Reglan And Breastfeeding

Metoclopramide

(Brand names: Reglan, Maxeran, Metozolv ODT, Maxolon)

This drug is FDA approved to treat nausea and vomiting associated with conditions such as radiation poisoning, infection and migraine headaches. It used to be given to cancer patients experiencing nausea and vomiting from chemotherapy treatments but it has since been replaced by more effective medication.

How it works to increase breast milk in breastfeeding women: dopamine, a chemical in the brain, keeps prolactin (the milk-making hormone) levels in check by inhibiting the production of prolactin. Reglan inhibits dopamine. If dopamine is the bouncer keeping prolactin out of the party, Reglan is the tough guy who beats up the bouncer.

In studies where breastfeeding women do see a milk increase from Reglan they experienced an increase of 50 to 100 percent. (100 percent means a doubling of breast milk supply). But not all studies agree that Reglan provides any benefit. One study showed that breastfeeding women who received instruction on proper breastfeeding techniques and breastfeed every three hours had just as much breastfeeding success as women who received the same instructions and took Reglan.

Another study showed that breastfeeding women who continued to struggle with low milk supply after being taught proper nursing techniques who then took Reglan showed no increase in breast milk supply.

Additionally, if your prolactin levels are normal (a blood test from your doctor can determine this) taking Reglan will likely not provide any benefit. If your blood tests show low levels of prolactin, Reglan is an option but beware of the risks.

Risks of Reglan for Breastfeeding Women

  • Severe depression – Do not take Reglan if you are experiencing any symptoms of depression or have a personal or family history of depression. Please be extra careful because postpartum depression can sneak up on all of us. Reglan crosses the blood-brain barrier and can cause depression even in moms who feel fine. Symptoms of depression will go away once use is stopped. The longer Reglan is taken, the more likely the breastfeeding mother is to experience depression, so preferably it should not be taken for more than three weeks.
  • Present in breast milk – Reglan is present in breast milk but at a much lower concentration than what the mother experiences. Studies of the effect on breastfed infants mostly conclude that there are no side effects other than occasional gastrointestinal discomfort and slightly increased prolactin levels in the baby. However, The American Academy of Pediatrics considers Reglan use during breastfeeding to be of concern, citing the potential nervous system effects of the drug. And the manufacturer of the drug recommends caution to breastfeeding mothers.
  • Other possible side effects (for the mother) – nausea, stomach pain, diarrhea, anxiety, drowsiness, fatigue, twitching and seizures.
  • Only temporarily increases breast milk production - If Reglan does increase milk supply, the effect is only experienced while taking the drug. Milk supply returns to prior levels after use is discontinued.

Since it should not be taken for more than 3 weeks and the results do not last, the risks far outweigh the benefits in this author’s opinion. There are plenty of horror stories to be found online about this drug so I would consider it a last resort. Instead, consider trying all-natural herbal options to increase breast milk supply.

However, if you are interested in this form of treatment, see your doctor for a blood test to check your prolactin levels. If your results show low prolactin, discuss the possibility of taking Reglan and always follow your doctor’s advice. heart-logo

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