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Posted 2010-02-08 20:53:57
My wife and I have been trying for almost a decade to have a child. She was diagnosed with "unexplained infertility". We have finally succeeded in achieving a pregnancy using her egg, my sperm, IVF and her sister in law as a gestational surrogate.
We are investigating the possibilities for allowing my wife to breast feed the baby instead of the surrogate. The general literature on the internet seems to assume that this is only desirable by adoptive parents, and there seems to be some kind of prejudice against this as being unnatural. In this case however, my wife is the genetic mother of the child. It is only due to her inability to conceive naturally that she will not be lactating.
It seems the most effective way to induce lactation is a combination of a stimulating breast pump and the dopamine inhibitor drug domperidone.
Does anyone know if this drug is available in Bangkok? If so, do we need a prescription to obtain it, or can we buy it in a pharmacy? If we need a prescription, can anyone recommend a doctor who would be knowledgeable to counsel us in this matter?
For that matter, does anyone know who sells an electric breast pump with a nipple stimulator in Thailand?
Posted 2010-02-08 23:04:43
Thanks katana. I've actually seen that announcement. There obviously is some controversy surrounding it, but I have also spoken personally to people who swear by it. These are people who are using it in Canada and it was recommended by their doctors.
This is one rather high profile disagreement:
They make a valid case here. Why not come out against metoclopramide instead of or in addition to domperidone? It is clearly much more dangerous. There does seem to be some political element involved in the announcement. I guess one reason why I wouldn't mind speaking to a physician here in Thailand. Obviously I don't want to do anything dangerous, but I would like to have all the facts.
Sometimes the US FDA can be overly cautious and keep very useful medications off the market when they are quite acceptable elsewhere in the world. I wouldn't discount the idea of using it simply because of this one warning. Multiple warnings accompanied with real studies specifically with regard to breast feeding would be a different story of course, and negative viewpoints are just as important as positive one.
Here is some more information on its use in breastfeeding.
Posted 2010-02-09 10:29:38
It is readily available over the counter in Thailand both as brand name Motilium (an import) and as locally made generic equivalent, the latter having under a a multiitude of brand names.
Must say I never knew it could be used to promote lactation. Live and learn!
However as I read it, it serves to increase lactation in women who are already lactating. Has it really been found to induce lactation in women who haven't given birth?
Also I wonder if there has been on research on use of progesterone, as I'm sure you know this hormone has high levels in pregnancy then drops off just before delivery and that drop is thought to be a factor in starting lactation. A micronized form of natural progesterone is available OTC in Thailand under the brand name utrogestan. ???
Posted 2010-02-09 11:28:09
Hi domperidone is widely available as Motilium-M is all pharmacies. A strip of 10 costs 36-40Baht depending upon the pharmacy. It is indeed prescribed by leading hospitals here as an aid to lactation. It is also used by women who have not given birth physically but are desirous of producing breast milk. But it is not some kind of wonder drug that upon eating it, the breast milk starts flowing!! Emotions and hormones also play a large role and domperidone is an aid.
Regarding the other question, breast pumps are widely available in most department stores. Try the childrens section in any Central Dept Store. Various models and makes costing from 4000Bhat for a single breast hand-held mechanically operated pump upto 40,000 Baht for a heavy duty electric operated twin pump. Alternately, they can be rented at a much cheaper price (you rent the machine and buy the disposable parts so there is no hygeine issue).