Sara,
I don't know much about the oxytocin nasal spray because it's not used much
anymore since now having to be compounded by a pharmacist. I've never used
it or recommended it for a client, I don't think. But I would not think it
would be a problem, anymore than the natural oxytocin being released during
MER many many times a day. If it is used in an appropriate dose, of which I
wouldn't know what that would be without looking it up, and I would expect
it would be rapidly cleared from the system.
Now, you didn't ask for advice about your client, but what about using a
supply line (nursing supplementer) to deliver the ebm/formula so that baby
could be at breast more? This could help with supply. Admittedly the
expressing and effective milk removal are the key to this bf recovery. What
about herbs? Are they used in your area? What about prescription drugs like
domperidone?
Re the district nurse: unfortunately I'm sure she beleives what she is
advising is sound advice (dietary advice). Lots of healthcare providers
still advocate forcing fluids to make more milk or drink a beer. I still
hear this to this day. What I would do is send her a brief report that baby
was not transferring milk and maybe with a succinct journal article
explaining the concept. You would need mom's permission but I would think
she would give it. It is so scary to think that these well-intentioned
nurses and others and really causing great harm to moms, babies, and bf.

Laurie Wheeler, IBCLC, MN, RN
Violet Louisiana, s.e. USA


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