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The Protocols for Induced Lactation — A Guide for Maximising Breastmilk Production
By Jack Newman, MD, FRCPC and Lenore Goldfarb, PhD, CCC, IBCLC, ALC

Based on the original Induced Lactation Protocol conceived and published by Jack Newman MD

The Newman-Goldfarb protocols were developed from information published in Dr. Newman’s book “Dr. Jack Newman’s Guide to Breastfeeding” (Harper-Collins, 2000). In the US the title is “The Ultimate Breastfeeding Book of Answers” by Dr. Jack Newman (Prima Publishing, 2000).

The Menopause Protocol

If the mother is menopausal due to surgical removal of her reproductive organs or naturally occurring menopause, she can still breastfeed and bring in her milk supply. A woman does not need a uterus or ovaries in order to breastfeed. All she needs are breasts and a functioning pituitary.

NOTE: If you are over the age of 35 and/or you are unable to use the estrogen-progesterone combination birth control pill, kindly replace the Ortho 1/35 of our protocols with EITHER Provera 2.5 OR prometrium 100 mg. There are health risks associated with the use of the estrogen-progesterone combination birth control pill for women over the age of 35 that you need to discuss with your doctor and this is why we replace the birth control pill protocols with Provera 2.5 OR prometrium 100 mg for women over 35.

The first step is to stop the mother’s hormone replacement therapy and replace it with Microgestin or Ortho 1/35 (once per day). The Microgestin or Ortho 1/35 contains enough estrogen and progesterone to keep the mother’s menopausal symptoms at bay while at the same time developing the milk making apparatus of her breasts. The mother also needs to take domperidone (10 mg 4 times a day for the first week and then increase to 20 mg 4 times a day). It is a good idea for the mother to stay on the combination of Microgestin or Ortho 1/35 and domperidone until she experiences significant breast changes. At least 60 days on the combination of Microgestin or Ortho 1/35 and domperidone are recommended for menopausal women. Significant breast changes include an increase in breast size (at least 1 cup) and breasts that feel full, heavy and painful.

Once the mother has completed at least 60 days on the combination of Microgestin or Ortho 1/35 and domperidone and has experienced significant breast changes she can stop the Microgestin or Ortho 1/35, maintain the domperidone and begin pumping with a double electric breast pump. A hand pump is just not up to the job.

It is recommended that the mother pump every 3 hours and once during the night. (See “pumping instructions”.)

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 1/2 hour before meals for best absorption. Many mothers on the protocols have noticed a significant increase in their milk supplies when they began to add oatmeal to their diets regularly.

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 breastmilk. It may take a few days, a week, or two, or more for the mother’s milk supply to come in. Everyone responds differently.

If the mother experiences menopause symptoms, please do not resume the mother’s hormone replacement therapy but rather suggest that she eat soya products to control her symptoms. Soya milk and/or soya butter are good choices because they contain phytoestrogens but the mother should eat only enough to stop "hot flashes" because too much will decrease her milk supply.

Newman-Goldfarb Protocols for Induced Lactation © 2002-2010
Jack Newman, MD, FRCPC and Lenore Goldfarb, PhD, CCC, IBCLC, ALC

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© 2002-2018 Dr. Lenore Goldfarb, PhD, CCC, IBCLC, ALC and contributing authors to All rights reserved.

Disclaimer: All material provided in is provided for educational purposes only. Consult your physician regarding the advisability of any opinions or recommendations with respect to your individual situation.