Still using the Newman-Goldfarb Protocols®?

I did and they worked great for me...twenty years ago. But why mess with a good thing even if it was developed a long time ago?¹

Because the Newman-Goldfarb Protocols for Induced Lactation^® aren't a good fit for everyone. And because we have learned a lot since then:

• Safety risks of domperidone. Although domperidone is safe for almost all lactating (and prospective lactating) parents and their babies, domperidone is not a safe medication for everyone.^2,3,4 And for the great majority for whom it is generally safe, domperidone can still lead to moderate to severe side effects if not properly dosed and discontinued.^5,6,7 Approaching inducing lactation without professional guidance on domperidone use is risky business. 
• Fenugreek and blessed thistle aren’t necessarily be best herbal options for inducing lactation. In fact, there may be reasons to avoid fenugreek and other herbs are probably more effective for inducing lactation anyway. Choosing the right herbs is not the only key to successfully using herbs for lactation. Herbs are not regulated by the US FDA and quality may vary. Also, effective use requires a safe and therapeutic dose.⁸ Your herb-savy IBCLC can help! 
• Proven methods for accelerating inducing lactation when time is short. I have been unable to validate or find any evidence supporting the effectiveness of The Newman-Goldfarb Accelerated Protocol, but I have developed my own accelerated approach that I have used successfully with countless clients starting to induce lactation shortly before baby's arrival or even once baby arrived.
• The potential for growing milk production continues after baby arrives. Inducing lactation doesn't end at baby's arrival. In fact, when breastfeeding and supplementation are effectively managed parents often find they have the potential to double the amount of milk produced before baby's arrival. The daily management of breastfeeding and supplementation are at least as important as medications, pumping, or other methods used to induce lactation. They are an important part of any inducing lactation plan.
• Parents may choose to co-lactate. Back when the N-G protocols were developed, queer parents sharing lactation was pretty much unheard of. Now we have some pioneer parents who have showed us how this can work so beautifully and how to handle any stumbling blocks.^9,10,11,12
• Trans and intersex women may induce lactation. Just like co-lactation, inducing lactation by trans and intersex women is new on the scene. Because their baseline hormone production is different than for a cis woman, a protocol for inducing lactation for a trans or intersex woman should be customized to their needs.^{13,14,15,16,17,18,19,20,21,22,23}

These are just a few examples. We continue to learn more about lactation all of the time. Sometimes new tools and and approaches to general lactation can be applied to induced lactation. And other times we learn new things specifically applicable for induced lactation. Either way, you and your baby deserve the best and most supported experience possible!

If you have any questions or need guidance on inducing lactation, feel free to schedule a free mini consultation with me HERE. Or if you are ready to jump right in, check out my consultation packages HERE. I work with parents in person or via telehealth from wherever you are.

References

¹Newman, J. & Goldfarb, L. (2002-2016). Breastfeeding: Induced lactation and the Newman-Goldfarb protocols for induced lactation®. Ask Lenore. https://www.asklenore.info/breastfeeding/induced_lactation/gn_protocols.shtml

²Haase, B., Taylor, S. N., Mauldin, J., Johnson, T. S., & Wagner, C. L. (2016). Domperidone for treatment of low milk supply in breast pump–dependent mothers of hospitalized premature infants: a clinical protocol. Journal of Human Lactation, 32(2), 373-381. https://journals.sagepub.com/doi/abs/10.1177/0890334416630539

³Flanders, D. (2012). The (not so) great Canadian domperidone debacle. Retrieved from Kindercare Pediatrics: http://kindercarepediatrics.ca/2012/03/the-not-so-great-canadian-Domperidone-debacle-%E2%80%93-next-steps/

⁴Asztalos, E. V., Campbell-Yeo, M., da Silva, O. P., Ito, S., Kiss, A., Knoppert, D., & EMPOWER Study Collaborative Group. (2017). Enhancing human milk production with domperidone in mothers of preterm infants: results from the EMPOWER trial. Journal of Human Lactation, 33(1), 181-187. https://doi.org/10.1177/0890334416680176

⁵Newman, J. & Polokova, A (2022). What doctors don't know about breastfeeding.  Amarillo, TX: Praeclarus Press.

