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Canadian Breastfeeding Foundation

The Protocols for Inducing Lactation and Maximizing Milk Production:

The Menopause Protocol

If the mother is menopausal due to surgical removal of her reproductive organs or naturally occurring menopause, she can still breastfeed and bring in her milk supply. A woman does not need a uterus or ovaries in order to breastfeed. All she needs are breasts and a functioning pituitary.

The first step is to stop the mother’s hormone replacement therapy and replace it with Yasmin or Microgestin (once per day). The Yasmin or Microgestin contains enough estrogen and progesterone to keep the mother’s menopausal symptoms at bay while at the same time developing the milk making apparatus of her breasts. The mother also needs to take domperidone (10 mg 4 times a day for the first week and then increase to 20 mg 4 times a day). It is a good idea for the mother to stay on the combination of Yasmin or Microgestin and domperidone until she experiences significant breast changes. At least 60 days on the combination of Yasmin or Microgestin and domperidone are recommended for menopausal women. Significant breast changes include an increase in breast size (at least 1 cup) and breasts that feel full, heavy and painful.

Once the mother has completed at least 60 days on the combination of Yasmin or Microgestin and domperidone and has experienced significant breast changes she can stop the Yasmin or Microgestin, maintain the domperidone and begin pumping with a double electric breast pump. A hand pump is just not up to the job.

It is recommended that the mother pump every 3 hours and once during the night. (See “pumping instructions”.)

Once the mother has started pumping she can add the herbs Blessed Thistle herb (390 mg per capsule) and Fenugreek seed (610 mg per capsule). The recommended herb dosage is 3 capsules of each, 3 times a day with meals. The domperidone should be taken 1/2 hour before meals for best absorption. Many mothers on the protocols have noticed a significant increase in their milk supplies when they began to add oatmeal to their diets regularly.

Fluids are very important. The human body naturally consumes and excretes the equivalent of 8 - 10 glasses of water per day. It is recommended that mothers drink at least 6 - 8 glasses of water a day if possible. Usually if mothers drink water when they are thirsty during the day, adequate fluid intake is achieved. Beverages containing caffeine should be avoided as they cause rapid excretion of fluids.

The arrival of the milk supply while pumping follows a particular pattern. It begins with clear drops, which become more opaque and whiter in color. Drops will appear, followed by milk spray, and then a steady stream of breastmilk. It may take a few days, a week, or two, or more for the mother’s milk supply to come in. Everyone responds differently.

If the mother experiences menopause symptoms, please do not resume the mother’s hormone replacement therapy but rather suggest that she eat soya products to control her symptoms. Soya milk and/or soya butter are good choices because they contain phytoestrogens but the mother should eat only enough to stop “hot flashes” because too much will decrease her milk supply.