%PDF-1.3
%
8 0 obj
<>>>/BBox[0 0 612 792]/Length 147>>stream
x%A
0D9,jүhuhA].)VҤ$-7̼ŻI&jBٳ!UO9Ektf[Wkt\i[^`Z3w#bt6MjFyD2Xf/
%gxH0U
endstream
endobj
5 0 obj
<>>>/BBox[0 0 612 792]/Length 147>>stream
x%A
0D9,jүhuhA].)VҤ$-7̼ŻI&jBٳ!UO9Ektf[Wkt\i[^`Z3w#bt6MjFyD2Xf/
%gxH0U
endstream
endobj
7 0 obj
<>>>/BBox[0 0 612 792]/Length 147>>stream
x%A
0D9,jүhuhA].)VҤ$-7̼ŻI&jBٳ!UO9Ektf[Wkt\i[^`Z3w#bt6MjFyD2Xf/
%gxH0U
endstream
endobj
4 0 obj
<>>>/BBox[0 0 612 792]/Length 147>>stream
x%A
0D9,jүhuhA].)VҤ$-7̼ŻI&jBٳ!UO9Ektf[Wkt\i[^`Z3w#bt6MjFyD2Xf/
%gxH0U
endstream
endobj
6 0 obj
<>>>/BBox[0 0 612 792]/Length 147>>stream
x%A
0D9,jүhuhA].)VҤ$-7̼ŻI&jBٳ!UO9Ektf[Wkt\i[^`Z3w#bt6MjFyD2Xf/
%gxH0U
endstream
endobj
9 0 obj
<>>>/BBox[0 0 612 792]/Length 147>>stream
x%A
0D9,jүhuhA].)VҤ$-7̼ŻI&jBٳ!UO9Ektf[Wkt\i[^`Z3w#bt6MjFyD2Xf/
%gxH0U
endstream
endobj
3 0 obj
<>>>/BBox[0 0 612 792]/Length 147>>stream
x%A
0D9,jүhuhA].)VҤ$-7̼ŻI&jBٳ!UO9Ektf[Wkt\i[^`Z3w#bt6MjFyD2Xf/
%gxH0U
endstream
endobj
1 0 obj
<>>>/BBox[0 0 612 792]/Length 147>>stream
x%A
0D9,jүhuhA].)VҤ$-7̼ŻI&jBٳ!UO9Ektf[Wkt\i[^`Z3w#bt6MjFyD2Xf/
%gxH0U
endstream
endobj
11 0 obj
<>stream
Arbortext Advanced Print Publisher 9.0.114/W
2018-09-11T11:26:19-07:00
2018-06-12T07:15:32+05:30
application/pdf
BFM-2018-29092-wjb-ver9-Breastfeeding_2P 307..314
Acrobat Distiller 8.1.0 (Windows); modified using iText 4.2.0 by 1T3XT
uuid:8a63fdba-a944-4424-85ca-9e5637b148e6
uuid:a9d5cb55-e1d9-4d75-9f39-dc8bfb1b4706
endstream
endobj
12 0 obj
<>stream
x+ |
endstream
endobj
13 0 obj
<>stream
xS**T0T0 Bi ye(
endstream
endobj
14 0 obj
<>stream
x+ |
endstream
endobj
15 0 obj
<>stream
xS**T0T0 Bi yA$
endstream
endobj
16 0 obj
<>stream
x+ |
endstream
endobj
17 0 obj
<>stream
xS**T0T0 Bi yw*
endstream
endobj
18 0 obj
<>stream
x+ |
endstream
endobj
19 0 obj
<>stream
xS**T0T0 Bi yS&
endstream
endobj
20 0 obj
<>stream
x+ |
endstream
endobj
21 0 obj
<>stream
xS**T0T0 Bi yn)
endstream
endobj
22 0 obj
<>stream
x+ |
endstream
endobj
23 0 obj
<>stream
xS**T0T0 Bi y8#
endstream
endobj
24 0 obj
<>stream
x+ |
endstream
endobj
25 0 obj
<>stream
xS**T0T0 Bi y\'
endstream
endobj
26 0 obj
<>stream
x+ |
endstream
endobj
27 0 obj
<>stream
xS**T0T0 Bi yJ%
endstream
endobj
29 0 obj
<>stream
/GS1 gs
BT
/F5 1 Tf
8.9663 0 0 8.9663 62.022 725.7825 Tm
0 0 0 rg
0 Tc
0 Tw
[(Pharmaceutical)-336.7(Galactogogues)]TJ
/F8 1 Tf
9.843 0 0 9.843 72 709.3416 Tm
[(Human)-233.4(growth)-226.4(hormone)]TJ
7.3823 0 0 6.5614 168.4913 713.7069 Tm
(1113)Tj
9.843 0 0 9.843 186.9732 709.3416 Tm
[(\(lB,)-232.5(llA\))-230.1(\(quality)-235(of)-226.8(evidence)]TJ
-12.6944 -1.1116 TD
[([levels)-286.5(of)-284.4(evidence)-290.1(IA,)-282.9(IB,)-283.1(IIA,)-289.8(IIB,)-284.2(III,)-283.1(and)-286.7(IV])-286.3(is)-284.4(based)-284.1(on)]TJ
0 -1.1174 TD
[(levels)-262.4(of)-255.6(evidence)-261.3(used)-253(for)-256.7(the)-258(National)-260.1(Guidelines)-262.1(Clearing)]TJ
0 -1.1116 TD
(House)Tj
7.3823 0 0 6.5614 87.137 680.825 Tm
(14)Tj
9.843 0 0 9.843 97.4551 676.4597 Tm
[(and)-304(is)-295.9(noted)-300.5(in)-296.1(parentheses\),)-303.2(sulpride)]TJ
7.3823 0 0 6.5614 246.1606 680.825 Tm
[(15,1)-8.6(6)]TJ
9.843 0 0 9.843 262.8283 676.4597 Tm
[(\(llB\),)-298.1(and)]TJ
-20.4009 -1.1116 TD
[(thyrotropin-releasing)-528(hormone)]TJ
7.3823 0 0 6.5614 185.5558 669.8833 Tm
[(17,)-9.4(18)]TJ
9.843 0 0 9.843 202.2236 665.5179 Tm
[(\(lB\))-523.9(may)-518.3(be)-521.7(helpful)-521.7(as)]TJ
-14.2438 -1.1174 TD
[(galactogogues)-191.8(in)-180.9(some)-190.9(populations,)-183.9(but)-187.7(are)-184.1(not)-187.7(currently)-185.2(used)]TJ
0 -1.1116 TD
[(in)-290.3(most)-287.8(countries.)-292.2(Do)20(mp)19.6(er)19.7(id)20.7(on)15.1(e)-278.7(a)0(n)19.7(d)-277.6(me)18.4(to)20.7(cl)19.6(op)20.8(ra)19.7(mi)19.5(de)-268.3(ar)14(e)-278.7(t)0(h)20.7(e)]TJ
T*
[(mo)19.6(st)-330.4(co)19.7(mm)18.4(on)20.8(ly)-330.6(us)21(ed)-331.7(ph)20.8(ar)19.7(ma)18.4(ce)18.5(ut)20.7(ic)19.6(al)-331.8(ga)19.7(la)19.6(ct)19.6(og)15.1(og)20.8(ue)19.7(s)-340.7(a)0(t)-326(p)0(r)15.1(e)0(s)19.9(-)]TJ
T*
[(en)19.7(t.)-453.9(Bo)19.8(th)-451.6(ar)19.7(e)-457.3(d)0(o)15.1(p)0(a)19.7(m)0(i)19.5(n)0(e)-446.9(a)0(n)19.7(t)0(a)13.8(g)0(o)20.8(n)0(i)20.7(s)0(t)20.9(s)-461.7(th)20.7(at)-452.7(in)20.7(cr)19.7(ea)18.5(se)-452.4(pr)20.9(ol)15(ac)18.5(ti)20.6(n)]TJ
0 -1.1174 TD
[(se)19.9(cr)19.7(et)13.8(io)20.7(n.)-401.9(A)-416.7(n)0(u)15.1(m)15(be)13.9(r)-415.8(o)0(f)-405.3(o)0(l)20.7(d)0(e)19.7(r)-415.8(ma)18.4(in)20.7(ly)-405.5(ob)15.1(se)19.9(rv)20.9(at)19.5(io)20.7(na)19.7(l)-415.9(o)0(r)-411.1(c)0(o)19.7(n)0(-)]TJ
0 -1.1116 TD
[(tr)20.7(ol)20.7(le)13.8(d)-243(s)0(t)20.9(u)0(d)20.8(i)0(e)19.6(s)-248.6(do)20.8(cu)19.7(me)18.4(nt)20.7(ed)-239.5(in)20.7(cr)19.7(ea)18.5(se)19.9(d)-248.8(b)0(a)19.7(s)0(e)19.9(l)0(i)20.6(n)0(e)-233.7(p)0(r)15.1(o)0(l)20.7(a)0(c)18.5(t)0(i)20.6(n)-243(le)13.8(ve)19.7(ls)]TJ
T*
[(in)-186.6(la)19.5(ct)19.5(at)19.5(in)20.7(g)-196.9(w)0(o)20(m)0(e)18.4(n)-191.2(wh)20(o)-196.9(t)0(o)20.7(o)0(k)-186.5(m)0(e)18.4(t)0(o)20.7(c)0(l)19.5(o)0(p)20.8(r)0(a)19.7(m)0(i)19.5(d)0(e)-187.7(o)0(r)-180.7(d)0(o)20.8(m)0(p)19.6(e)0(r)14(i)0(d)20.7(o)0(n)20.8(e)]TJ
0 -1.1174 TD
[(an)19.7(d)-196.9(p)0(r)20.9(o)0(v)20.8(i)0(d)20.7(e)-198.1(so)21(me)-188.9(ev)19.7(id)20.7(en)19.7(ce)-188.8(fo)20.9(r)-191.1(t)0(h)15(e)0(i)19.5(r)-191.1(ef)14(fe)19.7(ct)19.5(iv)20.7(en)19.7(es)19.9(s.)]TJ
7.3823 0 0 6.5614 253.8141 581.2156 Tm
[(19)24.7(,2)28.1(0)]TJ
9.843 0 0 9.843 269.9716 577.814 Tm
[(\(l)20.7(lA)19.8(,)-193.5(l)0(l)14.8(l)0(\))]TJ
-20.1129 -1.1116 TD
[(However,)-337.7(high-quality)-331.7(evidence)-336.1(is)-336.2(lacking.)-336.3(The)-334(numbers)]TJ
-1.0137 -1.1116 TD
[(of)-238.3(women)-233.4(in)-238.5(randomized,)-238.1(placebo-controll)-11.2(ed)-233.7(blinded)-239.5(studies)]TJ
0 -1.1174 TD
[(\(RCTs\))-447.4(with)-443.3(each)-445.6(of)-445.7(these)-445.5(agents)-446.6(are)-443.3(small.)-443.4(Studies)-446.5(also)]TJ
0 -1.1116 TD
[(tended)-181.9(to)-180.9(have)-185.3(high)-177.3(dropout)-180.6(rates,)-184(differed)-184(in)-180.9(patient)-183.2(selection)]TJ
T*
[(\(i.e.,)-181.9(some)-185.2(were)-180.4(expressing)-185.8(for)-181.8(preterm)-184.1(infants,)-179.4(not)-182(all)-183.3(women)]TJ
0 -1.1174 TD
[(had)-298.2(documented)-298.1(low)-292.3(milk)-299.6(supply\),)-293.3(and)-298.2(differed)-299.2(in)-296.1(dose)-293.4(and)]TJ
0 -1.1116 TD
[(duration)-361.5(of)-365(the)-361.7(galactogogue)-363.7(and)-361.6(application)-361.7(of)-365(other)-358.1(non-)]TJ
T*
[(pharmacological)-300.4(measures)-295.3(before)-291.1(starting)-292.4(the)-292.6(galactogogue.)]TJ
T*
[(Most)-281.7(studies)-285.2(also)-282(had)-280.9(limited)-281.3(follow-up.)]TJ
/F10 1 Tf
8.9663 0 0 8.9663 62.022 456.5479 Tm
(Domperidone)Tj
/F8 1 Tf
9.843 0 0 9.843 72 440.107 Tm
[(A)-439.7(Cochrane)-445.3(systematic)-447.7(review)]TJ
7.3823 0 0 6.5614 198.5385 444.529 Tm
(21)Tj
9.843 0 0 9.843 205.9653 440.107 Tm
[(\(lA\))-443.1(published)-443.1(in)-440.1(2012)]TJ
