Melisa - in Southern Africa we use sulpiride (a mild anti-depressant, which
needs a doctor's prescription) to increase prolactin levels as an aid to
breastmilk production.  This drug is very commonly used here, and my
observation of the very few moms I have worked with who have been prescribed
metoclopramide instead, is that sulpiride works better.

Several years ago I worked with a mom who had early menopause and was taking
HRT who wanted to induce lactation for an adopted baby.  She took sulpiride,
50 mg three times daily, and hand-expressed until there was more than just a
tiny quantity of milk (producing drops within just a few days), then pumped
with a manual pump.  By the time the baby was born, about 6 weeks later, she
was producing >200ml/day, and she combined breast and bottle-feeding for
about 9 months.  I worked out that once the baby was nursing her supply
probably increased.  My client was reluctant to do without her estrogen
replacement therapy, but I always wondered if her milk production would have
been enhanced if she had stopped taking it for a while.

Since your client is only 47 and probably newly menopausal, I would think it
is likely that involution of the breast tissue would be minimal, and since
estrogen is a lactation suppressant, I would think that the fact that she is
menopausal would have little effect on her chances of re-lactating.  THe
main stimulus to milk production seems to be breast stimulation - frequent,
short, gentle, manual expression sessions throughout the day - and then
frequent drainage of whatever milk is being produced, 8 - 10 times daily, to
maintain/increase the supply.  I would think that a medication known to
enhance prolactin levels would help and give quicker "results", although it
is not essential.  Here, as I say, we use sulpiride, and we find it very
effective.  It is necessary to taper it off very gradually once the desired
goal of lactation has been achieved to avoid depression and greatly reduced
breastmilk production, but as long as this is done carefully, I have not
observed any negative effects.

Best wishes to your mom.  Her little boy is very lucky that she wants to do
this for him.

Pamela Morrison IBCLC, Zimbabwe
[log in to unmask]

>I have a new client who is wanting to lactate after 10 years of not.  She
is 47 >and menopausal.  Her son is 8 years old and autistic....  She is
interested in >relactating but wanted to know if the common drugs to bring
on lactation will >work with her body in menopause...

>Melisa

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