II. Indications
- Inducing Lactation in women who have not given birth (e.g. adoptive mother)
III. Management
- Step 1: Start Oral Contraceptive (OCP)
- Select an OCP with low Progestin Androgenic Activity
- Example: Ethinyl Eastradiol 35 mcg/Ethynodiol Diacetate 1 mg
- Start early and continue until 48 hours before planned Lactation
- Step 2: Stimulate Lactation
- Stop Oral Contraceptive
- Domperidone 20 mg orally four times daily
- Dopamine Antagonist that stimulates Prolactin secretion and does not cross blood brain barrier
- Initiate Breast Pump use every 2-3 hours
- Consult Lactation specialist