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Metoclopramide Increases Prolactin Release and Milk Secretion in Puerperium without Stimulating the Secretion of Thyrotropin and Thyroid Hormones^*

Department of Obstetrics and Gynecology and Clinical Chemistry, University of Oulu SF-90220 Oulu 22, Finland

Address all correspondence and requests for reprints to: Antti Kaup-pila, Department of Obstetrics and Gynecology, University of Oulu, SF-90220 Oulu 22, Finland.

To explore the effect of metoclopramide (MC) on the secretion of PRL, TSH, and thyroid hormones (T₃ and T₄)and on defective lactation, 17 mothers with poor lactation were treated with oral MC (10 mg, three times daily) for 3 weeks starting 18–141 days post partum. After a pause of 1 week, the medication was givenfor a further 2 weeks. The breast milk yield was monitored objectively before and duringthe trial. Furthermore, iv stimulation tests with MC (10 mg) and TRH (200 µ) were done before and at the end of oral MC therapies.

Oral MC increased the mean (±SEM) plasma PRL level from 36.6 ± 9.2 to 90.6 ± 7.5 ng/ml(P < 0.001) after 1 week, and the PRL level remained elevatedfor as long as MC was administered. During the pause, the PRL level decreased to 19.5 ± 7.5 ng/ml, but increased once again during the second MC treatment t o 85.5 ± 16.0 ng/ml (P < 0.01). Plasma TSH, ₎₃ and T₄ did notchange.

The PRL level rose significantly after TRH and MC injections before and during oral treatments with MC, whereas the TSH concentrations were elevated only after TRH stimulation. The PRL response to iv MC or TRH and the TSH response to iv TRH were not affected by oral MC treatment.

The mean daily milk volume increased from 433 ± 55 to 626 ± 76 ml (P < 0.001) during the first treatment and from 390 ± 73 to 606 ± 56 ml (P< 0.01) during the second oral MC treatment. Correspondingly, the volume of daily supplemental alimentation decreased from 348 ± 61 to 280 ± 59 ml (P < 0.05)and from 526 ± 68 to 363 ± 66 ml (P < 0.01), respectively. MC caused no significant side effects.

^* This work was supported by Grant from Paulo Foundation.

Received May 19, 1980.

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