Introduction to the Protocols for Induced Lactation

The protocols that follow are designed to prepare the mother’s breasts for making breastmilk, just as occurs during pregnancy. Until recently, the typical advice that lactation consultants and members of the medical profession suggested to women who were interested in adoptive breastfeeding was to either pump and stimulate the breasts or do nothing before the baby arrives, just put the baby to the breast when the baby arrives and in a while the mother may or may not have breastmilk. The option of pumping alone requires serious dedication and commitment to pumping and breast stimulation many times per day for several months.

Many mothers may prefer to go the route of putting the baby to the breast and waiting to see what happens, not using any preparation at all or any medication. This is a legitimate option but one that will much less likely produce significant amounts of breastmilk.

There is more to breastfeeding than breastmilk but if it is possible to breastfeed AND bring in the breastmilk … why not do it?

There is a concern on the part of many lactation consultants and medical practitioners about the use of the birth control pill. It takes some getting used to … the notion of using a birth control pill to bring in a milk supply when we in the "lactation field" are told that the combination birth control pill (estrogen and progesterone) is BAD for milk supply. The thing to remember is that these mothers are not lactating YET. The use of the birth control pill and domperidone enables us to provide 3 of the 4 necessary hormones to simulate pregnancy and induce lactation. The forth one being human placental lactogen which is only available with a pregnancy.

The birth control pill can be started at any time in a woman’s cycle because she is taking it for her breasts not her uterus. In fact, her uterus and ovaries do not need to be present at all in order for her to induce lactation. Many mothers question the need to take birth control pills when they have had a hysterectomy. These mothers require assistance to understand that the birth control pill is not for contraception, it’s for her breasts.

Typically, patients undergoing in-vitro fertilization procedures are given the equivalent of 200 mg progesterone (vaginal suppositories) to help support and maintain their pregnancies while it only takes 1-2 mg progesterone (oral) to induce lactation. Another thing to remember is that these protocol are for the most part short term (less than 1 year).

Many have asked how we arrived at the current protocols. We followed a series of deductions:

  1. Ladies on the birth control pill experience breast changes but they do not lactate. They can be on the birth control pill for YEARS and nothing happens after the initial increased breast size if any.
  2. Some ladies on the domperidone for upper GI dysfunction did experience, as a side effect, lactation depending on the dosage taken…so did men.
  3. Combining the birth control pill with domperidone is similar to making water boil. The birth control pill is the water (breast changes) and the domperidone is the salt (prolactin) that makes the water boil (milk production) much faster.
  4. Add the breast pump or the baby at the breast and the result is copious breastmilk production.
  5. Add the herbs, oatmeal and water and we have the recipe for increased milk supply.

It’s as simple as that.

The protocols that follow involve the use of medications and herbs. There is the Regular Protocol, the Accelerated Protocol, and the Menopause Protocol. As a rule, the longer the mother can be on her particular protocol, the more milk she will end up with. The mother will need to take a monophasic large dose birth control pill non-stop, only active pills, no sugar pills together with a medication called domperidone (see the medications and herbs section).

Newman-Goldfarb Protocols for Induced Lactation © 2002-2016
Jack Newman, MD, FRCPC and Lenore Goldfarb, Ph.D., CCC, IBCLC