Pat

The protocol I use (and most recently for a mom inducing lactation 
for her baby in a surrogate situation) is to have mom see doctor 
about adviseability of sulpiride as a galactogogue, 50 mg three times 
in 24 hours), and use massage and manual expression, ideally 8-10 
times in 24 hours (usually only 2-3 minutes until she obtains drops 
of milk - which happens within 4-5 days) and then longer until all 
drops are drained.  She should switch-express to maximize output.  As 
drops become teaspoonfuls, save and freeze all EBM for 
supplementation as needed after baby's birth.  Once she can express 
about 30ml then start using pump, but switch-pump and finish each 
session with manual expression.  If mum has approx 3 months before 
baby's birth I've found they produce between 250 - 400ml in 24 
hours.  After birth, breastfeed as usual, watch baby's intake 
carefully (output and fairly frequent weight checks), then supplement 
with EBM as necessary.  I had one mother manage to exclusively 
breastfeed with this protocol, but most have had to supplement.  Once 
mother is happy with her milk supply, and/or realizes that it will 
not increase any more then she can taper off the sulpiride (50mg 
twice a day for a week, and then 50mg once a day for a week) without 
negatively compromising her milk production.  Once the baby reaches 6 
months weaning foods can gradually take the place of any formula 
supplements and mom and baby can continue breastfeeding as long as they want.

Sulpiride seems not to be used in England, but the last mom was 
living in another country and had a South African OB who was very 
happy to prescribe.  I suspect it is more effective than domperidone 
which is the galactogogue of choice here.

Pamela Morrison IBCLC
Rustington, England



From: Lactation Information and Discussion 
[mailto:[log in to unmask]] On Behalf Of Patricia Bilyk
Sent: Wednesday, July 17, 2013 12:12 PM
Subject: Newman-Goldfarb Protocol for Induced Lactation

Wondering if any Lactation Consultants on this Listserv , other than 
those working with Dr. Newman,have every used this protocol with 
their adoptive moms? If yes, what was the outcome.
Anyone use another protocol?
Thank you in advance,

Pat Bilyk, RN, IBCLC

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