Hi Dawn,

Thank you for bringing this to my attention. Since I've been away from ABRW and busy setting up this new message board, I haven't been to the ABRW site much if at all. And since my IP address had been banned, I am unable to post or respond to this type of thing over there.

If you think this is something, you should see some of the posts that have been made by a certain member of ABRW recently, mostly questioning the protocols, domperidone, etc. on Lact-net. Carole has been handling them.

Before I left ABRW this particular member gave me a bit of a hard time. She's a mom who adopted an older child and got her to the breast with domperidone. She posted the WHO position paper on adoptive breastfeeding that Elizabeth Hormann co-wrote in 1998. I responded by saying the document was informative but that the information did not include the new protocols because they were only released in 2000. I said I had been in touch with Elizabeth Hormann and that she includes the protocols on her lecture tour and was supportive of them. (She was very supportive when she spoke with me, said Chele Marmet of the Lactation Institute had told her to get in touch with me, and has had email contact with me several times.) I have the utmost respect for Elizabeth Hormann and am convinced that her post was based on only one side of the story.

I think that in all likelyhood someone emailed her my comments on her document and that it was taken out of context of the general discussion and misunderstood. The 1998 WHO position paper was an excellent and well researched review of the available literature at that time. The document contains important and relevant information. But of course the protocols were not yet released when the document was prepared. That doesn't mean the WHO document isn't relevant.

The point that I was trying to make was that there is more information now. There is another way that works. We know this because at this point over 400 women have tried the protocols and have brought in their milk supplies. How do we measure success? Full milk supplies? Half milk supplies? To me, what is important is breastfeeding period. If the mother can bring in her milk too...why the heck not? As Carole recently put it, there are many ways to induce lactation. We have to assist the mother to weigh the risks and benefits of using medications that are filtered through the breast and that which is given directly to the baby. Remember, formula is modified cow's milk manufactured by a pharmaceutical company and therefore a form of over the counter medication.

I am of course very concerned about this post which I have no way to respond to. The statement that bothers me the most is this one " and the results have not, on average, been better than those achieved by many women using protocols involving less medical intervention - or no protocol at all except the baby at the breast."

We know that many women who have done the protocols have been able to breastfeed their babies from birth with a full milk supply. There is no way that a mother who has done no preparation whatsover is going to be able to fully breastfeed her baby from birth by just putting the baby to the breast. If one were to follow the logic of no preparation or minimal medication or preparation, one would also have to agree to the use of formula feeding from birth. And in fact, this is what tends to happen. It's inevitable that these babies end up formula fed from birth because they need to eat from birth right? There is not a single first time adoptive mother (who never lactated before) at ABRW who was able to just put the baby to the breast without any sort of preparation and breastfeed without a supplementer. And unless they were able to get banked human milk, their babies were formula fed.

I contacted Dr. Newman about this and he agreed with me but in all fairness, Elizabeth Hormann cannot publically endorse a protocol that has not yet appeared in a respected peer reviewed journal. Dr. Newman and I are aware of the need to put out a journal article and put this whole issue about the protocols to rest. In the meantime, he made a very good point, he said that since there is nothing yet published, how can Elizabeth Hormann say the results are not better?

I wish to add that when I left ABRW the membership was just over 200. So if every single mother there were on the protocols and if every single one posted a negative result, and since we've been in touch with over 400, where are the rest? The answer is that the majority of women on the protocols never heard of ABRW before they contacted either Dr. Newman or myself. So again, it's not a fair statement to discuss results that no one but Dr. Newman and myself are privy to.

Women at ABRW who posted difficulties often did not follow the protocols as witten for whatever reason. The most common problem was that they did not do the domperidone/birth control pill combination for any length of time or used a low dose bcp. A major issue was pumping. Women who pumped 2 or 3 times per day instead of at least the 8 times in 24 hours that we recommend had difficulties. Women who didn't use a double electric breast pump had difficulties. Women who didn't contact me for moral support when I was more than happy to assist had difficulties.

As for the comments of the other ladies...keep in mind who's responding. It's like the anti-medical members "bon voyage to the protocols" party. Although Dr. Newman and I have not as yet recinded our permission to post the protocols on ABRW, we suspect that they will not remain there much longer. If anyone is interested in reading them they can be found here:
http://www.asklenore.info/breastfeeding/induced_lactation/gn_protocols.html

Keep the faith everyone. We're working on the article. It takes time to accumulate and analyze all the data. If anyone would like to help, we're interested in the pediatric reports (specifially the growth charts) for any baby that was breastfed following the use of domperidone, Diane 35, herbs, pumping, Lact-aid/SNS, or a combination of any of these. We are also intersted in the pediatric reports of any babies who were breastfed without medications, just the Lact-aid or breast alone and then supplemented with bottles.

If you are interested in participating in our study, please contact me directly via the ask Lenore email link at the bottom of the page.

Well that's my opinion for what it's worth. I'm happy to have a place to voice it. Thanks Dawn for asking.

Fondly,