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Subject:
From:
"Jessica L. Callahan" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 18 Sep 2010 14:39:19 -0400
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I am a newer IBCLC but have been interested in BM/BF for a long time so i do have a really good basic knowledge baseline but still have many areas that I need to learn more about. 
I have been working with a mother whose baby is in NICU currently 7 days old. Mother was pumping q3 hours and nursing infant at the breast TID. When i talked with her at 4 days after delivery she was still only producing 4mls with pumping. I discussed increasing pumping frequency, hand expression after pumping, massing breast prior to pumping and trying to increase the suction on the pump (she was using the easiest suction setting). The following day i talked with her and she was able to get out 5-7mls. It has stayed this way since then. I was thinking reglan but upon talking with mother she has had a past episode of depression so quickly scratched that idea. 
When i asked about concieving mother has said that she had problems and she was given a shot (unsure what it was - something to do with hormones) prior to being inseminated. I am thinking that this issue with concieving has resulted in this delayed lactogenisis II. My question is would domperidone help? If it is suggested then how does someone actually get it in the US. I have read that it can be ordered at a compounding pharmacy. But does the presciption have to say what it needs to be compounded with and what exactly is the medication that it is compounded with. What is the dose and how can you talk a physicain into writing this order (for fear because it is not FDA approved). I did suggest that she see about getting a prolactin level drawn but what do i do once i get that information if it is low? Will the domperidone work to increase her prolactin level? How long should she take the domperidone for and at what dose? 
Also if anyone has any other suggestions I would greatly appreciate it. 
Thank you so much 

Newly learning IBCLC 
Jessica
NC, USA

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