If this expectant MOM lives in an area with LLL or some other mother support
group, I'd highly encourage her to attend meetings if possible or at least
establish contact with the group. Also, I'd highly encourage her to
subscribe to the Yahoo group APMultiples, which is like an online  BF
support group for MOT/MOM and includes several MOTrips -- if she goes to
Links at my web site, it is the first one listed. One of our LLL Multiples
group moms fully BF triplets from 38-39 weeks gestation to start of solids
for each. (They'd been born between 34-35 weeks GA.) One weaned between 1-2
years and the other 2 continue to BF --  now over 2 y.o. This MOM is now a
LLLL and usually very happy to correspond with other mothers interested in
BF triplets; she's also on APMultiples. I'm active on APMultiples as well.

I wouldn't immediately assume she should use some sort of galactogogue,
unless or until *proper* management of BF and/or milk expression
demonstrates a need for a boost (We've had MOT/MOM with PCOS in our LLL
Multiples group or on APMultiples who did not and who did need a boost for
production. It's a condition with signs/symptoms that vary per person.) Is
she or has she ever been on an antidiabetic med, such as glucophage or
glyburide for insulin resistance related to the PCOS? If so, remaining on or
resuming that type of med postpartum may be important re: milk production.

Re: reglan - this mom, as per all MOT/MOM, is at significantly higher risk
for a postpartum mood disorder (PPMD) into the 2nd year postpartum. In
addition to a PPMD link, reglan has been associated with tardive dyskinesia
http://www.ninds.nih.gov/disorders/tardive/tardive.htm. We should all be
extremely cautious about mentioning it as a galactogogue, esp re: length of
use and/or dose.

Would second Hilary Jacobson's book as well as MOBI Motherhood International
web site: http://www.mobimotherhood.org/MM/default.aspx and West & Marasco's
Making More Milk http://www.makingmoremilk.com/

A number of MOM complement or supplement some BF simply because of
transitioning 3 babies to breast and time management issues. Some also use a
tube system at breast (at one time or another), depending on either one/more
babies' sucking ability and/or milk production. Of those using tube systems,
I've heard more positive feedback re: Lact-Aid
http://www.lact-aid.com/Home/tabid/955/Default.aspx vs. SNS.

All the best for this MOM.

Karen Gromada (author of Mothering Multiples: Breastfeeding and Caring for
Twins or More)
www.karengromada.com/

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