II. Indications

  1. Inducing Lactation in women who have not given birth (e.g. adoptive mother)

III. Management

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

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