⁶Hale, T. W. (2024). Medications and Mother’s Milk: Domperidone. Springer Publishing Company: New York.

⁷Majdinasab, E., Haque, S., Stark, A., Krutsch, K., & Hale, T. W. (2022). Psychiatric manifestations of withdrawal following domperidone used as a galactagogue. Breastfeeding Medicine, 17(12), 1018-1024

⁸Schnell, A., and Cole, M. (2024). Exploring Pharmaceutical and Herbal Approaches to Inducing Lactation [PowerPoint slides]. virtual presentation by Luna Lactation. 

⁹Schnell, A. (2022). Successful co-lactation by a queer couple: A case study. Journal of Human Lactation, 38(4), 644-650. https://doi.org/10.1177/08903344221108733 

¹⁰Juntereal, N. A., & Spatz, D. L. (2020). Breastfeeding experiences of same‐sex mothers. Birth, 47(1), 21-28.

¹¹McGuire, E. (2019). Induced lactation and mothers sharing breastfeeding: A case report. Breastfeeding Review, 27(2), 37-41

¹²Wilson, E., Perrin, M. T., Fogleman, A., & Chetwynd, E. (2015). The intricacies of induced lactation for same-sex mothers of an adopted child. Journal of Human Lactation, 31(1), 64-67.

¹³Elkin, B., Duran, A., Rauwerdink, K., & Goldsmith, E. S. (2024). Inducing Lactation in a Transgender Woman Without Galactagogues: A Case Report. Journal of General Internal Medicine, 1-4.

¹⁴Ikebukuro, S., Tanaka, M., Kaneko, M., Date, M., Tanaka, S., Wakabayashi, H., ... & Mizuno, K. (2024). Induced lactation in a transgender woman: case report. International Breastfeeding Journal, 19(1), 66.

¹⁵van Amesfoort, J. E., Van Mello, N. M., & van Genugten, R. (2024). Lactation induction in a transgender woman: case report and recommendations for clinical practice. International Breastfeeding Journal, 19(1), 18.

¹⁶Delgado, D., Stellwagen, L., McCune, S., Sejane, K., & Bode, L. (2023). Experience of induced lactation in a transgender woman: Analysis of human milk and a suggested protocol. Breastfeeding Medicine, 18(11), 888-893.

¹⁷Weimer, A. K. (2023). Lactation induction in a transgender woman: macronutrient analysis and patient perspectives. Journal of Human Lactation, 39(3), 488-494.

¹⁸Wamboldt, R., Shuster, S., & Sidhu, B. S. (2021). Lactation induction in a transgender woman wanting to breastfeed: case report. The Journal of Clinical Endocrinology & Metabolism, 106(5), e2047-e2052.

¹⁹Trautner, E., McCool-Myers, M., & Joyner, A. B. (2020). Knowledge and practice of induction of lactation in trans women among professionals working in trans health. International breastfeeding journal, 15, 1-5.

²⁰Moravek, M. B., & Pasque, K. B. (2019, March). Lactation Can Be Successfully Induced in Transgender Women While Maintaining Gender-Congruent Serum Hormone Levels. In REPRODUCTIVE SCIENCES (Vol. 26, pp. 136A-136A). 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA: SAGE PUBLICATIONS INC.

²¹Reisman, T., & Goldstein, Z. (2018). Case report: Induced lactation in a transgender woman. Transgender health, 3(1), 24-26.

²²Voon, K., & Stuckey, B. G. (2023). Induction of lactation in a patient with complete androgen insensitivity syndrome. Endocrinology, Diabetes & Metabolism Case Reports, 2023(4).

²³LeCain, M., Fraterrigo, G., & Drake, W. M. (2020). Induced lactation in a mother through surrogacy with complete androgen insensitivity syndrome (CAIS). Journal of Human Lactation, 36(4), 791-794.