-14.6239 -1.1116 TD
[(included)-259.1(two)-257.7(studies)-256.4(with)-259(a)-255.7(total)-260.5(of)-255.6(59)-255.6(mothers)-257.7(with)-259(preterm)]TJ
T*
[(infants)-187.5(and)-188.8(found)-184(a)-186.6(moderate)-186.4(benet)-187.5(\(mean)-187.6(increase)-191.9(of)-186.5(99)-163.5(mL)]TJ
T*
[(per)-344.3(day\))-345.4(when)-340.5(using)-345.3(domperidone,)-347.5(30)-163.5(mg)-343.3(per)-344.3(day,)-347.7(for)-343.1(7)-340.9(o)0(r)]TJ
0 -1.1174 TD
[(14)-382.3(days.)-383.2(Other)-382(systematic)-384.4(reviews)-385.2(have)-381.1(similar)-384.6(ndings,)]TJ
7.3823 0 0 6.5614 293.7259 400.6487 Tm
(22)Tj
9.843 0 0 9.843 62.022 385.3416 Tm
[(with)-230.2(the)-229.2(most)-224.4(recent)-229.1(review)-234.5(that)-224.7(included)-230.3(one)-229.1(nding)-225.4(a)-232.6(mean)]TJ
0 -1.1116 TD
[(increase)-289.8(of)-290.2(88.3)-168(mL)-286.8(per)-286.7(day)-286.7(\(95%)-287.7(condence)-290.9(interval)-288(56.8)]TJ
0 -1.1174 TD
(119.8\).)Tj
7.3823 0 0 6.5614 89.9149 367.7668 Tm
(23)Tj
9.843 0 0 9.843 97.3417 363.4015 Tm
[(\(lA\))-206.9(There)-210.6(have)-208.3(been)-208.3(four)-205.9(RCTs)-209.1(using)-207(domperidone)]TJ
-3.5883 -1.1116 TD
[(si)20.9(nc)19.7(e)-198.1(t)0(h)20.7(e)-192.3(Co)19.8(ch)19.7(ra)19.7(ne)-187.7(re)19.7(vi)20.7(ew)18.8(.)-193.5(I)0(n)-180.7(o)0(n)15.1(e)-192.3(st)20.9(ud)20.8(y)-196.9(o)0(f)-180.7(4)0(5)-180.7(w)0(o)20(m)0(e)18.4(n)0(,)-183.1(2)0(2)-186.5(w)0(e)18.8(r)0(e)]TJ
T*
[(gi)20.7(ve)19.7(n)-358.2(d)0(o)20.8(m)0(p)19.6(e)0(r)19.7(i)0(d)15(o)0(n)20.8(e)0(,)-345.5(3)0(0)-146.2(m)0(g)-349(p)0(e)19.7(r)-358.2(da)19.7(y,)-350.1(fo)20.9(r)-358.2(4)-358.2(d)0(a)19.7(y)0(s)-347.6(p)0(o)20.8(s)0(t)20.9(c)0(e)18.5(s)0(a)14.1(r)0(e)19.7(a)0(n)]TJ
0 -1.1174 TD
[(se)19.9(ct)19.5(io)15(n)-427.3(a)0(n)19.7(d)-433.1(we)18.8(re)-423.8(fo)20.9(un)20.8(d)-433.1(t)0(o)-422.8(h)0(a)19.7(v)0(e)-423.8(i)0(n)20.7(c)0(r)19.7(e)0(a)18.5(s)0(e)19.9(d)-433.1(mi)19.5(lk)-422.8(pr)20.9(od)20.8(uc)13.9(ti)20.6(on)]TJ
0 -1.1116 TD
.0125 Tc
[(du)5.6(ri)5.5(ng)-276.6(th)5.6(at)-276.7(ti)5.5(me)-277.7(compar)5.7(ed)-276.6(with)-276.6(t)5.5(h)-.1(e)-277.7(c)-1.3(o)5.6(n)-.1(t)5.5(rol)-276.7(g)5.6(rou)5.6(p.)]TJ
7.3823 0 0 6.5614 265.7763 323.9432 Tm
.0145 Tc
(24)Tj
9.843 0 0 9.843 273.3732 319.5779 Tm
.0131 Tc
[(\(l)6.1(B\))]TJ
-20.4585 -1.1116 TD
0 Tc
[(In)-244.1(a)-244.2(second)-250.6(study)-247.3(of)-244.1(only)-246.4(15)-244.1(women)-244.9(with)-247.4(low)-246.2(milk)-247.8(supply)]TJ
-1.0137 -1.1116 TD
[(who)-205.8(were)-203.4(expressing)-208.9(for)-204.8(preterm)-207.2(infants,)-208.2(there)-203.8(was)-206.7(a)-203.8(300-mL)]TJ
0 -1.1174 TD
[(per)-522.8(day)-522.8(difference)-528.3(in)-520.7(milk)-524.3(production)-525(for)-521.6(women)-521.4(given)]TJ
0 -1.1116 TD
[(domperidone,)-428.2(60)-169.2(mg)-429.6(per)-424.9(day,)-428.4(for)-429.5(4)-427.3(weeks)-429(compared)-428.2(with)]TJ
T*
[(women)-469.6(given)-467.6(domperidone,)-474.2(30)-163.5(mg)-470(per)-465.2(day,)-468.7(for)-469.8(a)-468.8(similar)]TJ
0 -1.1174 TD
[(length)-422.7(of)-416.9(time.)]TJ
7.3823 0 0 6.5614 123.307 258.1795 Tm
(25)Tj
9.843 0 0 9.843 130.6771 253.8141 Tm
[(\(lB\))-426(A)-416.7(third)-420.4(trial)-421.7(in)-422.8(the)-419.3(United)-423.6(Kingdom)]TJ
-6.975 -1.1116 TD
[(compared)-359.1(the)-355.9(effects)-362.4(of)-353.5(domperidone,)-359(30)-169.2(mg)-354.8(per)-355.8(day,)-353.5(with)]TJ
T*
[(metoclopramide,)-354.6(30)-169.2(mg)-349(per)-350(day.)-353.5(Women)-350(had)-350(24-hour)-347.5(milk)]TJ
0 -1.1174 TD
[(production)-409.8(measured)-410.7(from)-403(10)-411.1(days)-402.8(before)-412(the)-407.8(commence-)]TJ
0 -1.1116 TD
[(ment)-300.7(of)-272.9(me)18.4(di)20.7(ca)12.8(ti)20.6(on)-272.9(ad)19.7(mi)19.5(ni)14.9(st)20.9(ra)19.7(ti)20.6(on)-278.7(an)19.7(d)-283.3(d)0(u)15.1(r)0(i)20.7(n)0(g)-272.9(t)0(h)15(e)-284.5(10)-278.7(da)19.7(ys)-278.5(of)]TJ
T*
.0128 Tc
[(m)12.8(e)31.2(d)12.8(i)12.8(c)-3.3(ation)-351.2(a)4.8(dministration.)]TJ
7.3823 0 0 6.5614 171.3826 203.4141 Tm
.0145 Tc
(26)Tj
9.843 0 0 9.843 182.4944 199.0488 Tm
.0132 Tc
[(Th)6.3(e)-351.9(5).6(1)-350.8(w)-.3(omen)-345(were)-351.9(expres-)]TJ
-12.2394 -1.1174 TD
.0128 Tc
[(sing)-224.4(for)-224.4(their)-224.4(preterm)-219.9(infants)-224.2(a)-1(nd)-224.4(had)-224.4(documented)-224.4(l).1(ow)-225.3(milk)]TJ
0 -1.1116 TD
[(supply.)-284.4(They)-287.8(all)-287.9(r).2(eceived)-287.8(high-quality)-287.8(b)5.9(r).2(eastfeeding)-287.8(a)-1(ssis-)]TJ
T*
[(tance)-185.3(t).1(hroughout)-184.3(the)-191(s).4(tudy.)-186.5(Mil)5.8(k)-189.9(productio)5.9(n)-189.9(a)-1(lmost)-184.3(doubled)]TJ
T*
.013 Tc
[(from)-260(the)-260(s).6(teady)-258.8(premedic)5(ation)-258.8(l).3(evel)-258.9(with)-264.6(b)6.1(o).4(th)-264.6(m)4.9(e)-.8(dications)]TJ
0 -1.1174 TD
.0132 Tc
[(and)-275.9(p).6(lateaued)-275.9(after)-281.6(a)-.6(b)6.3(out)-281.8(7)-275.9(d).6(ays)-281.4(o).6(f)-275.8(t).5(reatment.)]TJ
7.3823 0 0 6.5614 249.3354 148.5921 Tm
.0145 Tc
(26)Tj
9.843 0 0 9.843 256.9889 144.2267 Tm
.0131 Tc
(\(lB\))Tj
-18.7939 -1.1116 TD
0 Tc
[(The)-241.8(fourth)-242.8(and)-240.6(larges)-8.8(t)-237.4(trial)-243.2(to)-244.2(date)-243(\(EMPOWER\))-247.6(included)]TJ
-1.0137 -1.1116 TD
[(90)-439.9(wo)20(me)18.4(n)-427.3(w)0(h)20(o)-433.1(ha)19.7(d)-427.3(l)0(o)20.7(w)-433.9(mi)19.5(lk)-417(su)21(pp)20.8(ly)-422.8(wh)20(en)-418.1(ex)19.7(pr)15.1(es)19.9(si)20.9(ng)-416.9(fo)15.1(r)]TJ
0 -1.1174 TD
[(pr)20.9(et)19.5(er)14(m)-186.6(i)0(n)20.7(f)0(a)14(n)0(t)20.7(s)0(.)-177.1(T)0(h)19.6(e)0(y)-181.9(w)0(e)18.8(r)0(e)-181.9(r)0(a)19.7(n)0(d)15.1(o)0(m)19.6(i)0(z)19.6(e)0(d)-181.9(b)0(e)19.7(t)0(w)19.8(e)0(e)18.5(n)-191.2(8)-191.2(a)0(n)19.7(d)-191.2(21)-180.7(da)19.7(ys)]TJ
0 -1.1116 TD
[(po)20.8(st)20.9(pa)13.9(rt)20.7(um)-158.9(to)-163.6(re)19.7(ce)18.5(iv)20.7(e)-169.3(d)0(o)15.1(m)15(pe)13.9(ri)20.7(do)20.8(ne)19.7(,)-170.5(3)0(0)-146.2(m)0(g)-158.9(p)0(e)13.9(r)-168.1(da)19.7(y,)-160(fo)20.9(r)-173.9(2)0(8)-163.5(d)0(a)19.7(y)0(s)]TJ
T*
[(or)-180.7(a)-192.3(p)0(l)14.9(a)0(c)18.5(e)0(b)19.7(o)-191.2(fo)20.9(r)-191.1(1)0(4)-180.7(d)0(a)13.9(y)0(s)-180.6(a)0(n)19.7(d)-191.2(th)20.7(en)-181.9(do)15.1(m)15(p)0(e)13.9(r)0(i)20.7(d)0(o)20.8(n)0(e)19.7(,)-193.5(30)-146.2(mg)-182(pe)19.7(r)-191.1(d)0(a)19.7(y)0(,)]TJ
0 -1.1174 TD
[(fr)20.9(om)-256.9(da)19.7(y)-260.3(1)0(5)-255.6(t)0(o)-255.8(2)0(8)20.8(.)]TJ
7.3823 0 0 6.5614 134.6456 82.885 Tm
(27)Tj
9.843 0 0 9.843 144.5669 78.463 Tm
[(At)-250.9(14)-255.6(da)19.7(ys)21(,)-268.4(7)0(7)20.8(.)13.9(8%)-256.7(of)-255.6(wo)20(me)18.4(n)-260.3(i)0(n)-255.8(t)0(h)20.7(e)-261.4(r)15.3(st)]TJ
-8.3861 -1.1116 TD
[(gr)20.9(ou)20.8(p)-289.1(h)0(a)19.7(d)-289.1(in)20.7(cr)19.7(ea)18.5(se)19.9(d)-289.1(t)0(h)20.7(e)0(i)19.5(r)-289(mi)19.5(lk)-278.8(pr)20.9(od)20.8(uc)19.7(ti)20.6(on)-278.7(by)-278.7(50)20.8(%)-290.1(c)0(o)19.7(m)0(p)19.6(a)0(r)19.7(e)0(d)]TJ
T*
[(wi)19.8(th)-324.9(57)20.8(.8)18.5(%)-336.2(i)0(n)-324.9(t)0(h)20.7(e)-336.3(se)19.9(co)19.7(nd)-324.7(gr)15.1(ou)20.8(p.)-321.3(By)-325.8(28)-324.7(da)13.9(ys)21(,)-331.7(t)0(h)20.7(e)0(r)14(e)-336.3(we)18.8(re)-325.9(no)]TJ
