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What would you suggest for new mothers who are attempting to breast feed but have poor milk production. Also do you recommend bromocriptine for stopping milk production? The reason for the "poor milk production" must first be ascertained. Is the baby's latch correct, are there any sucking problems and has the mother tried to express milk after feedings to help increase milk supply? Assuming that these factors have been adequately dealt with then a trial of herbal products to increase breast milk production may be tried. The success of these herbs are based primarily on anecdotal reports, and to my knowledge have not been subjected to any scientific controlled study. Before trying any of these herbs mothers should be informed that even herbs can have side effects, some of which can be quite serious. These adverse reactions, were they to occur, would be unlikely to affect the baby who would get very little if any of the mother's dose. The two products that are most commonly recommended are fenugreek and blessed thistle (2 capsules of each herb 3 or 4 times a day). Other herbs that have been used without proven efficacy include raspberry leaf, fennel and brewer's yeast. In the pharmaceutical line, Domperidone (Motillium) which increases prolactin and stimulates breast milk production has been used. This should never be used as the first approach to correcting breast feeding difficulties and should only be used after all other methods of increasing breast milk supply have been tried. The recommended starting dose is 20mg 4 times a day. Side effects include dry mouth, headache and abdominal cramps.(1) Bromocriptine for post partum lactation suppression is not recommended. There have been several reports in the literature recently in which bromocriptine has been associated with fatal myocardial infarction and severe cerebrovascular accidents in the postpartum period in mothers taking bromocriptine for ablactation (2,3,) References: 1. Newman J. Breast feeding-Starting out right. www.bflrc.com/jn_arts.htm 2. Dutt S,Wong F, Spurway JH. Fatal myocardial infarction associated with bromocriptine for postpartum lactation suppression. Aust N Z Obstet Gynaecol 1998;38:116-117. 3. Iffy L, Lindenthal J, Meardle JJ et al. Severe cerebral accidents postpartum in patients taking bromocriptine for milk suppression. Isr j Med Sci 1996;32:309-312.
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