Dear Laurie - You may find helpful the article by Gupta and Gupta, Clinical Pediatrics, May 85, Metoclopramide as a Lactogogue. It should be used before day 30, and presumably the sooner the better. However, standard stimulation should be attempted first. I have not seen anything published on breast reductions and Metoclopramide. My suspicion is that this drug works best when glandular tissue is adequate but lactation has been undermined by poor management in the first week. My experience with reduction surgery is limited but those I have seen have had too much ductal damage and are left with too little glandular tissue. I would not recommend Metoclopramide under these conditions. Gupta and Gupta cite no side effects. Lucky them! My mothers sometimes experience one of the following: headaches, fatigue and diarrhea (severe enough to require cessation of treatment). Joanna Koch, IBCLC