Subject: Inducing Lactation
Protocol Authors: Lenore Goldfarb PhD & Dr Jack Newman
Website: Ask Lenore.info
Publication: Dr. Jack Newman’s Guide to Breastfeeding
Book Authors: Dr. Jack Newman & Teresa Pitman
Publish Date: 2000
This is an excerpt from the Newman/Goldfarb Protocols for Inducing Lactation and Maximizing Milk Production. The contraceptive used in this protocol, (Diane 35), is apparently no longer available in the USA. If you are considering using this method of inducing lactation, you should check Lenore Goldfarb's website, Ask Lenore.info, for the most current information regarding this protocol.
The Newman/Goldfarb Protocol for Inducing Lactation and Maximizing Milk Production
The Accelerated Protocol:
Suitable for intended mothers or adoptive mothers who have little time to prepare, or for mothers who wish to relactate.
Milk production may be significantly lower with this protocol than that achieved with the Regular Protocol but there is more to breastfeeding than breast milk.
Diane 35 is taken for 30-60 days non-stop, only active pills, no sugar pills, together with the domperidone 20 mg 4 times per day. If significant breast changes occur within 30 days, the birth control pill is stopped while maintaining the domperidone, and the pumping schedule begins.
Significant breast changes include an increase in breast size (1 cup) and breasts that feel full, heavy and painful. Note: stopping the protocol before these breast changes occur is not recommended.
Milk production is not as great on the accelerated protocol but the supply is usually sufficient to provide a significant amount of the baby's needs. The mother can use the feeding tube device filled with either breast milk or artificial infant milk to breastfeed her baby while she is going through the protocol. There are milk banks and milk exchange services that can provide the adoptive mother with breast milk if it is not feasible for her to ask the birthmother to provide breast milk. Many adoptive mothers and intended mothers have asked the birth mother to provide breast milk for a limited amount of time ranging from two weeks to 1 month or more in order to provide colostrum to the baby. Many birth mothers are happy and willing to provide the child with a healthy start in life. At least one birth mother has reported that providing breast milk helped her to cope with the adoption process. Many surrogate mothers have provided expressed colostrum and breast milk for their couples to give their children. This has become more common in recent years.
If the mother has 4 weeks or less or even if the baby has arrived and the mother suddenly decides that she wants to do the accelerated protocol, she can. The Diane 35 (once a day) is started immediately, regardless of the mother's cycle day, (see the section that describes the medications above) together with 20 mg of domperidone 4 times a day. The mother can expect to feel fatigued due to the rapid start of medications. If the mother can take the Diane 35 together with the domperidone for at least 30 days she will have a good result.
Once the mother has completed at least 30 days on the combination of Diane 35 and domperidone and has experienced significant breast changes she can stop the Diane 35, maintain the domperidone and begin pumping with a double electric breast pump. A hand pump is just not up to the job. See the section on breast pumps. Significant breast changes include an increase in breast size (at least 1 cup) and breasts that feel full, heavy and painful.
Pump as for the Regular Protocol and at least once during the night. A mother's serum prolactin levels naturally rise between 1 am and 5 am. Pumping during the night takes advantage of this natural occurrence. Additionally research has shown that frequency of breast emptying is more influential on milk supply than duration of breast emptying. The more often the mother pumps, the more milk she can store, and the better her supply will be.
Once the mother has started pumping, she can add the herbs Blessed Thistle herb (390 mg per capsule) and Fenugreek seed (610 mg per capsule). Take 3 capsules of each 3 times a day with your meals. She should take her domperidone ½ hour before meals for best absorption. She should try to eat oatmeal for breakfast at least 3 times a week. Oatmeal has been found to increase milk supply. Many mothers on the protocols have noticed a significant increase in their milk supplies when they began to add oatmeal to their diets. Fluids are very important. The human body naturally consumes and excretes the equivalent of 8 - 10 glasses of water per day. It is recommended that mothers drink at least 6 - 8 glasses of water a day if possible. Usually if mothers drink water when they are thirsty during the day, adequate fluid intake is achieved. Beverages containing caffeine should be avoided as they cause rapid excretion of fluids.
The arrival of the milk supply while pumping follows a particular pattern. It begins with clear drops, which become more opaque and whiter in color. Drops will appear, followed by milk spray, and then a steady stream of breast milk. It may take a few days, a week, or two, or more for the mother's milk supply to come in. Everyone responds differently.
The mother will need to pump every 3 hours and once during the night. Once the mother has started pumping she can add the herbs Blessed Thistle herb (390 mg per capsule) and Fenugreek seed (610 mg per capsule). The recommended herb dosage is 3 capsules of each, 3 times a day with meals. The domperidone should be taken ½ hour before meals for best absorption. Many women on the protocols have found that eating oatmeal for breakfast at least 3 times a week and drinking 6 glasses of water a day has significantly increased their milk supplies.
Remember that if the mother is fertile, she must use an alternative method of contraception. It is advisable for the mother to store as much breast milk as she can. Once her baby arrives, or if her baby is already here, the baby should be fed on demand. The baby can be supplemented if necessary using a feeding tube device filled with either the stored breast milk, donor milk from a milk bank or milk exchange service, or artificial infant milk until the mother's milk supply is well established. Remember, not all the milk has to come from the mother. Whatever amount of breast milk she can provide to her baby is a precious gift. There is more to breastfeeding than breast milk.
Note that the birth control pill and domperidone are both approved by the American Academy of Pediatrics for use in breastfeeding mothers.