About a year ago, WHO published a document entitled "Relactation: Review of
experience and recommendations for practice" written by Elizabeth Hormann
and Felicity Savage.  I recommend this booklet as a recent review of
literature.  It's official number is WHO/CHS.CAH/98.14.  I was unable to
find it in downloadable form on the WHO website, but it may be there.
(http://www.who.int/chd).

Looking at the booklet quickly, there does not seem to be a preferred
medication protocol.   In fact, the general thrust is to get breastfeeding
off to a start ASAP to encourage milk production through nipple stimulation.

 To quote from p. 24 "If the physiologically based methods described above
are not efective alone and no milk appears... pharmacological methods can
be considered. . . It is important to recognise that although certain drugs
may enhance the effect of stimulation of the breast, they are not fully
effective alone.  Thus even if the drugs are used, full stimulation of the
breasts is necessary. "

Later on, "Preparations of oestrogen, progesterone or hormonal
contraceptives, both oral and injectable, are sometimes given, most
commonly to induce lactation in adoptive mothers who have never been
pregnant.. . Milk production is expected to begin a few days after the
hormones are discontinued, which is timed to coincide with the arrival of
the adopted infant.  No controlled studies have been identified, and it is
not possible at this time to recommend any specific method."(p.25)

On herbs "A variety of natural lactogogues. . have been used by relactating
mothers.  . . There are anecdotal reports of their effectiveness, but few
have been evaluated scientifically." (p.27)


Cindy Turner-Maffei, MA, IBCLC
Massachusetts, USA

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