
helpful in increasing breastmilk production *if* the mother is prepared to
maintain very frequent and efficient drainage of the breasts.  Sulpiride
also boosts prolactin levels.  Once the mother has achieved her milk
production goal it is possible to slowly tail off the sulpiride and maintain
the supply at that level.  My understanding is that it is *drainage* rather
than prolactin levels which *maintains* breastmilk production.  However,
there must be more to it than this, because if the sulpiride is abruptly
stopped (a frequent occurrence!) then the breastmilk supply plummets about
four days later - just long enough for the mother *not* to make the
connection between stopping the drug and "losing" her milk!  I have been
unable to find any studies about what happens "after sulpiride" either, so
if anyone has any more thoughts about either Reglan or sulpiride (brand
names Eglonyl or Equemote) I would really like to hear more too.

Pamela, Zimbabwe