Anyone got a Hales?

There is a discussion on one of the medical fora about use of
Domperidone as a galactogogue. One problem is that the source most
people have for information on safety of drugs in breastfeeding is the
British National Formulary, which gives only very scanty information
which is often largely based on CYA statements from manufacturers.

Is there anyone with a Hales to hand who would be willing to post the
information about Domperidone from there, so that I could copy and paste
it on the forum? It would be useful to have an authoritative source.


All the best,

Sarah
--
http://www.goodenoughmummy.typepad.com

"That which can be destroyed by the truth, should be" - P. C. Hodgell

I don't and recently there doesn't seem to be anyone on here who does.
You do know about his website? http://neonatal.ttuhsc.edu/lact/ as a
health care professional, you'd be able to get an account and ask
questions, but obviously, it's polite to reference the book first before
doing so. However over the course of time there can be quite a lot of
content on any given drug, sometimes including the text from the book,
so it's always worth searching, though the way to do this is a little
bit broken, you kind of go round in a loop and hit the search button
more than once, but eventually you get there. There is a fair bit of
information on domperidone on the site - it seems there are some
reported problems with high continuing doses, but when used for milk
supply, the recommendation is usually to start with a high dose then to
drop down to a point where supply is maintained. Dr Hale himself
considers it safer than Reglan by far.

I find with drugs, it's also worth checking out kellymom.com, so again,
without the complete information from Hales, it's also clearly stated as
L1, according to the 2004 edition of MMM. It's also approved by AAP.
I'd be interested to hear what the BNF says, I can no longer access it
online, they brought in a new login system and only allow access from
certain countries, excluding the US.

I know in Cambridge, the Sure Start breasfeeding people had access to a
copy and so did the city breastfeeding team (it could have been the same
copy!), but as far as I know the health visitors didn't, might be worth
befriending the relevant people so if you need to you could get
access, better still convince your practice to buy a copy!

For reference, I'd expect that any of the breastfeeding helplines would
eventually get you to correct information, though it could be long
winded, if the person you get through to isn't someone who has it, but
most helpfully, breastfeeding network has a drugs line, manned (or
womaned!) by a lovely pharmacist, Wendy iirc, and she is very
knowledgeable and up to date, she was able to give me advice regarding
cymbalta/duloxetine, which is not even in the book.

Cheers
Anne

PS I'm starting to wonder if pharmacy might actually be a good career
for me, shame I didn't realise 10 years ago!

"Anne Rogers" wrote in message
PS I'm starting to wonder if pharmacy might actually be a good career for
me, shame I didn't realise 10 years ago!

You can still study to be a pharmacist. )
--
Sue

Sue wrote:
"Anne Rogers" wrote in message
PS I'm starting to wonder if pharmacy might actually be a good career for
me, shame I didn't realise 10 years ago!

You can still study to be a pharmacist. )

I've not even looked into it yet, it's only just dawned on me that it's
an area I have a strong interest in. I went through university in the UK
the last year there were no fees to pay, if I'd done it then, I'd have
not had to pay a penny and would have come out of with all the necessary
academic qualifications. In the UK you tend to narrow studies much
earlier than in the US and it's normal to start a degree leading to a
specific career at 18, a lot of things that you study after a first
degree in the US are a first degree in the the UK, even now there are
fees in the UK, it's still going to cost less than in the US, though it
does mean there is a pressure to make choices at a young age, I ended up
studying the subject I was best at and enjoyed most, without really
thinking about what I would do afterwards.

Cheers
Anne

Anne Rogers skrev:
Sue wrote:
"Anne Rogers" wrote in message
PS I'm starting to wonder if pharmacy might actually be a good career
for me, shame I didn't realise 10 years ago!

You can still study to be a pharmacist. )

I've not even looked into it yet, it's only just dawned on me that it's
an area I have a strong interest in. I went through university in the UK
the last year there were no fees to pay, if I'd done it then, I'd have
not had to pay a penny and would have come out of with all the necessary
academic qualifications. In the UK you tend to narrow studies much
earlier than in the US and it's normal to start a degree leading to a
specific career at 18, a lot of things that you study after a first
degree in the US are a first degree in the the UK, even now there are
fees in the UK, it's still going to cost less than in the US, though it
does mean there is a pressure to make choices at a young age, I ended up
studying the subject I was best at and enjoyed most, without really
thinking about what I would do afterwards.

Cheers
Anne

Move to Denmark - universities are free and you get subsidies to live
for (though not enough).

Books you have to pay yourself.

Did I mention that we pay 63% tax of the last penny we earn?

Tine, Denmark

Move to Denmark - universities are free and you get subsidies to live
for (though not enough).

Books you have to pay yourself.

Did I mention that we pay 63% tax of the last penny we earn?

