Lactation specialist warns against use of Reglan
March 31st, 2010 by Jennifer Walker-Journey
Melissa Kotlen Nagin is not a fan of the prescription drug Reglan, especially to stimulate milk production in breast feeding mothers. Nagan, a mother of three, is an International Board Certified Lactation Consultant and Registered Lactation Consultant who maintains an active private practice, teaches prenatal breastfeeding classes in New York City, and lectures on lactation topics at The Mount Sinai Hospital in New York City. She has assisted hundreds of women on breastfeeding issues in the past eight years. Lately, she has fielded numerous questions from her clients about how to increase milk supply. She says, “For the majority, aside from increasing stimulation, we talk about going the herbal route; for a smattering, we chat about Domperidone. For NONE do I discuss Reglan.”
Reglan, or metoclopramide, is a medication approved by the Food and Drug Administration (FDA) for the treatment of heartburn and GERD. It is also prescribed, off label, to help stimulate lactation, “but it is definitely not as benign as Domperidone, which carries with it virtually NO side effects,” she says.
For one, Reglan can cause depression in mothers who are already more susceptible to depression because of hormone changes following childbirth. But Reglan also carries an FDA black box warning. Long-term use of Reglan greatly increases a woman’s risk of a serious involuntary movement disorder known as Tardive Dyskinesia. The condition can be debilitating and often does not go away, and often worsens, after the medication is discontinued.
Nagin’s advice? “If you are having milk supply issues, be sure to see a lactation consultant ASAP! The longer you wait, the more intense the process to get your supply back to where it should be.”