title: Metoclopramide to augment lactation, does it work? A randomized trial.
abstract: OBJECTIVE
  The objective of this study was to investigate the efficacy of metoclopramide on augmentation of milk production in mothers of premature newborns.
  
  
  METHODS
  This was a randomized, double-blind, placebo-controlled trial. Women who delivered at ≤34 weeks of gestation, with no prior breastfeeding experience, singleton pregnancy, and no contraindications to using metoclopramide were eligible for entry. Twenty-five women were randomly assigned to receive 10 mg of metoclopramide or placebo three times daily for 8 days starting within 36 h of birth. Certified lactation nurses provided breastfeeding education. Breast milk expressed at each pumping session over the 8 days of treatment was recorded.
  
  
  RESULTS
  Data from 18 patients were available for analysis. Milk production in both groups increased rapidly during the first 4 days and then more gradually to an average for the last 4 days of 633 ± 168 (9) ml/day [mean ± SEM (n)] for the placebo group and 459 ± 91 (10) ml/day for the metoclopramide group. Analysis with a repeated-measures ANOVA indicated a significant increase in milk production during the 8-day measurement period [within subjects p < 0.001]; however, there was no significant difference in milk production between the two groups [between subjects p = 0.427]. Side effects were similar between groups.
  
  
  CONCLUSIONS
  In mothers with preterm babies, metoclopramide treatment does not augment (sample size had 80% power for detection of 50% difference) the breast milk production. Maternal interest, education, and support are recognized as mainstay in accomplishing successful lactation.
authors.affiliation: Department of Obstetrics and Gynecology, Aultman Health Foundation, Canton, Ohio, USA.
authors.forename: Shannon
authors.initials: S
authors.lastname: Fife
authors.forename: Prabhcharan
authors.initials: P
authors.lastname: Gill
authors.forename: Michael
authors.initials: M
authors.lastname: Hopkins
authors.forename: Carol
authors.initials: C
authors.lastname: Angello
authors.forename: Sue
authors.initials: S
authors.lastname: Boswell
authors.forename: Karl M
authors.initials: KM
authors.lastname: Nelson
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007774:Lactation / Q000187:drug effects*; D008787:Metoclopramide / Q000008:administration & dosage* / Q000009:adverse effects; D010919:Placebos; D011247:Pregnancy; D047928:Premature Birth / Q000503:physiopathology*
chemical_list: D010919:Placebos; D008787:Metoclopramide