25.504 67.9242 TD
[(si)15.1(gn)20.8(i)20.9(ca)18.5(nt)-209.7(di)20.7(ff)15.1(er)19.7(en)19.7(ce)18.5(s)-219.8(b)0(e)19.7(t)0(w)19.8(e)0(e)12.8(n)-220(th)20.7(e)-221.1(t)0(w)19.8(o)-220(gr)20.9(ou)20.8(ps)15.3(,)-216.5(n)0(o)20.8(r)-225.7(we)18.8(re)-210.7(th)20.7(er)19.7(e)]TJ
0 -1.1174 TD
[(di)14.9(ff)20.9(er)19.7(en)19.7(ce)18.5(s)-277.4(a)0(t)-268.4(t)0(e)19.5(r)0(m)-268.3(o)0(r)-267.1(a)0(t)-268.4(6)-277.6(we)18.8(ek)19.7(s)-277.4(p)0(o)20.8(s)0(t)15.1(-)0(t)20.7(e)0(r)19.7(m)0(.)]TJ
7.3823 0 0 6.5614 483.5904 718.5825 Tm
(27)Tj
9.843 0 0 9.843 490.7904 714.1605 Tm
[(\(l)15(B\))-268.2(Th)19.6(e)-273(r)0(e)13.9(s)0(u)21(l)0(t)20.6(s)]TJ
-18.0567 -1.1116 TD
[(of)-232.6(on)20.8(e)-244.2(o)0(l)20.7(d)0(e)19.7(r)-243(ve)19.7(ry)-226.8(sm)19.8(al)19.5(l)-243.1(s)0(t)20.9(u)0(d)20.8(y)-243(\()]TJ
/F4 1 Tf
12.0551 0 TD
(n)Tj
/F9 1 Tf
.6566 0 TD
(=)Tj
/F8 1 Tf
.7084 0 TD
[(6\))-232.6(su)21(gg)20.8(es)19.9(te)19.6(d)-243(t)0(h)20.7(a)0(t)-233.9(i)0(n)20.7(d)0(i)20.7(v)0(i)20.7(d)0(u)20.8(a)0(l)]TJ
-13.4201 -1.1116 TD
[(wo)14.2(me)18.4(n)-450.4(m)0(a)18.4(y)-456.1(be)-441.1(re)13.9(sp)21(on)20.8(de)19.7(rs)-445.5(or)-445.7(no)20.8(nr)20.9(es)19.9(po)20.8(nd)20.8(er)13.9(s)-450.2(a)0(n)19.7(d)-456.1(th)20.7(at)-447(pr)20.9(i-)]TJ
T*
[(mi)19.5(pa)13.9(ra)19.7(s)-375.3(m)0(a)18.4(y)-375.5(re)19.7(sp)15.3(on)20.8(d)-375.5(t)0(o)-371(d)0(o)20.8(m)0(p)19.6(e)0(r)19.7(i)0(d)20.7(o)0(n)20.8(e)-376.6(wi)14.1(th)-365.2(hi)20.7(gh)20.8(er)-372(pr)20.9(ol)20.7(ac)18.5(ti)20.6(n)]TJ
0 -1.1174 TD
[(le)13.8(ve)19.7(ls)-261.3(th)20.7(an)-256.8(mu)19.6(lt)14.8(ip)20.7(ar)19.7(as)19.9(.)]TJ
7.3823 0 0 6.5614 400.8188 674.7021 Tm
-.0162 Tc
(28)Tj
9.843 0 0 9.843 408.0188 670.3369 Tm
0 Tc
[(\(l)20.7(B\))]TJ
-8.6338 -1.1116 TD
[(Wi)12.7(th)-261.5(re)14(sp)15.3(ec)12.8(t)-271.9(t)0(o)-261.5(p)0(o)15.1(t)0(e)13.8(n)0(t)14.9(i)0(a)19.6(l)-271.9(ri)15(sk)15.3(s,)-263.5(th)15(er)14(e)-273(i)0(s)-261.3(e)0(v)13.9(i)0(d)15(e)0(n)13.9(c)0(e)-263.7(t)0(h)14.9(a)0(t)-262.7(d)0(o)15.1(m)0(-)]TJ
-1.0137 -1.1116 TD
[(pe)13.9(ri)15(do)15.1(ne)-199.2(in)15(cr)14(ea)12.8(se)14.1(s)-208.2(t)0(h)15(e)-209.6(QT)18.8(c)-209.6(i)0(n)15(t)0(e)13.8(r)0(v)15.1(a)0(l)-199.3(a)0(n)13.9(d)-208.4(it)-204(ha)19.7(s)-208.3(b)0(e)13.9(e)0(n)-204.9(i)0(m)19.5(p)0(l)14.9(i)0(c)13.8(a)0(t)13.8(e)0(d)]TJ
0 -1.1174 TD
[(in)-180.9(ve)19.7(nt)14.9(ri)15(cu)13.9(la)13.8(r)-179.6(a)0(r)14(r)0(h)15.1(y)0(t)14.9(h)0(m)13.9(i)0(a)19.5(s)-185.2(an)13.9(d)-179.6(s)0(u)15.3(d)0(d)15.1(e)0(n)-176.2(c)0(a)12.8(r)0(d)15.1(i)0(a)13.8(c)-180.8(de)13.9(at)13.8(h,)-171.6(pa)13.9(rt)15(ic)13.8(ul)14.9(ar)]TJ
0 -1.1116 TD
[(in)-296.1(ol)14.9(de)13.9(r)-306.3(a)0(n)19.7(d)-306.4(un)15.1(we)18.8(ll)-296.2(ad)13.9(ul)14.9(ts)15.1(.)]TJ
7.3823 0 0 6.5614 418.6771 630.8786 Tm
[(29)17(,3)20.4(0)]TJ
9.843 0 0 9.843 434.9479 626.5132 Tm
[(\(l)20.7(A,)-299.1(lV)14.1(\))-300.6(T)0(h)13.9(e)-301.8(ri)15(sk)-295.7(fo)15.1(r)-306.3(d)0(o)15.1(m)0(p)19.6(e)0(r)14(-)]TJ
-12.3834 -1.1116 TD
[(id)15(on)15.1(e)-296(t)0(o)-284.6(i)0(n)20.7(c)0(r)14(e)0(a)12.8(s)0(e)-285.4(t)0(h)15(e)-290.2(in)15(ci)13.8(de)13.9(nc)19.7(e)-296(o)0(f)-284.4(a)0(r)14(r)0(h)15.1(y)0(t)20.7(h)0(m)13.9(i)0(a)13.8(s)-294.6(in)-278.8(po)15.1(st)15.1(pa)13.9(rt)15(um)]TJ
0 -1.1174 TD
[(wo)14.2(me)12.7(n)-208.4(w)0(i)14.1(t)0(h)-203.9(n)0(o)-198(o)0(t)14.9(h)0(e)13.9(r)-208.4(ri)15(sk)-203.6(fa)19.7(ct)13.8(or)15.1(s)-208.3(a)0(p)13.9(p)0(e)13.9(a)0(r)14(s)-208.2(to)-203.9(be)-199.2(ve)13.9(ry)-203.8(sm)19.8(al)13.8(l,)-200.5(bu)15.1(t)]TJ
0 -1.1116 TD
[(ma)12.7(y)-467.6(i)0(n)20.7(c)0(r)13.9(e)0(a)12.8(s)0(e)-458.2(w)0(i)14.1(t)0(h)-457.3(o)0(t)20.7(h)0(e)13.9(r)-467.6(fa)13.9(ct)19.5(or)15.1(s)-467.4(s)0(u)15.3(c)0(h)-458.4(a)0(s)-452.4(a)-468.8(pa)13.9(st)-457.2(hi)20.7(st)15.1(or)15.1(y)-467.6(o)0(f)]TJ
T*
[(ve)13.9(nt)14.9(ri)15(cu)13.9(la)13.8(r)-300.6(a)0(r)14(r)0(h)15.1(y)0(t)14.9(h)0(m)19.6(i)0(a)13.8(s)0(,)-298.1(h)0(i)14.9(g)0(h)-295.9(B)0(M)18.9(I)0(,)-298.2(h)0(i)14.9(g)0(h)15.1(e)0(r)-291.3(d)0(o)15.1(s)0(a)14.1(g)0(e)13.9(s)0(,)-298.1(a)0(n)19.7(d)-306.4(co)13.9(n-)]TJ
T*
[(co)13.9(mi)13.7(ta)13.8(nt)-180.9(us)15.3(e)-192.3(o)0(f)-186.5(m)0(e)12.7(d)0(i)20.7(c)0(a)12.8(t)0(i)14.8(o)0(n)15.1(s)-191(th)15(at)-182(in)14.9(hi)14.9(bi)14.9(t)-191.3(C)0(Y)13.2(P)0(3)15.2(A)0(4)14.2(.)]TJ
7.3823 0 0 6.5614 504.5101 576.1132 Tm
-.0162 Tc
(31)Tj
9.843 0 0 9.843 511.7101 571.7479 Tm
0 Tc
[(\(l)15(ll)14.8(\))-191.1(I)0(n)-186.5(t)0(h)15(i)0(s)]TJ
-20.182 -1.1174 TD
[(la)13.8(rg)15.1(e)-203.8(s)0(t)15.1(u)0(d)15.1(y)-208.4(of)-192.2(mo)13.9(re)-199.2(th)14.9(an)-193.4(22)15.1(5,)12.7(53)15.1(2)-202.7(p)0(o)15.1(s)0(t)15.1(p)0(a)19.7(r)0(t)15(u)0(m)-199.3(w)0(o)14.2(m)0(e)18.4(n)0(,)-200.4(t)0(h)15(e)-203.8(on)15.1(ly)]TJ
0 -1.1116 TD
[(wo)14.2(me)12.7(n)-323.6(w)0(h)14.2(o)-329.4(de)13.9(ve)19.7(lo)15(pe)13.9(d)-329.4(v)0(e)19.7(n)0(t)14.9(r)0(i)15(c)0(u)13.9(l)0(a)13.8(r)-323.6(ar)13.9(rh)15.1(yt)14.9(hm)13.9(ia)19.5(s)-329.2(w)0(h)14.2(i)0(l)14.8(e)-324.8(ta)13.8(ki)14.9(ng)]TJ
T*
[(do)15.1(mp)13.8(er)14(id)15(on)15.1(e)-296(h)0(a)13.9(d)-300.6(a)-296(p)0(a)13.9(s)0(t)-290.1(h)0(i)14.9(s)0(t)15.1(o)0(r)15.1(y)-294.8(of)-290.1(ve)13.9(nt)14.9(ri)15(cu)13.9(la)13.8(r)-294.8(a)0(r)13.9(r)0(h)15.1(y)0(t)15(h)0(m)13.9(i)0(a)19.5(s)0(.)]TJ
7.3823 0 0 6.5614 544.8754 543.2313 Tm
(32)Tj
9.843 0 0 9.843 313.0582 527.8676 Tm
[(Se)14.1(e)-273(T)0(a)12.7(b)0(l)14.9(e)-273(1)-271.8(f)0(o)15.1(r)-271.8(fu)15.1(rt)15(he)19.7(r)-277.5(i)0(n)20.7(f)0(o)15.1(r)0(m)13.9(a)0(t)13.8(i)0(o)14.9(n)0(.)]TJ
/F10 1 Tf
8.9663 0 0 8.9663 313.0582 503.433 Tm
(Metoclopramide)Tj
/F8 1 Tf
9.843 0 0 9.843 323.0361 486.992 Tm
[(Five)-414.5(randomized,)-422.5(placebo-controlled)-417.8(blinded)-418.1(studies)-411.9(re-)]TJ
-1.0137 -1.1116 TD
[(searching)-272.5(the)-269.5(effect)-275.1(of)-267.1(metoclopramide)-270.6(have)-271.7(been)-265.9(published)]TJ
0 -1.1174 TD
[(betwe)-8.8(en)-418.1(1980)-413.3(and)-419.2(2011.)]TJ
7.3823 0 0 6.5614 414.4251 469.4739 Tm
(3337)Tj
9.843 0 0 9.843 432.907 465.0518 Tm
[(\(lB\))-420.2(Of)-417.7(these,)-420.1(participants)-420.2(in)]TJ
-12.176 -1.1116 TD
[(three)-347.7(studies)-342.8(commenced)-345.3(metoclopramide)-345.4(within)-341.9(4)-340.9(days)-339.4(of)]TJ
T*
[(birth)-201.6(without)-193.3(a)-198.1(diagnosis)-201(of)-198(low)-194.4(milk)-196(supply,)]TJ
7.3823 0 0 6.5614 486.8786 447.5338 Tm
(33,34,37)Tj
9.843 0 0 9.843 514.6581 443.1684 Tm
[(one)-200.3(study)]TJ
-20.4815 -1.1116 TD
[(invest)-7.8(igated)-510.3(women)-509.9(who)-505.3(were)-514.4(relactating,)]TJ
7.3823 0 0 6.5614 490.2802 436.592 Tm
(36)Tj
9.843 0 0 9.843 502.6959 432.2267 Tm
[(and)-511.3(one)-505.6(re-)]TJ
-19.2662 -1.1174 TD
[(cruited)-217.6(women)-216.1(whose)-208.9(infants)-216.3(had)-211.8(not)-210.8(gained)-216.4(500)-164.6(g)-214.2(within)-215.2(the)]TJ
