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Date: | Mon, 8 Jun 2009 08:03:43 -0400 |
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In my practice I have seen an increasing number of women with PCOS and
infertility issues that are being helped to conceive. As with your client, their
pregnancy is often a rocky road with multiple complications. We are now
having them stay on their metformin during prenancy and after. As a result
their hormonal imbalance is improving, they are having spontaneous pregancies
with fewer complications but they are not showing an improvement with their
milk supply. Theoretically it would seem like a good course of action, but the
hormonal improvement is not quick enough to solve current issues.
We have also tried herbal galactagogues like Fenugreek, without success in
this group of women. We have not tried Domperidone. Our protocol is to try
Reglan first, if that is successful in improving the milk supply, but not well
tolerated, then we request domperidone from the providers. Reglan's side
effect profile is the reason it is not our first line choice in this group of mothers
already experiencing complications. We encourage breastfeeding as primary
and supplement as necessary for as long as mother and infant are comfortable
with the plan. It has been our experience that the need for increasing amounts
of supplement ultimate leads to weaning.
Karen Doering
Glens Falls, NY
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