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From:
The Bentleys <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 19 Oct 2001 00:40:42 -0400
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A guy in Australia has done a lot on something related to this recently - Dr Peter Hartman (sp?)

Notes from a session:
Pumping - 70% variation realtion to # of MER, not time
- averages 2.3 MER which is about 70ml per feed (5 minutes of pumping is almost full feed)
"One milk ejection roughly equivalent to an adult drinking 300 ml"
-amount of milk pumped depends on small or large ducts, blood supply varies between moms and between breasts, small storage capacity means less volume will be pumped (he had lots of info on what affects mom's milk supply)
- pressure of the milk coming opens the ducts (they are not open all the time - the ultrasound video of this was amazing!)
- the vacuum of the pump is not that closely related to the amount of milk pumped so set vacuum for comfort level

In Canada, Domperidone is used instead of Reglan for the medical choice for increasing milk supply (doesn't cross into the brain - not yet available in the US).

Michelle Bentley, CLE, LLL
  ----- Original Message ----- 
  From: Phyllis Adamson 
  Sent: Thursday, October 18, 2001 10:44 AM
  Subject: Re: oversupply issues: prolactin & Reglan



  Pardon me if I seem to have missed something here.  Obviously I need to study this prolactin issue more.  I know for most moms, supply is directly related to frequency / duration of feeding or pumping.  WHY do some moms, whether feeding directly or pumping for a preemie, seem to produce unreasonable volumes?  It seems unrelated to breast size / volume or to frequency or duration of feeding / pumping.  And WHY some of my NICU moms seem to respond to Reglan with higher production & that production drops when Reglan is discontinued?  Of course I stress with them the importance of regular, effective, thorough pumping as the primary means of increasing their supply.  We suggest Reglan only after they inquire about supply problems, often after 3-6 weeks of pumping.  These are usually the moms of babies who do not  yet go to breast or who have insufficient transportation options to get to visit baby with any reliability.

  Can anyone send me to resources to study so I can bring myself up to date?  Thanks.

  --- Phyllis Adamson, IBCLC
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