During tonight's chat at Pedschat, on the topic of breastfeeding after
breast reduction surgery (BFAR), we discussed the issue of when it is
optimal to begin ingesting galactagogues in the postnatal period
(considered generally, without specificity as to number of
pregnancies).  In my book, I advocate waiting until the need is
demonstrated, simply because it may not always be necessary.  I also feel
that administering galactagogues before the need has manifested may
undermine the confidence of some new mothers in their lactational
capabilities.  However, domperidone does have an average three day delay
until the supply is increased, so taking it immediately postpartum could
prevent the need for formula supplementation in some cases.

My best answer to the question is that it is an art that requires a
judgement call based upon the maternal history, her temperament, her
wishes, and her circumstances.  But I suspect there may be more issues to
consider and hence a better answer.  I would be very interested in your
thoughts on this concept.

Diana West
http://www.bfar.org

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