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Subject:
From:
Jenifer McAllister <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 28 Jun 2005 10:34:59 -0400
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I came across this article and wondered if it could be useful to use 
oxytocin spray for women who do not experience lactogenesis II as a result 
of nerve damage following breast reduction. Has anyone tried it? Would 
using domperidone also help? How early or late could these things be 
impelemnted to be effective?  

Jenny McAllister. Hospital IBCLC.
Looking foreward to ILCA


KC Cowley
Psychogenic and pharmacologic induction of the let-down reflex can 
facilitate breastfeeding by tetraplegic women: a report of 3 cases.
Arch Phys Med Rehabil, June 1, 2005; 86(6): 1261-4.

 

Abstract Cowley KC. Psychogenic and pharmacologic induction of the let-
down reflex can facilitate breastfeeding by tetraplegic women: a report of 
3 cases. Arch Phys Med Rehabil 2005;86:1261-4. Although an increasing 
number of women are becoming pregnant and rearing children after spinal 
cord injury (SCI), scant literature exists on breastfeeding after injury. 
In particular, it is unclear whether women with SCI above T7 can sustain 
breastfeeding in a manner similar to neurologically intact nursing 
mothers. A functional let-down reflex is required to provide adequate milk 
to a nursing infant. Infant suckling activates tactile receptors in the 
breast, and this signal is carried via afferent nerves in the T4-6 dorsal 
roots to the spinal cord and then to neurons in the hypothalamus, which 
release oxytocin into the bloodstream. Oxytocin triggers milk ejection 
from the breast. Suckling-induced afferent stimuli are absent in women 
with SCI above T4 and are reduced if the injury is between T4 and T6. This 
report describes the breastfeeding practices of 3 tetraplegic women and 
shows that breastfeeding can be maintained for extended periods (12-54wk) 
after delivery. Two women required active mental imaging and relaxation 
techniques, or oxytocin nasal spray, to facilitate the let-down reflex. 
These findings suggest that although an absence of suckling-induced 
afferent stimuli may impair the let-down reflex, long-term breastfeeding 
can be maintained. 

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