Amen. Great post, Janie.

Judie Gibel
Florida

> Date:    Fri, 25 Jun 2004 19:21:32 -0400
> From:    Janie Akerlund <[log in to unmask]>
> Subject: Domperidone
>
> Hey All,
> We may be correct in our belief that this warning is
> politically motivated
> but that does not release us from the professional
> responsibility to search
> the literature and review the original documents
> that the FDA cites as
> showing risk.  I am guessing that we will find that
> it is as safe as we
> expected but until that work is done and references
> in hand we haven't
> anything to protest.
>
> We also do not have any proof that domperidone is an
> effective
> galactogogue, I personally have had many mothers who
> feel that it does
> increase their supply but an equal or greater number
> who feel that it
> didn't help at all.  Randomized control trials would
> be difficult as each
> mother infant dyad has their own unique
> circumstances making it impossible
> to compare groups.  BFAR moms seem to me to be the
> most promising group for
> such trials, has anyone done this? Tom Hale
> questions efficacy of
> domperidone and says that there is no mechanism by
> which it should work.
> This leaves us with a drug of questionable efficacy
> and potential risk.  To
> dismiss this warning out of hand is dangerous and
> unprofessional.
>
> I think that most of us were breastfeeding advocates
> first and lactation
> professionals second.  In cases like these our
> advocate hats are firmly in
> place making it difficult to draw on our
> professional experience.  We then
> come off to the media and the public as
> unprofessional fanatics.
> Presenting ourselves as rational professionals able
> to analyze the
> situation without bias is critically important to
> our status as
> professionals and to our ability to promote, support
> and protect
> breastfeeding.
>
> Janie Akerlund RN IBCLC
> Nurse-Midwifery Birth Center
> Eugene, OR USA




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