Improvement of defective lactation by using oral metoclopramide

Abstract

An attempt was made to pharmacologically enhance PRL [prolactin] secretion to improve lactation. Twenty-one puerperal women with past history of defective lactation and PRL levels under the normal range were studied for 4 wk postpartum. Eleven patients who received orally 20 mg a day of metoclopramide showed persistently elevated basal levels of serum PRL during the 4 wk observation period. These women also had a good milk production and their infants did not need supplements. Ten women receiving placebo, however, showed an abrupt decrease in basal PRL levels and this decrease persisted despite the continuation of lactation. Simultaneously a decline in the milk yield was observed and by the 14th postdelivery day milk production was minimal. The administration of metoclopramide at this moment to this group of poor lactating mothers produced an increase in serum PRL levels which persisted for the rest of the study. Metoclopramide also augmented the milk production so that these women were able to continue breast feeding their infants. Defective lactation associated with low prolactin levels (prolactipenia) can be treated by the manipulation of endogenous PRL secretion through the administration of metoclopramide or drugs which enhance PRL release.