Oops I started an uproar - sorry. First of all I am partially parsing what was
taught in the CLC course. I lent my course packet to someone, otherwise I
could find the studies they were citing regarding both the efficacy and the
potential complications of Fenugreek. The other poster reported correctly
that the instructors mentioned medical complications of fenugreek (among
those were anticoagulation/blood thinning), and that there haven't been
studies that showed it actually did increase supply. I am among those who
know many women who would disagree and seemed to have great results from
it.
In terms of recommending/prescribing - I'm saying everyone should consider
how they discuss these things with moms. If you make a suggestion to the
*physician* and leave it up to the MD or midwife to do the actual prescribing,
that is very different than instructing a woman to go to her pharmacy and buy
something, even if it is over the counter. I still maintain that it's possible that
the latter situation could be construed as prescribing, and therefore have all
the liabilities that potentially come along with that. Another scenario is as
someone else described - to help a mom gather information about a drug or
herbal, and then leave the decision up to her. That too, in my opinion, is very
different than telling/suggesting/recommending that she try something.
Even if everyone were inarguably within their scope of practice to recommend,
prescribe or provide domperidone, we would be remiss and irresponsible, I
think, if we didn't inform moms of the potential side effects, just as any
prescriber should get informed consent for any type of prescription.
Someone brought up the cytotec example - that is a really intersting
comparison, and of course we all know how much the FDA is influenced by
political pressures, so that's worth bringing into the discussion here. The
recent morning after pill fiasco is another example.
When I get my CLC course packet back, I'll post some of the studies they
were citing. Really, in my view it was an excellent course that was highly
evidence based and research supported overall.
Carry on.
Diana Graham, MD, CLC (although perhaps that's not a good thing?)
NYC soon to be Tar Heel
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