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Subject:
From:
Denise Fisher <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 25 Aug 2004 09:26:07 +1000
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June asks about prescribing domperidone antenatally for a mother who has
had reduction mammaplasty and whether this would be beneficial.
That's a really interesting question.  My first reaction is to say that it
wouldn't be useful because the prolactin levels are already sky-high as a
result of the pregnancy, so making them go higher isn't necessary.  But
then how quickly postpartum do prolactin levels drop in women who are
breastfeeding but may have their neurohormonal reflex impaired?   And if we
do prescribe domperidone and keep the prolactin levels up is that
beneficial if we aren't also able to stimulate the release of oxytocin to
remove that milk from the breasts?

And the corollary ... if we are able to stimulate a milk ejection then the
prolactin release that occurs as well may be adequate until the two to
three month time when for some women it does work really well to keep the
levels a bit higher and saturate the prolactin receptors on what glandular
tissue remains.

My thoughts ... after a little cogitation... prescribe it one or two days
before birthing (should we know when this is going to happen!) and then
assess to see the effectiveness of the milk ejection reflex in the first
week after birthing.  If that's OK then cease the domperidone for the time
being, with view to perhaps needing it as the prolactin levels gradually drop.

Denise

***************************************
Denise Fisher
Health e-Learning
http://www.health-e-learning.com
****************************************

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