0 -1.1116 TD
[(rst)-269.1(month)-260.3(of)-261.4(life.)]TJ
7.3823 0 0 6.5614 385.2282 414.6519 Tm
(35)Tj
9.843 0 0 9.843 395.2062 410.2865 Tm
[(None)-265.6(of)-261.4(these)-267(studies)-262.2(found)-264.7(differences)]TJ
-8.3458 -1.1116 TD
[(in)-296.1(milk)-293.9(volumes)-292.3(and/or)-295.9(breastfeeding)-301.2(duration)-292.4(between)-300.2(me-)]TJ
0 -1.1174 TD
[(tocloprami)-9.2(de)-325.9(and)-332.8(placebo)-328.1(groups,)-332.4(even)-329.3(with)-328.1(optimal)-333(breast)]TJ
0 -1.1116 TD
[(expression)-272.2(and)-263.6(counseling.)]TJ
7.3823 0 0 6.5614 419.8676 381.77 Tm
(37)Tj
9.843 0 0 9.843 429.9022 377.4046 Tm
[(However,)-262.9(as)-268.1(mentioned)-267.2(above,)]TJ
-11.8708 -1.1116 TD
[(Ingram)-331.5(et)-326(al.)]TJ
7.3823 0 0 6.5614 364.8188 370.8282 Tm
(26)Tj
9.843 0 0 9.843 375.4203 366.4629 Tm
[(found)-322.3(similar)-327(positive)-332.7(effects)-327.9(with)-328.1(metoclo-)]TJ
-6.3357 -1.1174 TD
[(pramide)-287.8(and)-280.9(domperidone.)]TJ
1.0137 -1.1116 TD
[(In)-307.4(addition,)-307.5(a)-307.5(number)-308.5(of)-307.4(older)-312(randomized)-309.6(controlled)-313.2(tri-)]TJ
-1.0137 -1.1116 TD
(als,)Tj
7.3823 0 0 6.5614 326.4944 337.9464 Tm
(3841)Tj
9.843 0 0 9.843 345.033 333.581 Tm
[(\(lB,)-566.6(llA\))-570(controlled)-572.4(tria)-11.6(l)-12.7(s)-6.7(,)]TJ
7.3823 0 0 6.5614 455.5275 337.9464 Tm
.0138 Tc
(42,43)Tj
9.843 0 0 9.843 472.6487 333.581 Tm
.0115 Tc
[(\(l)4.5(lB\))-571.3(a)3.5(nd)-565.6(ob)4.6(serva-)]TJ
-16.2136 -1.1116 TD
[(tio)4.5(nal)-387.3(s)4.7(tu)4.5(dies)]TJ
7.3823 0 0 6.5614 368.107 327.0046 Tm
.0141 Tc
(20,4446)Tj
9.843 0 0 9.843 396.6235 322.6393 Tm
.0122 Tc
[(\(l)5.2(ll\))-380.5(r)5.4(e)-1.6(p)5.3(ort)5.2(ed)-380.5(a)-381.7(s)-.2(i)5.2(g)-.4(n)5.3(i)-.5(can)5.3(t)-380.7(i)-.5(ncrease)-381.7(i)5.2(n)]TJ
-8.4898 -1.1174 TD
.012 Tc
[(mi)5(lk)-380.8(yield)-380.8(u)5.1(sin)5.1(g)-386.5(met)5(o)-.6(clo)5.1(prami)5(de,)-383.1(5)-.6()5.1(2)-.6(0)-161.9(m)-1.8(g)5.1(,)-383.1(th)5.1(ree)-381.9(t)5(imes)-380.6(a)]TJ
0 -1.1116 TD
[(day)-386.4(f)-.5(o)5.2(r)-392.1(p)5.2(e)-1.7(r)5.3(i)-.6(od)5.2(s)-392(o)5.2(f)-392.1(5)-386.4(days)-386.2(to)-386.4(4)-392.2(w)4.4(eeks.)-388.7(T)12.1(h)31.7(e)-370.3(o)12.1(n)32.9(e)-370.3(s)12.1(t)33(u)12.1(d)32.9(y)-369.1(t)12.1(h)32.8(a)12.1(t)]TJ
T*
0 Tc
[(co)13.9(m)15(p)0(a)13.9(r)0(e)19.7(d)-461.9(di)20.7(ff)20.9(er)14(en)19.7(t)-462(d)0(o)20.8(s)0(e)19.9(s)-467.4(of)-451.4(me)18.4(to)20.7(cl)19.5(op)20.8(ra)14(mi)19.5(de)-452.6(fo)20.9(un)20.8(d)-467.6(n)0(o)-451.5(r)0(e)19.7(-)]TJ
0 -1.1174 TD
[(sp)15.3(on)20.8(se)-245.1(wi)19.8(th)-250(15)-146.2(mg)-245.3(pe)19.7(r)-254.5(d)0(a)19.7(y)0(,)-246.4(b)0(u)20.8(t)-260.4(si)20.9(mi)19.5(la)19.5(r)-254.5(r)0(e)19.7(s)0(p)15.3(o)0(n)20.8(s)0(e)19.9(s)-254.3(wi)19.8(th)-250(30)-244.1(an)19.7(d)]TJ
0 -1.1116 TD
[(45)-152(m)15(g)-266(pe)19.7(r)-266(d)0(a)19.7(y)0(.)-258(T)0(h)19.6(e)-267.2(sc)19.9(ie)19.6(nt)20.7(i)20.9(c)-267.2(r)0(i)20.7(g)0(o)15.1(r)-266(of)-249.8(th)15(es)19.9(e)-267.2(o)0(l)20.7(d)0(e)19.7(r)-266(st)20.9(ud)20.8(ie)19.6(s)-265.9(m)0(a)18.5(y)]TJ
T*
[(no)15.1(t)-248.9(b)0(e)-239.5(a)0(s)-239.3(s)0(t)20.9(r)0(o)15.1(n)0(g)-238.3(a)0(s)-239.3(m)0(o)19.6(r)0(e)-239.5(r)0(e)19.7(c)0(e)12.8(n)0(t)-238.5(s)0(t)20.9(u)0(d)20.8(i)0(e)19.6(s)0(,)-240.5(s)0(o)-238.2(t)0(h)14.9(e)0(i)19.5(r)-248.7(re)19.7(su)21(lt)20.6(s)-254.3(s)0(h)21(o)0(u)20.8(l)0(d)]TJ
0 -1.1174 TD
[(be)-360.5(in)20.7(te)19.6(rp)15.1(re)19.7(te)19.6(d)-369.7(w)0(i)19.8(t)0(h)-353.7(c)0(a)18.5(u)0(t)14.9(i)0(o)20.7(n)0(.)-355.9(A)0(s)-360(f)0(o)20.9(r)-369.7(po)20.8(te)19.6(nt)20.7(ia)19.6(l)-369.9(r)0(i)20.7(s)0(k)21(s)0(,)-361.4(m)0(e)18.4(t)0(o)20.7(c)0(l)19.5(o)0(-)]TJ
0 -1.1116 TD
[(pr)15.1(am)18.5(id)20.7(e)-376.6(m)0(a)18.4(y)-381.2(ca)18.5(us)21(e)-382.4(n)0(e)19.7(u)0(r)20.9(o)0(l)20.7(o)0(g)15.1(i)0(c)19.5(a)0(l)-366.4(s)0(i)15.1(d)0(e)-366.2(e)0(f)14(f)0(e)19.7(c)0(t)19.5(s)-381(in)-365.2(th)15(e)-376.6(m)0(o)19.6(t)0(h)20.7(e)0(r)14(.)]TJ
T*
[(Fu)15.2(rt)20.7(he)19.7(r)-271.8(i)0(n)20.7(f)0(o)20.9(r)0(m)19.6(a)0(t)19.5(i)0(o)20.7(n)-271.8(ca)18.5(n)-271.8(b)0(e)-256.8(f)0(o)15.1(u)0(n)20.8(d)-266(in)-261.5(Ta)18.5(bl)20.7(e)-273(1)0(.)]TJ
/F10 1 Tf
8.9663 0 0 8.9663 313.0582 199.559 Tm
(Summary)Tj
/F8 1 Tf
9.843 0 0 9.843 323.0361 183.1181 Tm
[(Despite)-402.6(the)-396.3(widespread)-401.2(use)-395.9(of)-393.8(these)-399.4(pharmaceutical)-398.4(ga-)]TJ
-1.0137 -1.1174 TD
[(lactogogues)-9.9(,)-279.9(there)-278.6(are)-282.1(important)-283.4(issues)-283.8(to)-278.8(consider:)]TJ
1.0022 -1.7164 TD
[(1.)-499.9(Pharmaceutical)-640.1(galactogogues)-635.3(do)-630(increase)-629.7(baseline)]TJ
1.2499 -1.1174 TD
[(serum)-445.4(prolactin,)-448(and)-448(there)-445.7(is)-445.6(evidence)-451.3(for)-446.7(increased)]TJ
0 -1.1116 TD
[(milk)-426.3(production)-427.1(with)-426(domperidone)-430.5(use)-424.7(\(and)-426(perhaps)]TJ
T*
[(metoclopramide\).)-303.9(However,)-297.4(the)-298.3(population)-294.8(that)-299.6(would)]TJ
0 -1.1174 TD
[(most)-316.6(benet)-319.9(from)-322.3(this)-315.5(treatment)-320.3(is)-318.9(still)-316.9(uncertain)-324.7(as)-314.2(it)]TJ
0 -1.1116 TD
[(is)-376.5(unknown)-383(if)-376.7(all)-379.1(women)-377.4(with)-379.9(low)-378.7(milk)-374.5(supply)-380.9(have)]TJ
T*
[(low)-476.6(levels)-475.5(of)-474.5(prolactin)-479.1(and)-476.8(whether)-477.5(increasing)-481.1(pro-)]TJ
0 -1.1174 TD
[(lactin)-354.9(increases)-359.9(milk)-351.5(supply)-357.9(in)-347.9(women)-360.1(with)-351.1(both)-355.9(low)]TJ
0 -1.1116 TD
.0124 Tc
[(an)5.5(d)-414.9(n)-.2(o)5.5(r)-.2(mal)-415(p)5.5(rol)5.4(actin)-409.2(lev)5.5(e)-1.4(l)5.4(s)0(.)-411.5(I)-.2(n)-414.9(a)-1.4(d)5.5(d)-.2(i)5.4(t)-.3(i)5.4(on,)-411.5(th)5.5(er)5.6(e)-416.1(does)]TJ
T*
.013 Tc
[(no)6.1(t)-270.5(a)5(ppe)5(ar)-264.5(to)-270.3(b)6.1(e)-271.5(a)-265.7(d).4(i)6(r).4(ec)5(t)-270.5(c)5(orr)6.2(el)6(at)6(ion)-264.6(b).4(e)5(t).3(w)5.3(een)-264.6(ba)5(se)5(lin)6.1(e)]TJ
/F5 1 Tf
8.9663 0 0 8.9663 62.022 749.6502 Tm
0 Tc
(308)Tj
46.3849 0 TD
[(ABM)-336(PROTOCOL)]TJ
ET
endstream
endobj
39 0 obj
<>stream
hlSmPU~^vȧ0*_`6,
Hh9"٠e
#Za'b2&S90wΏsyJЪJ5lzYbMIaq9odܿ `
9?N1"D52RӑoqH 6{n7%)j:8$a(fk9ߒi,(ۍ&sѾB-Yrm<;K2&EupXLbv #`A$aZ#B 4A/TatuzW&KsFH;VT[7z٧ ) L>!y
DV ZC01+>]}y=%)t=Eg|XG⭪ONG5j|%z<]~i1p3M;
)Z9zHɾrhQ5՟O#
\`P=Ah*773_^.{R,
cpstW~~xz>.v^N\#)!wt/Q ^oK}ΰKKT|?ϤήH+qحdoK
,Ҙ:lv^FkIҷd"YאY㽚!YxO7EdP(QAX
0a(ƻ
m` O_Rп$.P@p)N[>0w9ϛ o8/QOAV1+S"grlm5p^^sD뺉kÇKXBjƂ%ʣڮ4ṼHt_%Sh#S&`qd-NX[mIV_j:?:_D/@#)E)LC
{pC4Xy7Mc0(F}O2&O%v_AaKcME:&lھQ Y0 1O_W# ȋ
endstream
endobj
42 0 obj
<>stream
0 0 0 rg
/GS1 gs
59.754 719.149 490.167 .28345 re
f
59.754 700.497 490.167 .22681 re
f
BT
/F7 1 Tf
9.845 0 0 9.845 211.9747 725.1588 Tm
0 Tc
0 Tw
(Table)Tj
/F8 1 Tf
3.0002 0 TD
(1.)Tj
/F7 1 Tf
1.2496 0 TD
[(Commonly)-334(Used)-332.7(Galactogogues)]TJ
/F4 1 Tf
-10.7685 -1.8715 TD
[(Domperidone)-6792.7(Fenugreek)-5629.2(Metoclopramide)-5046.7(Silymarin)]TJ
/F8 1 Tf
7.3837 0 0 6.5625 519.6471 711.099 Tm