Well exactly, it's swings and roundabouts, tax in the UK is not exactly
low though, I've been looking up a bit more about it in the US, looks
like from the point I'm at it's 4 years study, which is kind of ironic,
as is the UK it would have been 3 years, with 4 years of the study I've
already done unnecessary. The problem for me with studying in the US is
that I'm not eligible for any benefits or subsidies, my visa allows me
to study, but some schools simply don't accept students on this type of
visa, nor any of the ones I could switch to, also, my visa doesn't allow
me to work, so I'd have no way of raising any money to pay for it. All
in all, it's something that's really not very likely to happen for many
years to come, same with studying for any other career choice, which is
a shame, if we end up staying in the US longer term, I should be able to
work in about 5 years time, it makes sense to do any study in the gap,
but I won't be able to. By which time I'll be 32/33, though even with 4
years study, I'd still have 25-30 years of potential work, so that
shouldn't really be a barrier, but it will be a longer time since I have
studied and lots of places don't accept qualifications over 10 years old
as prerequisets and so on...

anne

"Anne Rogers" wrote in message
In the UK you tend to narrow studies much
earlier than in the US and it's normal to start a degree leading to a
specific career at 18, a lot of things that you study after a first degree
in the US are a first degree in the the UK, even now there are fees in the
UK, it's still going to cost less than in the US, though it does mean
there is a pressure to make choices at a young age, I ended up studying
the subject I was best at and enjoyed most, without really thinking about
what I would do afterwards.

I am not sure what you mean by starting a degree earlier in the UK. Kids
graduate high school at 18 and then they are off to college to study what
interests them, so I am not understanding the difference there. So, what I
understand from you is that you don't want to go back to school because you
will have to pay for it? Well, nothing is free and if it was something you
are really interested in, you would find a way to do it. I have decided at
age 42, to go back to school in the fall. It's definitely not free, but it
will be worth it to me when I am done.

Sue

Sue wrote:
"Anne Rogers" wrote in message
In the UK you tend to narrow studies much
earlier than in the US and it's normal to start a degree leading to a
specific career at 18, a lot of things that you study after a first
degree in the US are a first degree in the the UK, even now there
are fees in the UK, it's still going to cost less than in the US,
though it does mean there is a pressure to make choices at a young
age, I ended up studying the subject I was best at and enjoyed most,
without really thinking about what I would do afterwards.

I am not sure what you mean by starting a degree earlier in the UK.
Kids graduate high school at 18 and then they are off to college to
study what interests them, so I am not understanding the difference
there. So, what I understand from you is that you don't want to go
back to school because you will have to pay for it? Well, nothing is
free and if it was something you are really interested in, you would
find a way to do it. I have decided at age 42, to go back to school
in the fall. It's definitely not free, but it will be worth it to me
when I am done.

The difference is that in the UK if you want to be a vet, say, you go to
university at 18 and study medicine and 3 years later you're a doctor. The
way it seems to work in the US is that you do a bachelor's degree and then
you do another degree to become a vet. So what is a first degree in the UK
is a second degree in the US. The same is true of pharmacy - it's a 3 year
first degree course in the UK, but may not be in the US.

I am not sure what you mean by starting a degree earlier in the UK. Kids
graduate high school at 18 and then they are off to college to study what
interests them, so I am not understanding the difference there.

it's what the degree qualifies you for that's the difference in the UK,
you can do a degree in 3 years that will train you for many different
health care jobs, such as pharmacist, physical therapist, optometrist
and so on. The training for those in the US tends to be after you've
spent 4 years doing a degree in science subjects rather than being your
first degree.



So, what I
understand from you is that you don't want to go back to school because you
will have to pay for it? Well, nothing is free and if it was something you
are really interested in, you would find a way to do it. I have decided at
age 42, to go back to school in the fall. It's definitely not free, but it
will be worth it to me when I am done.

you read me completely wrong, I was saying it was a shame I hadn't done
it earlier on, as it would have saved money, not that I wouldn't do it
later because it costs money, the tricky thing is for me, that has my
visa doesn't allow me to work, I can neither work now to save money for
education later, nor work part time to help pay for my education, so
it's not necessarily a case of making sacrifices, it may be a complete
impossibility.

Cheers
Anne

The difference is that in the UK if you want to be a vet, say, you go to
university at 18 and study medicine and 3 years later you're a doctor. The
way it seems to work in the US is that you do a bachelor's degree and then
you do another degree to become a vet.

Well actually becoming a vet is rather like becoming a doctor for
humans, it's 3 years to get the first degree, then 3 years clinical
school, but unlike medicine, when you apply to a vet course you are
accepted for the full 6 years and don't have to apply in the middle for
a clinical placement. I think Dentistry takes longer too. Just offhand I
can't think of any career in the UK that requires a degree, but you'd
train post degree at an educational institution, maybe Law, I'm not sure
you have to have a law degree to get your LLM. Some things you train for
on the job after a non specific degree, such as accountancy. Fairly
much, if you compare the same job in the UK to the US, it will take less
years of education to get the qualification in the UK, I think in part
due to the tendenancy in the UK to specialise area, so the number of
hours on the subject will be similar, but in a more compressed time due
to the lack of hours spent on other subject areas.

Cheers
Anne