A few weeks ago there was a posting about a woman who had taken
bromocriptine (parlodil) during the early months of pregnancy and her
inability subsequently to produce sufficient milk.  I recently have been
following a new mother with almost the exact story. She was producing
not just little milk, she was producing almost none, as far as I could
tell.  I know I have seen women who have been on bromocriptine in order
to suppress prolactin secretion so that they could get pregnant, and
they have had no problem with milk production.  Perhaps the difference
in these two mothers is that they were taking bromocriptine during the
first 2 or 3 months of their pregnancies, something I do not believe the
others were doing--they stopped the bromocriptine as soon as they knew
or suspected they were pregnant.  In other cases they had taken
bromocriptine well before they became pregnant.  There would be no
reason to continue to surpress prolactin secretion once the woman was
pregnant because maintenance of the pregnancy does require low prolactin
levels.  As you all know, prolactin secretion rises during pregnancy,
but its effects are diminished by the action of placental hormones.
What if there is considerably diminished prolactin secretion during this
time when the breasts are being prepared to produce milk?

        It would be important to know if this is coincidental or if there may
be a difference in how the fertility clinics are using this drug.  If
anyone has had other experiences such as this, or contrary ones, it
would be interesting to know.  If we are getting consistent stories such
as the one above, this would make a good study, and an important thing
for physicians in fertility clinics to know.  This may be a great use
for Lactnet, to get case reports together and publish together many
reports which would be much more convincing than one or two here and
there.  The details of studies could be done by e-mail rather than on
Lactnet.

Jack Newman, MD, FRCPC