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Subject:
From:
Kathy Boggs <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 22 Jun 2003 23:55:18 EDT
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In a message dated 6/22/2003 6:26:27 PM Pacific Daylight Time,
[log in to unmask] writes:

> Karleen writes:
> After reading your post I wondered how common is it for mothers in your area
> to use a pharmaceutical galactagogue. It really surprised me that a drug to
> increase milk supply would be discussed (commonly?) in an ordinary mother's
> group. This should be something that is helpful only rarely shouldn't it? Is
> basic breastfeeding physiology ie supply/demand stuff discussed too?
> Karleen Gribble
> Australia


Karleen, I have no statistics on how common pharmaceutical galactagogue use
is in the San Francisco Bay Area. Many of the women I work with are very
educated and internet savvy--they need only lurk on Lacnet or any number of other
listserves to get plenty of info on galactagogues. In the Mother's Group, which
is not run by the Lactation Center but by the perinatal education dept of the
hospital, it takes just one mother on a galactagogue to spread the word to the
others. This mother's group is not primarily breastfeeding focused, but as
most of the mothers breastfeed it is a common topic. That being said, I wish I
could report that only rarely do the mothers I see need more than education on
supply and demand to fix milk supply problems. Our hospital has a 60 bed NICU,
does 5000 births per year and is a high risk perinatal center. In our
outpatient lactation clinic we see only problems, of course, so my viewpoint may be
skewed, but probably 10% or more of the moms we see have insufficient milk
supply refractory to increased stimulation. And the percentage is much higher in
the NICU moms who are totally pump dependent. Certainly some of this is
because, even in the San Francisco area where breastfeeding initiation is very high,
we are still not a breastfeeding society. Mothers get off to a rocky start due
to poor support or inaccurate information. Sometimes no amount of catch up
stimulation will bring that milk supply up. We work with mothers who have been
very sick post partum with delayed lactogenesis II. Some of these mothers never
get to a full supply. Some babies are poor at  transfering milk and can only
nurse if mother has an abundant supply. Premies certainly fit into this
category. They need the faster flow which comes with a higher supply to transfer
adequate or sometimes even any milk. We try all other measures before we discuss
pharmaceutical galactagogues, but unfortunately, in my world, it is not a
totally rare discussion.

Kathy Boggs, RN, IBCLC


















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