(a)Tj
9.845 0 0 9.845 59.7543 688.025 Tm
(References)Tj
7.3837 0 0 6.5625 121.0393 692.3904 Tm
[(21,2427,)-8(2931,47,)-8(61)-6570.6(56,6266)-11828.9(20,)-9.2(26,3337,3941)-11(,45)-4946.3(6770)]TJ
9.845 0 0 9.845 59.7543 678.0471 Tm
(Chemical)Tj
.9962 -1.0078 TD
[(class)-335.4(or)]TJ
0 -1.0135 TD
(properties)Tj
5.2288 2.0213 TD
[(Dopamine)-334.9(antagonist)-3058.9(A)-330.1(commonly)-339.8(used)-333.2(spice;)]TJ
12.6803 -1.0078 TD
[(active)-338(constituents)-337.1(are)]TJ
0 -1.0135 TD
[(trigonelline,)-335.2(4-)]TJ
T*
[(hydroxyisoleucine,)-335(and)]TJ
0 -1.0077 TD
(sotolon.)Tj
10.6936 4.0425 TD
[(Dopamine)-340.7(antagonist)-1838.1(Flavolignans)-313.8(\(presumed)]TJ
11.4653 -1.0078 TD
[(active)-338(ingredient\))]TJ
-41.0642 -4.0483 TD
[(Level)-336.9(of)]TJ
.9962 -1.0135 TD
(evidence)Tj
5.2288 1.0135 TD
[(Five)-333.4(Level)-336.9(1B)-337(studies;)]TJ
.9905 -1.0135 TD
[(others)-335.4(have)-334.5(inadequate)]TJ
T*
[(methodology)-336(or)-336(exces-)]TJ
0 -1.0077 TD
[(sive)-339.1(dropout)-329.6(rates)]TJ
10.6994 3.0348 TD
[(llA-llB)-331.9(\(three)-336.7(studies)-336.3(in)]TJ
.9905 -1.0135 TD
[(lactating)-335.6(women\))-337.3(most)]TJ
T*
[(not)-331.4(of)-336(high)-332.4(quality;)]TJ
0 -1.0077 TD
[(mixed)-335.7(results)]TJ
10.6936 3.0348 TD
[(lB-llB)-336.7(high-quality)-336.2(and)]TJ
.9962 -1.0135 TD
[(low-quality)-336.1(studies)]TJ
T*
[(give)-333.6(mixed)-335.7(results;)]TJ
0 -1.0077 TD
[(effect)-337.9(on)-330.2(overall)-337.9(rate)]TJ
0 -1.0135 TD
[(of)-330.2(milk)-333.7(secretion)-340.8(is)]TJ
T*
[(unclear,)-336.5(but)-331.4(may)-333.5(be)]TJ
T*
(effective)Tj
9.4786 6.0753 TD
[(llB)-338.3(\(one)-333.4(study)-333.2(in)-330.4(lac-)]TJ
.9905 -1.0135 TD
[(tating)-335.9(women\))]TJ
-41.0642 -6.0695 TD
(Suggested)Tj
.9962 -1.0135 TD
(dosage)Tj
5.2288 1.0135 TD
[(10)-169(mg,)-329(orally,)-339.1(3)-329.2(times)-335.7(per)]TJ
.9905 -1.0135 TD
[(day)-338.1(used)-333.2(in)-330.4(most)-339.1(of)-330.2(the)]TJ
T*
[(Level)-336.9(IB)-337(studies;)-331.8(one)]TJ
T*
[(Level)-336.9(1B)-337(study)-333.2(com-)]TJ
0 -1.0077 TD
[(pared)-329.8(10)-169(mg)-325.6(3)-323.5(times)-329.9(per)]TJ
0 -1.0135 TD
[(day)-338.1(with)-333.4(20)-163.2(mg)-337.1(3)-329.2(times)]TJ
T*
[(per)-332.4(day)-326.6(and)-332.4(found)-327.4(high-)]TJ
0 -1.0077 TD
[(er)-268.1(milk)-270.4(production)-270.5(using)]TJ
0 -1.0135 TD
[(the)-338.3(higher)-335.5(dose.)-330.8(Doses)]TJ
/F9 1 Tf
T*
(>)Tj
/F8 1 Tf
.5528 0 TD
[(60)-169(mg)-256.5(per)-257.5(day)-263.3(have)-259.7(not)]TJ
-.5528 -1.0135 TD
[(been)-334.5(studied)-336.5(in)-336.2(this)]TJ
0 -1.0077 TD
(context.)Tj
10.6994 11.1313 TD
[(Herbal)-320.2(tea)-328(\(200)-165.2(ml)-320(3)-323.5(times)]TJ
.9905 -1.0135 TD
[(per)-332.4(day\);)-334.5(570600)-168.2(mg)-331.4(3)]TJ
T*
[(times)-335.7(per)-332.4(day.)]TJ
10.6936 2.027 TD
[(10)-169(mg,)-334.8(orally,)-333.3(3)-335(t)0(o)-330.4(4)]TJ
.9962 -1.0135 TD
[(times)-335.7(per)-332.4(day)]TJ
9.4786 1.0135 TD
[(Micronized)-337.1(silymarin,)]TJ
.9905 -1.0135 TD
[(420)-170(mg,)-334.8(orally,)-333.3(per)]TJ
T*
[(day)-338.1(in)-330.4(the)-338.3(study)-333.2(by)]TJ
T*
[(Di)-337(Pierro)-335.4(et)-331.6(al.)]TJ
7.3837 0 0 6.5625 524.6361 532.0062 Tm
(67)Tj
9.845 0 0 9.845 532.0629 528.6046 Tm
(;)Tj
-6.9103 -1.0077 TD
(silymarin-)Tj
0 -1.0135 TD
(phosphatidylserine)Tj
T*
[(and)-338.1(galega)-337.9(\(5)-163.2(g)-335(per)]TJ
0 -1.0077 TD
[(day\);)-340.3(anecdotal,)]TJ
0 -1.0135 TD
[(strained)-338.7(tea)-333.7(\(simmer)]TJ
T*
[(1)-237.1(tsp)-239.1(of)-232.3(crushed)-239.4(seeds)]TJ
T*
[(in)-336.2(8)-335(o)0(z)-331.4(o)0(f)-336(water)-336.5(for)]TJ
0 -1.0077 TD
[(10)-336(minutes\),)-336.3(23)]TJ
0 -1.0135 TD
[(cups)-339(per)-332.4(day)]TJ
7.3837 0 0 6.5625 515.5652 443.3385 Tm
(71)Tj
9.845 0 0 9.845 59.7543 428.9951 Tm
(Length/dura-)Tj
.9962 -1.0135 TD
[(tion)-332.5(of)]TJ
0 -1.0077 TD
(therapy)Tj
5.2288 2.0212 TD
[(Various)-337.2(commencement)]TJ
.9905 -1.0135 TD
[(times)-237.8(from)-241.2(2)-231.3(days)-241.1(to)-238.3(3)-231.3(t)0(o)]TJ
0 -1.0077 TD
[(4)-335(weeks)-336.2(postpartum)-334.9(in)]TJ
0 -1.0135 TD
[(Level)-336.9(1B)-337(studies.)-334(Dura-)]TJ
T*
[(tion)-338.3(of)-330.2(therapy)-337.7(between)]TJ
0 -1.0078 TD
[(7)-335(and)-332.4(28)-336(days.)-336.6(Maxi-)]TJ
0 -1.0135 TD
[(mum)-333.5(effect)-337.9(usually)]TJ
T*
[(reached)-339.9(by)-330.2(714)-338(days.)]TJ
10.6994 7.083 TD
[(13)-331.2(weeks)-7355.8(714)-338(days)-333.2(in)-330.4(various)]TJ
12.6803 -1.0135 TD
(studies)Tj
9.4786 1.0135 TD
[(Micronized)-337.1(silymarin)]TJ
.9905 -1.0135 TD
[(was)-338.8(studied)-336.5(for)]TJ
0 -1.0077 TD
[(63)-336(days;)-334.4(silymarin-)]TJ
0 -1.0135 TD
(phosphatidylserine)Tj
T*
[(and)-292.1(galega)-291.8(were)-295.1(used)]TJ
0 -1.0078 TD
[(for)-337(28)-330.2(days)]TJ
-41.0642 -3.0405 TD
[(Herbal)-337.5(con-)]TJ
.9962 -1.0077 TD
(siderations)Tj
10.1926 1.0077 TD
[()-5726(Need)-335.4(reliable)-334.4(source)-336.3(of)]TJ
7.7164 -1.0077 TD
[(standard)-338.5(preparation)]TJ
0 -1.0135 TD
[(without)-336.5(contaminants)]TJ
15.0528 2.0212 TD
[()-5115.6(Need)-335.4(reliable)-340.2(source)-336.4(of)]TJ
7.106 -1.0077 TD
[(standard)-338.5(preparation)]TJ
0 -1.0135 TD
[(without)-313.5(contaminants)]TJ
-41.0642 -1.0135 TD
[(Effects)-338.7(on)]TJ
.9962 -1.0135 TD
(lactation)Tj
5.2288 1.0135 TD
[(Increased)-335.9(rate)-340.5(of)-330.2(milk)-333.7(se-)]TJ
.9905 -1.0135 TD
[(cretion)-337.9(in)-336.2(both)-332.4(pump-)]TJ
0 -1.0077 TD
[(dependent)-340.8(mothers)-331.7(of)]TJ
0 -1.0135 TD
[(preterm)-338.9(infants)-336.5(and)]TJ
T*
[(other)-334.5(mothers)-337.5(with)-333.4(low)]TJ
0 -1.0077 TD
[(milk)-333.7(supply.)]TJ
10.6994 5.056 TD
[(Insufcient)-335.7(evidence;)]TJ
.9905 -1.0135 TD
[(likely)-335.9(a)-330.4(signicant)-340.7(pla-)]TJ
0 -1.0077 TD
[(cebo)-334.5(effect)]TJ
10.6936 2.0212 TD
[(Possible)-337.2(increased)-336.1(rate)]TJ
.9962 -1.0135 TD
[(of)-330.2(milk)-333.7(secretion;)]TJ
0 -1.0077 TD
[(possible)-331.6(responders)]TJ
0 -1.0135 TD
[(versus)-335(nonresponders)]TJ
9.4786 3.0347 TD
[(Inconclusive.)-341.4(Possible)]TJ
.9905 -1.0135 TD
[(increase)-340.9(in)-330.4(milk)-339.5(se-)]TJ
0 -1.0077 TD
[(cretion)-337.9(in)-336.2(the)-332.6(short)]TJ
0 -1.0135 TD
(term)Tj
-41.0642 -3.0348 TD
[(Potential)-282.4(side)]TJ
.9962 -1.0135 TD
(effects)Tj
5.2288 1.0135 TD
[(Maternal:)-336.2(Dry)-337.8(mouth,)]TJ
.9905 -1.0135 TD
[(headache)-342(\(resolved)-333.7(with)]TJ
T*
[(decreased)-342.8(dosage\),)-334.9(and)]TJ
0 -1.0077 TD
[(abdominal)-335.2(cramps.)-340.9(One)]TJ
0 -1.0135 TD
[(case)-335.5(reported)-338.7(of)-336(psy-)]TJ
T*
[(chomotor)-338.7(withdrawal)]TJ
T*
[(symptoms)-338.3(from)-333.4(a)-330.4(dose)]TJ
0 -1.0077 TD
[(of)-336(160)-164.2(mg)-337.1(per)-332.4(day.)]TJ
7.3837 0 0 6.5625 207.2125 194.2866 Tm
(72)Tj
9.845 0 0 9.845 121.0393 179.9432 Tm
[(Although)-337.3(not)-331.4(reported)-332.9(in)]TJ
.9905 -1.0135 TD
[(studies)-336.3(of)-336(lactation,)-333.2(rare)]TJ
T*
