Sometime between 2001 and 2003, at an area hospital where I was working as 
a prn LC, I received a call from the Level II NICU that a mother wanted to see 
an LC re: concerns about a dropped milk supply.  She had been expressing her 
milk 8 times a day with a medical grade pump with great yields, but was in the 
process of moving to a new home with her husband and preparing for the 
baby's discharge home, had been doing a lot of packing and carrying small 
boxes, etc.  Her supply had quickly dropped to 15 ml from bottles full of milk 
with each pumping.  We chatted about galactogogues and getting more sleep 
re: stimulating prolactin, and when she asked about fenugreek, I explained 
that the neonatologists were generally not comfortable with herbals for NICU 
babies (if only we had some regulation here & a U.S. version of German 
Commission E) but that she could discuss the possibility of Reglan with the 
neo physician on duty, since newborns, both preterm and fullterm, are often 
on Reglan for GERD.  She was aware that her baby was receiving peds doses 
of Reglan for his reflux, and we discussed per Hale the safety of Reglan via 
maternal milk and possible maternal side effects of Reglan.  

I was also working the next evening, and enjoyed getting a call from NICU 
again re: this mother coming in and wanting to touch base with me.  She held 
up a bottle full of milk, explaining that the baby's NICU doctor had given her a 
prescription for Reglan the evening before, which she had filled on her way 
home.  She then started the Reglan, presumably slept overnight, and had a 
prompt, dramatic increase in supply in that short period of time - - less than 
24 hours - - and without any reported side effects at that point.  Though I 
had been an LC for several years, I had never before seen with my own eyes 
such a quick increase in volume with Reglan or any other galactogogue, so the 
memory is particularly happy and vivid.  I should also say that the NICU doc 
who provided the script was male, his wife nursed all their children, he was 
particularly interested in supporting lactation, had been a staff neonatologist 
for many years, kept a copy of Hale on that unit at all times, and had become 
chief of the neo unit a year or two before - - such a lovely human being.  
That mother could certainly have had much less medical support for a 
galactogogue in working to increase her dropped supply, had another less-
educated MD been on duty that evening or had she approached her own HCP 
for Reglan.  

That unit transitioned in 2001 from their long-standing NICU protocols to 
supplement babies after birth with glucose levels 60 and under, though all 
other area hospitals' protocols for such supplementation were for glucose 
levels at 45 and under, with the exception of one area hospital whose protocol 
was supplementation at glucose levels of 40 and under (at that location, the 
RNs were becoming comfortable approaching the peds for babies with glucose 
levels of 37, 38, 39 and asking, "If we can get the baby to breast and nursing, 
can we check the glucose level after the feed to see if we can get the 
glucose levels beyond 40 [and avoid supplementation]?"  And getting 
frequent "OK" answers from many of the peds.  

When the chief of neonatology left her position at the facility with protocol to 
supplement at 60 and under, within one month the staff pediatricians quickly 
developed new supplementation protocols of 45, though the nurses had a hard 
time with that, in that many nurses continued to supplement fullterm, non-
NICU, non-symptomatic babies with levels from 46 up to 60, "because her/his 
sugar levels are low."  In the days of the old protocol to supplement for 
glucose levels at 60 and under, the majority of babies born at that facility 
were admitted to NICU for low glucose levels etc. re: frequent 24 hour stays 
before transitioning to the well-baby nursery.  Insurance companies must have 
been paying out the wazoo for well over a decade with that protocol at that 
facility.  

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