Reglan And Breastfeeding

by Steve Fields on August 17th, 2009

In 1980, the FDA approved the use of Reglan as a short-term treatment solution for a number of ailments, including heartburn, acid reflux, and nausea. Since that time, the use of Reglan (also known by its generic label metoclopramide) has expanded to include nursing mothers who cannot produce a sufficient milk supply. There is a higher potential for long-term neurological side effects than most breastfeeding women realize. Making matters worse, traces of the drug may be passed along to their unsuspecting children through breast milk.Below, we’ll take a closer look at the use of Reglan in the context of breastfeeding. I’ll describe how the drug stimulates breast milk production and explain the inherent dangers unknown to many patients.

Why Nursing Mothers Use Reglan

There are several reasons why doctors might recommend Reglan as a stimulant for increased breast milk production. For example, a mother may be ill and as a result, unable to produce a sufficient supply for nursing. Or, she may need to increase her breast milk production in order to nurse a premature or adopted infant.

Reglan is often recommended because it increases the production of a peptide hormone called prolactin. This hormone is produced in the brain and stimulates milk production within the mammary glands. Women who are experiencing difficulty producing an adequate amount of breast milk can take Reglan to complement breast pumping.

The problem is that while the drug can potentially improve milk production for nursing mothers, there is risk involved. Prolonged use of Reglan can lead to the development of debilitating long-term neurological side effects.

The Dangers Of Using Reglan While Breastfeeding

In early 2009, the FDA issued a black box warning on all drugs containing metoclopramide, which is sold under the brand name Reglan. The warning specifically mentioned prolonged use of the drug for treating gastrointestinal disorders. However, as noted, metoclopramide is often recommended by doctors to help breastfeeding mothers increase their milk supply. It is reasonable to assume that nursing mothers may be susceptible to the same side effects as those who use Reglan for gastrointestinal ailments.

One of the neurological side effects of Reglan which has attracted attention is tardive dyskinesia. This is a severe disorder that manifests as uncontrollable repetitive movements in the facial area and extremities. An increasing pool of data has shown that tardive dyskinesia often develops in patients who use Reglan in extremely high doses or for periods exceeding three months.

Nursing mothers are typically advised to taper off use of the drug after the first week. Having said that, there are additional risks even with limited use. Breastfeeding women have reported other side effects, including bouts of depression, irregular heart rate, and neuroleptic malignant syndrome, a condition that can potentially become life-threatening.

Women who are considering using Reglan to increase their breast milk supply should go over all the risks and benefits with their doctor.