Yes, that is the one.  I don't know of any others, do you?  I haven't felt
like this study was all that appropriate for applying to anyone in western
cultures because there are just too many variables.  I think the success
rate was due much more to cultural factors than to anything the physician
might have done.  The ladies who wrote to me from Kenya had similar results,
without any kind of intevention.  I guess, however, that the study results
might be seen as suggesting that the depo at least didn't have a negative
effect.

The extra information about the PNG study is very interesting.  Do you have
any idea if this protocol has been used with domperidone, rather than
metoclopramide?  I suspect that combination might be alot more appropriate
for mothers who are adopting (versus those expecting through surrogacy) than
the BCP/dom in advance.

Best Wishes,
Darillyn

"The paper that you refer to is by Nemba? is that correct? I spoke to him
fairly recently about his paper (a nice guy, working in WAust now) That
particular drug protocol was used (and perhaps still is) extensively in PNG.
It is published in Paediatrics for Doctors in Papua New Guinea. My
daughter's paediatrician who worked in PNG for a number of years used it.
However, drugs are just a part of the story. Women were also told that they
would be successful in making milk (building confidence was explicitly
stated as being a part of the protocol), they were given traditional
galactagogues (milk to drink) to also build confidence, they were
hospitalised so that breastfeeding was all they concentrated on. They were
also within a breastfeeding culture and knew about breastfeeding and
practiced frequent suckling. I think that the other factors associated with
the success of milk production in relactation/induced lactation in PNG (ie
factors apart from drug use) should not be overlooked. Just how much of a
role the drugs play??? I just don't know. I considered using the PNG
protocol myself but decided not to in the end (and I did fine without it). I
guess my point is that lots and lots of women have used this protocol.
Karleen Gribble

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