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Establishing LactationFrom: Tom and Elizabeth Johnston (yesallours@nc.rr.com)Wed Dec 5 05:04:45 2007
>I have a patient who is adopting a newborn, and wishes to breastfeed if
>possible...
>I know there is some medication that one can take albeit possibly not
>too sucessful often...
>but I cannot remember the name...or really anything about it, and its
>effectivity.
>this adoption is going to take place around jan 13.
>thanks for any info...
>frances wren MD FRCS Dr Wren, As a lactation consultant I have helped 2 or 3 adopting women establish lactation and I routinely help women who failed at breastfeeding re-establish their milk supply. It is not exactly easy, but it is worthwhile and very valuable to the overall health and wellness of both mother and child (I will assume the el's comment was simply sarcasm). The first step is to get a good lactation consultant. If you go to www.ilca.org <http://www.ilca.org/> (international lactation consultant's association) you can click on the "find a midwife" tab and get in contact with one. This process needs the guidance of a trained professional. The patient would benefit from routine pumping of both breasts. I would say about 6 times a day and once at night for a total of approx 100 - 200 minutes on each breast each day. There are a host of Galactogues (please forgive the spelling). You can use Reglan 10 mg QID x 10 days then wean by one dose every three days. I find it works well, but it has a high side effect profile. You can also use Domperidone 20 mg caps BID x 10 days, that one I don't usually wean from. It is not commonly available and you will usually have to go to a compounding pharmacy to get it filled. You can also use mother's milk tea, or phenugreek tea, but they are not as potent as the first two. Third, the patient will need an SNS (supplemental nursing system) for the first couple of days or weeks after bringing baby home, until her body is up to the task. If this isn't working I suggest a prolactin level 45 minutes after pumping to see if you are getting the response you want. It is possible, if this is infertility that makes her adopt, that what ever is causing the infertility would also cause the agalactia. Hope it helps, let me know if you need more information. Tom Johnston CNM, IBCLC In NC
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