I have been in touch with a family doctor who has in his practice a
lesbian couple.  One of the partners became pregnant with IVF, and is
nursing the baby, apparently just fine.  The other partner would like to
nurse as well, and would like to go on domperidone so that she will make
milk.  This is an interesting situation, I think.

I have no problem prescribing domperidone (similar to metoclopramide,
Reglan) to a nursing mother to increase her milk supply.  I think the
very small risk of taking the medication, is more than balanced by the
benefits if we can get that mother and baby into a successful
breastfeeding relationship (to be defined in each circumstance).  But in
this case, the other partner does not *need* to breastfeed the baby,
since the baby is already being breastfed.  Furthermore, there is no
guarantee she will produce milk.  The baby does take her breast.
Shouldn't that be enough?  Or does she also need to produce milk?  Is
this situation analogous to the father wanting to feed the baby, which,
I think, many of us would say is not usually in the best interests of
the mother and baby?  What about the risks of the medication, still low,
but in this case an unnecessary risk?

On the other hand, this seems *sooo* important to both partners.  Does
their particular situation change the approach?

Interested in your thoughts.

Jack Newman, MD, FRCPC