Dr Wade is my physician mentor at Kaiser Riverside and also active in the new Acad of Breastfeeding Medicine. (Thanks for mentioning him Anne.) It seems that those moms who have never been pregnant have little success at producing more than drops of milk. It might be the lack of differentation and proliferation of breast tissue that occurs with pregnancy as Dr. Wade suggests or it may be related to the reason they are infertile. We have found a slight increase in production if the mom uses a pump that massages the areola in addition to the rhythmic suction. We tell moms to pump as if they had a baby to feed--'round the clock. We do not use medications to induce lactation. In fact, when we started the Riverside clinic in 1989, we made a conscious decision not to use medications for galactologues. We use brewer's yeast, occasionally fenugrek tea or other nutritional supplements instead. I believe we have good success without the use of drugs. I must admit that most of our success probably comes from the *sales pitch* we give mom when we recommend supplements. I have serious questions relating to using Reglan (Metoclopramide) for induced lactation or increasing supply. This discussion is better suited to one of our pharmaciests but, here's what I understand--- Theoretically, Metoclopramide doubles the milk supply by increasing prolactin release from the pitutary. It is also a dopamine antagonist, sensitizes tissues to acetycholine, and increases aldesterone levels. --- Double of nothing is still nothing. If mom has a 20cc supply is the new total 40 cc worth the risk of the drug's potential side effects? Cardiac arrhythmias, extrapyramidal symptoms (1in 500), parkinsonian-like symptoms, fluid retention, depression, anxiety, hypertension, to name a few. There are positive studies related to milk increase with Metoclopramide but Lawrence (p570) also cites a study where there was no difference in milk production in a double blind re-lactation study between sugar pills and Metoclopramide. Lawrence (p741) states 10-30% of newborn therapeutic dose in mother's milk, the drug was found in the infant's plasma (1 case of 5 ) and she also notes maternal Metoclopramide use may cause sedation and poor feeding in the infant. It seems oxymoronic to advocate something as pure as breastmilk and then suggest potient drugs with potential serious side effects. Perhaps, the rush to use medication is a side effect of our *magic pill* society. Marie Davis RNCLC