[(complications)-340.5(\(1.3/)]TJ
0 -1.0077 TD
[(10,000)-336.6(postpartum)]TJ
0 -1.0135 TD
[(women\))-337.3(of)-336(cardiac)-334.3(ar-)]TJ
T*
[(rhythmias)-339.7(due)-332.4(to)-330.4(a)-336.2(pro-)]TJ
0 -1.0077 TD
[(longed)-335.5(QTc)-334.4(interval)]TJ
0 -1.0135 TD
[(have)-334.5(been)-340.3(reported,)-330.5(but)]TJ
T*
[(all)-338.5(these)-335.5(women)-330.6(had)-338.1(a)]TJ
T*
[(past)-339.1(history)-329.6(of)-336(ventricu-)]TJ
0 -1.0077 TD
[(lar)-338.3(arrhythmias.)]TJ
7.3837 0 0 6.5625 194.1732 84.6992 Tm
(31)Tj
9.845 0 0 9.845 204.8881 80.3339 Tm
(Risk)Tj
3.173 18.2143 TD
[(Generally)-336.1(well)-334.5(tolerated.)]TJ
.9905 -1.0135 TD
[(Diarrhea)-334.9(\(most)-334.4(com-)]TJ
T*
[(mon\),)-331(unusual)-336.3(body)]TJ
0 -1.0077 TD
[(odor)-332.2(similar)-337.9(to)-330.4(maple)]TJ
0 -1.0135 TD
[(syrup,)-255.8(cross-allergy)-258.3(with)]TJ
T*
(Asteraceae/Compositae)Tj
T*
[(family)-336.9(\(ragweed)-334.7(and)-332.4(re-)]TJ
0 -1.0077 TD
[(lated)-335.9(plants\),)-334.1(peanuts,)]TJ
0 -1.0135 TD
[(and)-332.4(Fabaceae)-343(family)]TJ
T*
[(such)-333.2(as)-337(chickpeas,)-333.7(soy-)]TJ
T*
[(beans,)-315.7(and)-320.9(green)-318.3(peas)]TJ
0 -1.0077 TD
[(possible)-337.3(anaphylaxis.)]TJ
0 -1.0135 TD
[(Theoretically,)-339.5(asthma,)]TJ
T*
[(bleeding,)-336.5(dizziness,)-338.3(at-)]TJ
0 -1.0077 TD
[(ulence,)-335.5(hypoglycemia,)]TJ
0 -1.0135 TD
[(loss)-332(of)-336(consciousness,)]TJ
T*
[(skin)-332.2(rash,)-336.6(or)-336(wheez-)]TJ
T*
[(ingbut)-336.5(no)-330.2(reports)-336.3(in)]TJ
0 -1.0077 TD
[(lactating)-335.6(women.)]TJ
10.6936 18.2143 TD
[(Reversible)-342.8(CNS)-332.8(effects)]TJ
.9962 -1.0135 TD
[(with)-333.4(short-term)-334.9(use,)]TJ
T*
[(including)-333.1(sedation,)]TJ
0 -1.0077 TD
[(anxiety,)-335.5(depression/)]TJ
0 -1.0135 TD
[(agitation,)-332(motor)-334.5(rest-)]TJ
T*
[(lessness,)-335.6(dystonic)-331.7(re-)]TJ
T*
[(actions,)-335.3(and)]TJ
0 -1.0077 TD
(extrapyramidal)Tj
0 -1.0135 TD
[(symptoms.)-330.2(Rare)-341.3(re-)]TJ
T*
[(ports)-333.2(of)-330.2(tardive)-337.9(dys-)]TJ
T*
[(kinesia)-331.9(\(usually)]TJ
0 -1.0077 TD
[(irreversible\),)-336.8(causing)]TJ
0 -1.0135 TD
[(the)-332.6(FDA)-332.7(to)-336.2(place)-336.9(a)]TJ
T*
[(black)-255.1(box)-256.3(warning)-256.7(on)]TJ
0 -1.0077 TD
[(this)-332.4(drug)-332.2(in)-336.2(the)-332.6(Uni-)]TJ
0 -1.0135 TD
[(ted)-332.6(States.)]TJ
9.4786 15.1795 TD
[(Generally)-341.8(well)-334.5(tolerat-)]TJ
.9905 -1.0135 TD
[(ed;)-338.3(occasional)-337.2(mild)]TJ
T*
[(gastrointestinal)-342.5(side)]TJ
0 -1.0077 TD
[(effect;)-339(cross-allergy)]TJ
0 -1.0135 TD
[(with)-339.1(Asteraceae/)]TJ
T*
[(Compositae)-337.1(family)]TJ
T*
[(\(ragweed)-340.5(and)-332.4(related)]TJ
0 -1.0077 TD
(plants\)possible)Tj
0 -1.0135 TD
(anaphylaxis)Tj
4.1001 -11.8396 TD
(\()Tj
/F4 1 Tf
.334 0 TD
(continued)Tj
/F8 1 Tf
3.9561 0 TD
(\))Tj
/F5 1 Tf
8.9663 0 0 8.9663 59.7543 749.7069 Tm
[(ABM)-336(PROTOCOL)]TJ
53.0113 0 TD
(309)Tj
ET
endstream
endobj
47 0 obj
<>stream
/GS1 gs
BT
/F8 1 Tf
9.843 0 0 9.843 84.1889 155.3385 Tm
0 0 0 rg
.0131 Tc
0 Tw
[(p)6.2(rol)6.1(ac)5.1(ti)6.1(n)-396.9(l)6.1(ev)6.2(el)6.1(s)-396.7(a)5.1(nd)-391.2(r)6.3(a)-.7(t)6.1(e)-.7(s)-391(o).5(f)-391.1(m)5(il)6.1(k)-396.9(s)6.4(yn)6.2(the)5.1(s).7(i)6.1(s)-396.7(o)6.2(r)-391.1(me)5.1(a-)]TJ
0 -1.1116 TD
.0117 Tc
[(s)5(ured)-335(v)4.8(ol)4.7(umes)-334.8(o)4.8(f)-334.9(mil)4.7(k)-335(p)4.8(r)-.9(o)4.8(ducti)4.7(on)4.8(.)]TJ
-1.2499 -1.1174 TD
0 Tc
[(2.)-499.9(Potential)-271.8(side)-264.7(effects)-276(\(minor)-267.1(and)-269.4(signicant\))-273.6(should)-265.7(be)]TJ
1.2499 -1.1116 TD
[(weighed)-333.6(carefully)-341.9(against)-332.6(any)-338.5(potential)-335.3(benet.)]TJ
-1.2499 -1.1116 TD
[(3.)-499.9(Prescription)-436(medications)-431.7(used)-431.6(as)-435.1(galactogogues)-433.8(con-)]TJ
1.2499 -1.1116 TD
[(stitute)-475.7(off-label)-484.7(use)-476.6(in)-474.6(most)-477.9(countries)-478.8(\(they)-479.1(are)-477.9(not)]TJ
0 -1.1174 TD
[(approved)-420(by)-416.9(regulatory)-422.5(agencies)-422.3(for)-417.9(this)-419.2(indication\).)]TJ
0 -1.1116 TD
[(Domperidone)-385.3(is)-388(not)-383.6(approved)-385.5(by)-382.3(the)-384.7(Food)-384.4(and)-384.6(Drug)]TJ
T*
[(Administration)-491.4(\(FDA\))-490.8(for)-492.8(use)-488.1(in)-491.9(the)-488.4(United)-492.7(States,)]TJ
0 -1.1174 TD
[(except)-321.3(for)-325.8(some)-323.4(specic)-322(circumstances.)-329.9(The)-322.4(FDA)-321.7(has)]TJ
25.504 10.0219 TD
[(explicitly)-451.7(recommended)-456.9(against)-453.6(the)-448.1(use)-453.5(of)-445.7(Domper-)]TJ
0 -1.1116 TD
[(idone)-335.1(to)-336.4(increase)-335.9(milk)-334.2(production.)]TJ
7.3823 0 0 6.5614 473.7825 148.7621 Tm
(47,48)Tj
/F5 1 Tf
8.9663 0 0 8.9663 313.0582 116.8441 Tm
[(Herbals,)-339.3(Foods,)-334(and)-331.9(Beverages)-339.2(as)-331.3(Galactogogues)]TJ
/F8 1 Tf
9.843 0 0 9.843 323.0361 100.4031 Tm
[(In)-342(non-Western)-344.9(cultures,)-342.9(postpartum)-341.7(women)-342.8(are)-339.7(assisted)]TJ
-1.0137 -1.1116 TD
[(in)-255.8(a)-249.9(number)-256.6(of)-249.8(ways)-253.9(that)-253.5(are)-253.3(intended)-253.3(to)-255.8(ease)-255.4(their)-254.6(transition)]TJ
0 -1.1174 TD
[(to)-250(motherhood)-255.4(and)-252.1(to)-250(optimize)-248.9(breastfeeding.)-258.6(Many)-248.4(cultures)]TJ
0 -1.1116 TD
[(keep)-329.3(new)-327.9(mothers)-326.8(very)-328.1(warm)-330.2(and)-327(insist)-323.4(on)-330.5(a)-324.8(period)-324.6(of)-330.5(rest)]TJ
T*
(of)Tj
/F11 1 Tf
1.054 0 TD
(*)Tj
/F8 1 Tf
.9964 0 TD
[(1)-220(month.)-217.7(Many)-213.8(also)-218.6(have)-219.8(traditional)-222.4(foods)-218.4(and)-217.6(herbs)-213.8(for)]TJ
ET
62.022 213.052 490.167 .28348 re
f
62.022 719.036 490.167 .22681 re
f
62.022 700.101 490.167 .22681 re
f
BT
/F7 1 Tf
9.845 0 0 9.845 258.8031 724.762 Tm
(Table)Tj
/F8 1 Tf
3.0002 0 TD
[(1.)-499.6(\()]TJ
/F7 1 Tf
1.5836 0 TD
(Continued)Tj
/F8 1 Tf
4.8948 0 TD
(\))Tj
/F4 1 Tf
-20.5292 -1.8715 TD
[(Domperidone)-6798.4(Fenugreek)-5623.4(Metoclopramide)-5052.5(Silymarin)]TJ
/F8 1 Tf
7.3837 0 0 6.5625 521.9148 710.7022 Tm
(a)Tj
9.845 0 0 9.845 133.0582 687.6282 Tm
[(may)-333.5(increase)-340.8(with)-333.4(a)]TJ
0 -1.0078 TD
[(previous)-337.3(history)-329.6(of)-336(car-)]TJ
0 -1.0135 TD
[(diac)-334.7(arrhythmias,)-334.7(high)]TJ
T*
[(doses,)-337.4(high)-332.4(BMI,)-330.6(or)]TJ
T*
[(concurrent)-336.1(use)-338(of)-330.2(drugs)]TJ
0 -1.0078 TD
[(that)-333.7(inhibit)-335.9(domperi-)]TJ
0 -1.0135 TD
[(dones)-335.2(metabolism)-337.4(\(see)]TJ
T*
[(Interactions,)-335.8(immedi-)]TJ
0 -1.0077 TD
[(ately)-335.9(below\).)-334(Neonatal:)]TJ
0 -1.0135 TD
[(Very)-334.2(low)-338(levels)-330.9(in)-336.2(milk)]TJ
T*
[(and)-332.4(no)-336(QTc)-334.4(prolonga-)]TJ
T*
[(tion)-263.4(in)-267.1(premature)-267.1(infants)]TJ
0 -1.0077 TD
[(who)-332(had)-338.1(ingested)-332.9(breast)]TJ
0 -1.0135 TD
[(milk)-333.7(of)-336(mothers)-331.7(on)]TJ
T*
(domperidone.)Tj
7.3837 0 0 6.5625 187.5968 552.529 Tm
(73)Tj
9.845 0 0 9.845 123.307 538.1857 Tm
[(In)-330.2(the)-338.3(United)-336.5(States,)-334.1(the)]TJ
