{"id":5304,"date":"2019-08-05T12:54:03","date_gmt":"2019-08-05T16:54:03","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=5304"},"modified":"2020-07-23T11:57:52","modified_gmt":"2020-07-23T15:57:52","slug":"metoclopramide-reglan-for-breastfeeding","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/metoclopramide-reglan-for-breastfeeding\/","title":{"rendered":"Can you really take a prescription drug to boost your milk supply?"},"content":{"rendered":"

This is part of a series on breastfeeding in support of National Breastfeeding Month (August). Find the full coverage\u00a0<\/i>here<\/i><\/a>.<\/i><\/p>\n

Breastfeeding is often called the \u201cnatural\u201d way to feed a baby, but just because something is \u201cnatural\u201d doesn\u2019t mean it\u2019s easy. In fact, breastfeeding can be downright difficult: latch issues, cracked nipples, engorgement, and low milk supply all commonly plague the early weeks and months of breastfeeding.\u00a0<\/span><\/p>\n

Out of all these problems, low milk supply is probably the most troubling\u2014so it\u2019s understandable why many new moms turn to a number of different <\/span>strategies to make more milk<\/span><\/a>, including asking their doctor for prescription medications rumored to <\/span>increase milk supply<\/span><\/a>.\u00a0<\/span><\/p>\n

In the United States, there\u2019s only one drug FDA-approved for the use of lactation support: metoclopramide, brand name <\/span>Reglan<\/span><\/a>. (Canadians are often prescribed domperidone instead, but it\u2019s <\/span>not approved for sale<\/span><\/a> in the U.S. due to concerns over side effects.) According to Christine Masterson, MD, chief of the women and children\u2019s service line at <\/span>Summit Medical Group<\/span><\/a> in New Jersey, metoclopramide is a drug commonly used for treating various <\/span>gastrointestinal issues<\/span><\/a>; it just so happens that one of the drug\u2019s side effects is increased milk production.<\/span><\/p>\n

\u201cMetoclopramide turns off a chemical in the brain called dopamine, which allows for prolactin elevation,\u201d Dr. Masterson says. (Prolactin is a <\/span>hormone that promotes milk production<\/span><\/a>.) \u201cIt can vary tremendously in how effective it is for breastfeeding, though some patients may receive a 50 to 100 percent increase in milk supply.\u201d<\/span><\/p>\n

So what\u2019s the problem with using Reglan for breastfeeding? Actually, Dr. Masterson says there are several. For one, the use of metoclopramide for milk production isn\u2019t well-studied. Secondly, there is no clear indication about the dosage for milk production versus GI symptoms. And finally, because metoclopramide passes through breast milk, there can be side effects for both mom <\/span>and<\/span><\/i> baby.<\/span><\/p>\n

\u201cThe concentration of the drug in the baby\u2019s blood can vary tremendously, but could be as high as 10 percent of the mother\u2019s dosage,\u201d Dr. Masterson reveals. \u201cThis may affect the baby\u2019s GI tract: causing more gas formation and abdominal discomfort or changing their bowel movements to diarrhea.\u201d<\/span><\/p>\n

As unpleasant as that is for baby, the side effects for mom are potentially much worse. Dr. Masterson says that in addition to similar GI issues, headache, fatigue, dry mouth, and certain <\/span>movement disorders<\/span><\/a>, women may also find that metoclopramide triggers or worsens symptoms of anxiety and depression. At a time when moms are particularly vulnerable to the mood changes brought on by postpartum hormones and the stresses of feeding a newborn around the clock, a drug that carries a serious risk of depression may not be the best choice.<\/span><\/p>\n

\u201cHow we give birth has an impact on how we feel <\/span>after<\/span><\/i> we give birth,\u201d says New York-based lactation consultant Leigh Anne O\u2019Connor<\/a>, IBCLC. \u201cIf you had a challenging birth, with a planned or unplanned c-section [or another unexpected intervention], breastfeeding will also be challenging.\u201d<\/span><\/p>\n

RELATED: <\/b>How support can help mothers during breastfeeding<\/b><\/a><\/p>\n

These factors combined can create a recipe for <\/span>postpartum depression<\/span><\/a>, whether a new mother has a history of depression or not (although the chances are higher if she does); O\u2019Connor says she has seen too many women experience symptoms of anxiety and depression while taking metoclopramide to feel comfortable recommending it to her patients.\u00a0<\/span><\/p>\n

Instead, she emphasizes the importance of getting support during the early days of breastfeeding. A good place to start is with a full lactation evaluation from an <\/span>International Board Certified Lactation Consultant<\/span><\/a> (IBCLC), which can reveal whether or not a mother <\/span>truly<\/span><\/i> has low supply (often there\u2019s some other easily corrected problem masquerading as a supply issue). Even if a mom\u2019s supply is actually low, working with an IBCLC can identify the root cause\u2014and set her on a course toward correcting the problem and building a solid breastfeeding foundation for the future.<\/span><\/p>\n

\u201cMany people want to breastfeed, but they don\u2019t understand that our healthcare system is not set up to support or educate people on what it actually looks like and what the barriers are,\u201d O\u2019Connor says. \u201cPeople feel like a failure when it doesn\u2019t go smoothly right away.\u201d<\/span><\/p>\n

That said, there are some circumstances when a drug like metoclopramide to increase milk supply might be appropriate. According to Dr. Masterson and O\u2019Connor, people who might benefit from using Reglan for breastfeeding include:\u00a0<\/span><\/p>\n