On induced lactation

Claire, Michelle, Rebecca, Pam, Josey, Meg, Sloper (OMG, how did I miss out on your second pregnancy?!?!), thank you so much for your inputs.

I started reading up on induced lactation. Reglan is a no-no because it can cross the blood-brain barrier, and has one potential really scary side effect, tardive dyskinesia. My brother actually had that as a child.

Domperidone appears to be safer. Still, it can have cardiac effects---it can prolong something called the QT interval, and hence cause arrhythmia, which could potentially cause your heart to stop(!!). Here is a blogpost on the subject on the Skeptical OB blog, though I would say, this post does not seem to be wholly objective. The truth most likely is that this drug is safe in the majority of women, and would be dangerous for a smaller subset. Obviously it is more dangerous if you are mixing it with other medications that also prolong the QT interval, or you have underlying conditions that you are unaware of. The evidence for both intravenous and oral Domperidone causing arrhythmia comes from studies they did in people over 70 years of age.

But what genuinely scares me about this drug is the fact that the baby may get a tiny bit of it through breast milk, and if the baby has any underlying cardiac issues (one unverified source mentioned that 1 in 100 babies born have some sort of cardiac issue), this could be a bad combination. It is probably safe for 99 out of the 100 babies, but what if you are the 100th one?

So...if you are taking it, exercise caution with respect to dosage, be aware of your other medications, and I would suggest talking to your doctor too. I was also a little freaked out by Claire mentioning that her liver enzymes were elevated. So all in all, I'm going to give induced lactation a pass.

Human milk banking exists in Mumbai. However, the milk is pasteurized, which destroys most of the good stuff. I AM going to try to use the milk bank to find a wet nurse though, and if all else fails, supplement the goat milk formula with banked milk.

But all this is a ways away. I want to start doing stuff, but there is no way I will before I get to the "safe zone" of beyond 28 weeks, which I feel I am crawling towards one slow inch at a time. I'm sad to say that I'm not somebody who stops to smell the roses and celebrates what I have today, instead of thinking about tomorrow. I can't celebrate that the J has completed 22 weeks of pregnancy today...all I can think of is how much more time has to pass before we are in the relatively safer zone of 28 weeks and beyond.

But this is folly, because once you decide to have a child, there is no safe zone anymore. After birth, you worry about SIDS and diphtheria and the flu. You worry about Autism. Then one day you worry about your child being bullied at school. You worry about predators----it never ends.  Somebody described parenthood as having your heart walking outside of you, unprotected and vulnerable, for the rest of your life. And here we all are, eagerly signing up for all this.

Merry Christmas everybody. I'm so very happy for everybody who has gotten what they wanted for so long this year. For the ones who are still waiting or have had their hearts badly damaged, all I can say is that I am thinking about you. There are no words to make it better.