.9905 -1.0077 TD
[(FDA)-332.7(has)-338(issued)-335.2(an)-331.4(ad-)]TJ
0 -1.0135 TD
[(visory)-299.6(against)-303.1(the)-298(use)-303.4(of)]TJ
T*
[(domperidone)-337(in)-330.4(lactat-)]TJ
0 -1.0077 TD
[(ing)-331.4(women.)]TJ
7.3837 0 0 6.5625 180.4535 502.7526 Tm
(47)Tj
9.845 0 0 9.845 62.022 488.4093 Tm
[(Interactions)-1489.9(Increased)-335.9(blood)-333.4(levels)-336.7(of)]TJ
7.2155 -1.0135 TD
[(domperidone)-337(when)]TJ
T*
[(combined)-334.1(with)-333.4(some)]TJ
0 -1.0077 TD
[(substrates)-334.6(metabolized)]TJ
0 -1.0135 TD
[(by)-336(CYP3A4)-330.9(enzyme)-338.9(in-)]TJ
T*
[(hibitors,)-334.1(for)-337(example,)]TJ
T*
[(uconazole,)-334.7(macrolide)]TJ
0 -1.0077 TD
[(antibiotics,)-334(grapefruit)]TJ
0 -1.0135 TD
[(juice,)-333.5(cannabinoids,)-341.4(an-)]TJ
T*
[(tipsychotics,)-334.7(and)-338.1(others)]TJ
10.6994 9.11 TD
[(Hawthorne,)-333.2(hypoglyce-)]TJ
.9905 -1.0135 TD
[(mics,)-332.2(including)-338.8(insulin,)]TJ
T*
[(antiplatelet)-334.3(drugs,)-336.4(aspi-)]TJ
0 -1.0077 TD
[(rin,)-334.8(heparin,)-335.3(warfarin,)]TJ
0 -1.0135 TD
[(feverfew,)-338.1(primrose)-332.7(oil,)]TJ
T*
[(and)-332.4(many)-334.5(other)-334.5(herbals)]TJ
10.6936 5.0618 TD
[(Monoamine)-335.9(oxidase)-337.5(in-)]TJ
.9905 -1.0135 TD
[(hibitors,)-334.1(tacrolimus,)]TJ
T*
[(antihistamines,)-339.2(any)]TJ
0 -1.0077 TD
[(drugs)-338.8(with)-333.4(CNS)-332.9(ef-)]TJ
0 -1.0135 TD
[(fects)-335.5(\(including)-339.8(anti-)]TJ
T*
(depressants\))Tj
9.4843 5.0618 TD
[(Caution)-337.7(with)-333.4(CYP2C9)]TJ
.9905 -1.0135 TD
[(substratesmay)-341.8(in-)]TJ
T*
[(crease)-338.7(levels)-336.7(of)-330.2(the)]TJ
0 -1.0077 TD
[(drugs.)-336.4(Possible)-331.4(in-)]TJ
0 -1.0135 TD
[(creased)-339.7(clearance)-338.6(of)]TJ
T*
[(estrogens)-339.3(\(decreased)]TJ
T*
[(blood)-333.4(levels\).)-335.3(Possi-)]TJ
0 -1.0077 TD
[(ble)-338.3(increased)-336.1(levels)]TJ
0 -1.0135 TD
[(of)-336(statins.)]TJ
-41.0642 -2.027 TD
[(Comments)-1883.9(a.)-276.2(Do)-273.5(not)-273.8(advise)-273.2(exceeding)]TJ
7.2155 -1.0077 TD
[(maximum)-334.2(recom-)]TJ
0 -1.0135 TD
[(mended)-337.7(dosage.)]TJ
-.9905 -1.0135 TD
[(b.)-332.6(Generally)-336.1(licensed)-339.8(for)]TJ
.9905 -1.0077 TD
[(use)-332.2(as)-337(a)-336.2(drug)-332.2(for)-331.2(gas-)]TJ
0 -1.0135 TD
[(trointestinal)-338.6(dismotility)]TJ
T*
[(where)-336.4(doses)-334(of)-336(20)-163.2(mg)-337.1(3)]TJ
T*
[(or)-336(4)-329.2(times)-335.7(per)-338.1(day)-332.4(may)]TJ
0 -1.0077 TD
[(be)-337.1(recommended)-334.6(if)-336.2(no)]TJ
0 -1.0135 TD
[(response)-303.6(to)-301.6(lower)-306.6(doses.)]TJ
T*
[(Some)-248(areas)-244.4(use)-245.8(this)-246(dose)]TJ
T*
[(initially)-333.6(to)-336.2(stimulate)]TJ
0 -1.0077 TD
[(prolactin.)-337.6(However,)]TJ
0 -1.0135 TD
[(there)-335.7(is)-336(only)-332.4(one)-332.4(study)]TJ
T*
[(using)-333.2(this)-332.4(dose)-339(in)-330.4(lac-)]TJ
0 -1.0077 TD
[(tating)-335.9(women.)]TJ
-.9905 -1.0135 TD
[(c.)-258.9(Tapering)-265(of)-261.1(dose)-264.1(usually)]TJ
.9905 -1.0135 TD
(recommended.)Tj
10.6994 17.2008 TD
[(If)-330.2(patient)-338(develops)-332.7(diar-)]TJ
.9905 -1.0077 TD
[(rhea,)-332.2(reducing)-338.7(the)-332.6(dose)]TJ
0 -1.0135 TD
[(is)-330.2(often)-334.5(helpful.)]TJ
10.6936 2.0212 TD
[(Some)-334.4(studies)-336.3(suggest)]TJ
.9905 -1.0077 TD
[(tapering)-338.9(off)-331.2(the)-338.3(dose)]TJ
0 -1.0135 TD
[(at)-337.3(the)-332.6(end)-338.1(of)-330.2(treat-)]TJ
T*
(ment.)Tj
9.4843 3.0348 TD
[(No)-331(prescription)-337.1(re-)]TJ
.9905 -1.0077 TD
(quired)Tj
6.5633 0 0 5.8334 70.0157 205.1716 Tm
(a)Tj
8.7511 0 0 8.7511 72.9637 201.2598 Tm
[(Silymarin)-332.7(\(micronized)-332.7(silymarin\))-328.7(or)]TJ
/F4 1 Tf
15.0881 0 TD
[(Silybum)-336.1(marianum)]TJ
/F8 1 Tf
8.0008 0 TD
[(\(milk)-331.1(thistle\).)]TJ
-23.4258 -1.0236 TD
[(CNS,)-334.1(central)-334.8(nervous)-326.9(system;)-334.7(CYP,)-334.1(cytochrome)]TJ
/F4 1 Tf
20.07 0 TD
(c)Tj
/F8 1 Tf
.447 0 TD
[(;)-334.4(FDA,)-327.4(Food)-332(and)-334.6(Drug)-333(Administration.)]TJ
/F5 1 Tf
8.9663 0 0 8.9663 62.022 749.6502 Tm
(310)Tj
46.3849 0 TD
[(ABM)-336(PROTOCOL)]TJ
ET
endstream
endobj
52 0 obj
<>stream
/GS1 gs
BT
/F8 1 Tf
9.843 0 0 9.843 59.7543 725.1588 Tm
0 0 0 rg
0 Tc
0 Tw
[(postpartum)-353.3(women)-348.6(that)-345.6(are)-345.4(meant)-349(to)-347.9(increase)-353.2(the)-344.4(mothers)]TJ
0 -1.1174 TD
[(strength)-286.5(and)-280.9(enhance)-283.1(lactation.)]TJ
7.3823 0 0 6.5614 183.118 718.5825 Tm
(4952)Tj
9.843 0 0 9.843 201.5999 714.1605 Tm
(\(lV\))Tj
-13.3971 -1.1116 TD
-.0215 Tc
[(Ma)-6.5(ny)-350.9(o)-5.3(f)-350.9(t)-5.4(h).4(es)-5.1(e)-352.1(h).4(e)-6.5(r).5(ba)-6.5(l)-351(r).5(e)-6.5(m)-.8(ed)-5.3(ies)-356.5(h).4(av)-5.3(e)-352.1(b).4(e)-6.5(e)-.7(n)-350.9(u)-5.3(sed)-356.7(t).3(hr)-5.3(ou)-5.3(gho)-5.3(ut)]TJ
-1.0137 -1.1116 TD
[(h)-5.3(i).3(s)-5.1(t).3(or)-5.3(y)-350.9(t).3(o)-356.7(e)-.7(nh)-5.3(anc)-6.5(e)-352.1(mi)-5.4(lk)-350.9(s)-5.1(u).4(p)-5.3(p).4(ly)-5.3(.)-353.2(S).6(ome)-357.8(h).4(er)-5.3(bs)-356.5(com)-6.5(m)-.8(onl)-5.5(y)-350.9(m)-.8(e)-6.5(n).4(-)]TJ
T*
-.0217 Tc
[(t)-5.6(i).1(on)-5.5(ed)-454.8(a)-6.7(s)-454.6(ga)-6.7(lac)-6.7(t).1(o)-5.5(gog)-5.5(ues)-460.3(i).1(nc)-6.7(lud)-5.5(e)-455.9(fe)-6.7(nug)-5.5(ree)-6.7(k).2(,)-457.1(g).2(o)-5.5(a)-.9(t)-5.5(s)-454.6(r)-5.5(ue,)-457.1(m)-1(i)-5.6(l).1(k)]TJ
0 -1.1174 TD
[(t)-5.7(h).1(is)-5.4(tl)-5.7(e)-392.7(\()]TJ
/F4 1 Tf
3.0238 0 TD
[(Si)-5.6(lyb)-5.5(u).2(m)-392.3(m)-.6(a)-5.5(r).4(i)-5.6(anu)-5.5(m)]TJ
/F8 1 Tf
7.4243 0 TD
-.0209 Tc
[(\),)-392.9(oa)-5.9(ts,)-392.9(d)1(a)-5.9(nde)-5.9(lion,)-392.9(millet,)-387.2(s)-4.5(eaw)-5.6(eed,)]TJ
-10.4481 -1.1116 TD
-.0215 Tc
[(a)-6.5(n).4(is)-5.1(e,)-192(b)-5.3(a)-.7(si)-5.4(l,)-192(bl)-5.4(es)-5.1(sed)-195.4(t).3(hi)-5.4(st)-5.4(le,)-192(f)-5.3(en)]TJ
11.5597 0 TD
-.0203 Tc
[(nel)-194.3(s)1.8(ee)-5.3(ds,)-190.8(m)-5.3(arshma)-5.3(llow,)-190.8(moringa)]TJ
-11.5597 -1.1116 TD
-.0215 Tc
[(l)-5.4(eaf)-5.3(,)-301.4(s)-5.1(hat)-5.4(a)-.7(va)-6.5(ri,)-307.2(a)-.7(nd)-304.8(t)-5.4(o).4(rb)-5.3(ang)-5.3(u).4(n)-304.8(a)-.7(mo)-5.3(ng)-304.8(ot)-5.4(her)-5.3(s).6(.)]TJ
7.3823 0 0 6.5614 230.1165 652.8187 Tm
-.0246 Tc
(22,53)Tj
9.843 0 0 9.843 245.7637 648.4534 Tm
-.0206 Tc
[(\(lA\))-303.9(La)-5.6(ctM)-5.3(e).2(d)]TJ
-18.8976 -1.1174 TD
-.0215 Tc
[(\()-5.3(h).4(t)-5.4(t).3(ps)-5.1(://)-5.4(to)-5.3(xne)-6.5(t.nl)-5.4(m.nih)-5.3(.)-1.9(gov)-5.3(/n)-5.3(ewt)-5.4(oxn)-5.3(et/)-5.4(l).3(ac)-6.5(tme)-6.5(d).4(.ht)-5.4(m)-.8(\))-299(h)-5.3(as)-304.6(fu)-5.3(rth)-5.3(e)-.7(r)]TJ
0 -1.1116 TD
.1963 Tc
[(i)212.4(n)218.2(f)212.5(o)218.2(r)218.3(m)217(a)211.3(t)218.1(i)212.4(o)218.2(na)217.1(b)218.2(o)212.5(u)218.2(t)-.8(t)218.1(h)218.2(ee)217.1(f)212.5(f)218.3(e)217.1(c)211.3(t)5(o)212.5(n)5.1(l)212.4(a)217.1(c)217.1(t)212.4(a)217.1(t)218.1(i)212.4(o)218.2(no)218.2(fs)218.4(o)212.5(m)217(eo)212.5(ft)218.1(h)218.2(e)211.3(s)218.4(e)-1.8(h)218.2(e)217.1(r)212.5(b)218.2(s)218.4(.)]TJ
T*
-.0216 Tc
