Carmela, this is a much more complex question than it seems. Doing proper
studies would need to take into account a number of confounders - not just
whether artificial hormones had or had not been used. Such factors are:

1) Culture - a big one (In some societies people are very dependent on
taking pills for many situations in the hope of a quick fix, and lack
confidence without them - in other cultures pill-taking isn't common )
2) Culture - Some societies have warm networks of extended families for
support, in others the mother is isolated in varying degrees. However, does
the family have breastfeeding experience? What support - family,
professional, peer? How isolated is the mother?
3) Method of supplementation - NO bottles vs bottles
3A) if no bottles, what is used?
    - *at-breast feeding* with tube device, including home-made, or
variations
    - at-breast feeding with tube device and nipple shield
    - syringe, cup
3B) If the mother is using bottles, a) what type of teat (nipple) and b)
how is she (or a care-giver) using them? and c) is she combining these with
alternative supplementation methods?
3C) Use of dummy (pacifier, soother). This can reduce time at breast,
though it can have a limited use in a 'bait  and switch' technique, i.e.
soothe the child with a dummy and try slipping the breast in when the child
is calm or sleepy.
4) The reason why the woman is seeking to induce lactation is important -
her medical history, her individual anatomy, etc. If re-establishing a milk
supply for a child to whom she has given birth, have any child-related
factors for cessation of breastfeeding been resolved?

For comparison, a prospective study would be needed, in preference to a
retrospective one. A good study that takes into account  all those factors
(and more) is all very well, but then the researchers need the numbers for
statistical power. To control for all the above factors would need larger
numbers. Induced lactation and relactation aren't situations where large
numbers are easily available, particularly for a prospective study.
Multi-centre?

Mothers need to agree to being randomised for such a study - and cultural
reasons may make them reluctant to be randomised, especially in high-income
countries, and thus the study doesn't begin.

As Karleen mentioned, there have been case series and case reports where
mothers brought in milk without recourse to pills, by using stimulation and
non-pharmaceutical methods. Inducing lactation didn't just come into
existence with the invention of hormonal pills. In any case, breast
stimulation (by suckling, expressing massage) provides the relevant
hormones. Hormones don't necessarily come by pill.

Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA
IBCLC and medical historian
Ipswich, QLD, Australia
Author, Chapter 19 in Core Curriculum for Interdisciplinary Lactation Care

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