[(A)-6.3(lth)-5.4(ou)-5.4(gh)-241.6(be)-6.6(er)-241.5(i)-5.5(s)-241.4(us)-5.2(ed)-241.6(i)-5.5(n)-241.6(so)-5.4(me)-242.7(cu)-5.4(ltu)-5.4(re)-6.6(s)-241.4(t).2(o)-241.6(i)-5.5(ncr)-5.4(e)-.8(a)-6.6(s).5(e)-242.7(m)-.9(i)-5.5(l).2(k)-241.6(s)-5.2(upp)-5.4(ly)-5.4(,)]TJ
0 -1.1174 TD
[(h)-5.4(ops)-293.2(a)-6.6(ppe)-6.6(ar)-293.4(to)-293.4(b)-5.4(e)-294.6(the)-294.6(a)-.8(c)-6.6(tiv)-5.4(e)-294.6(i).2(ng)-5.4(red)-5.4(i).2(e)-6.6(n).3(t,)-295.7(whi)-5.5(l).2(e)-294.6(a)-.8(l)-5.5(c)-.8(oh)-5.4(ol)-293.5(may)-293.4(a)-6.6(c-)]TJ
0 -1.1116 TD
-.0195 Tc
[(tually)-164.6(reduce)-165.7(milk)-158.8(production.)]TJ
7.3823 0 0 6.5614 171.5527 597.9967 Tm
-.0315 Tc
(54)Tj
9.843 0 0 9.843 178.5259 593.6313 Tm
-.0215 Tc
[(\(l)-5.4(A\))-166.6(A)-161.7(b).4(a)-6.5(r).5(le)-6.5(y)-160.8(c)-6.5(ompo)-5.3(nen)-5.3(t)-161(o)-5.3(f)-160.8(be)-6.5(er)]TJ
-12.0666 -1.1116 TD
-.0204 Tc
[(\(eve)-5.4(n)-205.8(n)1.5(onalcoholic)-207(b)1.5(e)-5.4(e).4(r\))-211.5(can)-211.6(also)-205.8(incre)-5.4(a).4(se)-212.7(prolac)-5.4(tin)-211.6(sec)-5.4(r)1.6(e)-5.4(tion.)]TJ
7.3823 0 0 6.5614 291.685 587.0549 Tm
-.0239 Tc
(55)Tj
9.843 0 0 9.843 69.7323 571.7479 Tm
0 Tc
[(While)-193.5(the)-194.7(fact)-196.9(that)-190.1(these)-197.8(herbs)-196.5(have)-191(been)-196.8(used)-189.7(for)-193.3(centu)-8(ries)]TJ
-1.0137 -1.1174 TD
[(without)-273.9(apparent)-271.6(harm)-271.7(is)-272.8(reassuring,)-269.9(there)-272.9(is)-272.8(also)-270.4(little)-273.4(or)-267.1(no)]TJ
0 -1.1116 TD
[(scientic)-439.7(evidence)-439.8(for)-441(their)-433.1(effectiveness)-446.2(or)-434.1(safety.)]TJ
7.3823 0 0 6.5614 271.8424 554.1731 Tm
(56)Tj
9.843 0 0 9.843 283.5212 549.8077 Tm
(The)Tj
-22.7336 -1.1116 TD
[(mechanisms)-431.4(of)-422.6(action)-423.9(for)-423.7(most)-426(herbals)-424.6(are)-426.1(unknown,)-421(and)]TJ
0 -1.1174 TD
[(available)-360.5(studies)-354.3(for)-354.6(herbs,)-361.2(herbal)-354.6(medicines,)-358(or)-353.5(herbal)-354.6(ga-)]TJ
0 -1.1116 TD
[(lactogogues)-297.9(suffer)-295.5(from)-293.5(the)-292.6(same)-295.7(deciencies)-300.1(as)-296.9(the)-292.6(studies)]TJ
T*
[(for)-233.6(pharmacologic)-239.3(agents:)-234.7(small)-238.4(numbers)-234.5(of)-232.6(subjects,)-239.1(lack)-231.5(of)]TJ
0 -1.1174 TD
[(information)-585(regarding)-576.8(breastfeeding)-583.4(advic)-8(e,)-575.9(and)-580.4(lack)-577.1(of)]TJ
0 -1.1116 TD
[(randomization,)-564.3(controls,)-560.6(or)-560.9(blinding.)-559.8(The)-558.6(placebo)-564.3(effect)]TJ
T*
[(when)-559.4(taking)-561(herbal)-562(preparations)-558.1(may)-558.6(be)-556.3(the)-563.3(reason)-555.9(for)]TJ
0 -1.1174 TD
[(widespread)-326.3(anecdotal)-320.1(experience)-322.2(of)-319(their)-317.9(effectiveness.)-322.9(Be-)]TJ
0 -1.1116 TD
[(cause)-365.9(of)-359.3(the)-355.9(limited)-362(data)-364(available,)-364(only)-355.9(two)-361.4(herbal)-360.4(prepa-)]TJ
T*
[(rations)-285.4(have)-283.2(been)-283.2(included)-282.1(in)-278.8(Table)-285.6(1.)]TJ
1.0137 -1.1116 TD
[(It)-238.4(is)-232.5(im)19.5(po)20.8(rt)20.7(a)15(n)0(t)-238.5(t)0(o)-238.5(n)0(o)26.6(t)0(e)-239.6(t)0(h)20.7(a)0(t)-233.9(c)0(a)18.5(u)0(t)20.7(i)0(o)26.5(n)-248.8(is)-238.3(re)19.7(q)16.2(u)0(i)20.7(r)0(e)19.7(d)-248.8(fo)20.9(r)-243(t)0(h)20.7(e)-249.9(us)21(e)-244.2(o)0(f)]TJ
-1.0137 -1.1174 TD
[(he)19.7(rb)20.9(al)-216.6(pr)20.9(ep)19.7(ar)19.7(at)25.3(io)20.7(ns)-220.9(be)19.7(c)15(a)0(u)19.7(s)0(e)-222(o)0(f)-215.3(t)0(h)20.7(e)-226.9(la)19.6(ck)-222.2(of)-215.3(st)20.9(an)19.7(da)19.7(r)16.2(d)0(i)20.7(z)0(e)18.5(d)-231.5(d)16.2(o)0(s)21(i)0(n)20.7(g)]TJ
0 -1.1116 TD
[(pr)20.9(ep)19.7(ar)19.7(at)25.3(io)20.7(ns)-405.2(\(o)26.6(th)20.7(er)-406.5(t)16.1(h)0(a)19.7(n)-415.8(i)16.1(n)-415.8(re)19.7(se)25.6(ar)19.7(ch)-400.8(se)19.9(tt)20.6(in)20.7(gs)21(\),)-401.9(p)16.2(o)0(s)21(s)0(i)20.9(b)0(l)20.7(e)-411.2(co)19.7(n-)]TJ
T*
[(ta)19.6(mi)19.5(na)25.4(nt)20.7(s,)-378.7(al)19.5(le)25.3(rg)20.9(ic)-377.9(po)20.8(te)19.6(nt)26.5(ia)19.6(l,)-379(an)25.4(d)-392.8(d)16.2(ru)20.9(g)-387(i)0(n)20.7(t)0(e)19.6(r)0(a)19.7(c)15(ti)20.6(on)20.8(s.)-378.7(Ad)25.7(ve)19.7(rs)21.1(e)]TJ
0 -1.1174 TD
[(ef)19.7(fe)19.7(ct)19.5(s)-173.7(f)0(o)20.9(r)-173.9(bo)20.8(th)-163.6(mo)25.4(th)20.7(er)-164.6(an)19.7(d)-173.9(i)0(n)20.7(f)0(a)19.7(n)0(t)-163.6(f)0(r)20.9(o)0(m)-158.9(s)0(e)19.9(v)0(e)19.7(r)0(a)19.7(l)-174(he)19.7(rb)20.9(s)-173.7(h)0(a)19.7(v)16.2(e)-180.8(b)16.2(ee)18.5(n)]TJ
0 -1.1116 TD
[(re)19.7(po)20.8(rt)20.7(ed)19.7(,)]TJ
7.3823 0 0 6.5614 94.1669 378.8219 Tm
-.0162 Tc
(56)Tj
9.843 0 0 9.843 101.3669 374.4566 Tm
0 Tc
[(\(l)26.5(V\))-262.2(an)19.7(d)-271.8(s)0(o)21(m)15(e)-273(w)0(i)19.8(l)0(l)-255.9(i)0(n)20.7(c)0(r)19.7(e)0(a)18.5(s)0(e)-256.6(p)0(a)19.7(t)0(i)20.6(e)0(n)19.7(t)-271.9(b)16.2(l)0(o)20.7(o)0(d)-261.4(l)0(e)19.6(v)0(e)25.4(l)0(s)-261.3(o)0(f)]TJ
-4.2276 -1.1116 TD
[(wa)18.8(rf)20.9(ar)19.7(in)20.7(,)-274.1(h)0(e)25.4(p)0(a)19.7(r)0(i)20.7(n)0(,)-263.7(a)0(n)19.7(d)-271.8(ot)20.7(he)19.7(r)-277.5(a)15(nt)20.7(ic)19.6(oa)19.7(gu)20.8(l)16.1(a)0(n)19.7(t)0(s)20.9(,)-274.1(wh)20(il)20.6(e)-273(o)0(t)20.7(h)0(e)19.7(r)0(s)-261.2(m)0(a)18.4(y)]TJ
0 -1.1174 TD
[(af)19.7(fe)19.7(ct)-349.1(i)16.1(n)0(s)21(u)0(l)20.7(i)0(n)-347.9(r)0(e)19.7(s)16.4(is)20.9(ta)19.5(nc)19.7(e)-359.4(a)15(nd)-347.8(bl)20.7(oo)20.8(d)-352.4(s)0(u)21(g)0(a)19.7(r)0(s)21.1(.)-354.8(Th)19.6(er)19.7(e)-353.6(a)0(r)19.7(e)-359.4(se)19.9(v)16.2(e)0(r)19.7(a)0(l)]TJ
0 -1.1116 TD
[(re)19.7(po)20.8(rt)20.7(s)-173.7(o)0(f)-157.7(s)0(e)19.9(v)0(e)19.7(r)0(e)-164.6(m)15(at)19.5(er)19.7(na)19.7(l)-174(a)15(ll)20.6(er)19.7(gi)20.7(c)-175(r)0(e)25.5(a)0(c)18.5(t)0(i)20.6(o)0(n)20.8(s)-173.7(t)16.1(o)-173.9(fe)19.7(nu)20.8(gr)20.9(ee)24.3(k.)]TJ
7.3823 0 0 6.5614 277.285 345.9401 Tm
-.0162 Tc
(57)Tj
9.843 0 0 9.843 284.4283 341.5747 Tm
0 Tc
[(\(l)20.7(ll)20.6(\))]TJ
/F5 1 Tf
8.9663 0 0 8.9663 59.7543 320.0881 Tm
[(Practice)-338.1(Recommendations)]TJ
/F8 1 Tf
9.843 0 0 9.843 69.7323 303.6472 Tm
[(The)-293.6(following)-293.4(recommendations,)-297.8(based)-289.9(upon)-292.4(current)-298.1(evi-)]TJ
-1.0137 -1.1116 TD
[(dence,)-323.5(apply)-317.8(to)-313.3(women)-319.8(experiencing)-323.4(difculties)-319.8(with)-316.6(a)-313.3(low)]TJ
0 -1.1174 TD
[(rate)-248.7(of)-249.8(milk)-247.8(production)-248.6(\(e.g.,)-250.9(the)-246.5(infant)-249.9(is)-244(not)-245.3(gaining)-251(weight)]TJ
0 -1.1116 TD
[(normally)-374.3(or)-370.8(supplementation)-372.9(is)-370.8(being)-369.7(used)-374(because)-375(of)-365(low)]TJ
T*
[(milk)-201.7(production)-196.7(during)-202.5(either)-199.2(the)-200.4(initiation)-197.3(or)-198(maintenance)-203.7(of)]TJ
0 -1.1174 TD
[(milk)-213.2(supply\).)-206.9(It)-209.6(is)-215.2(always)-211.3(important)-208.5(to)-209.7(ensure)-216.1(that)-207.4(low)-211.6(weight)]TJ
0 -1.1116 TD
[(gain)-264.9(is)-261.3(due)-263.7(to)-267.3(insufcient)-262.1(calories)-265.8(from)-264.7(low)-263.5(milk)-265.1(supply)-260(and)]TJ
T*
[(not)-279.9(other)-283.2(infant)-284.5(causes.)]TJ
1.0137 -1.1116 TD
[(Specic)-362.4(information)-360.4(about)-358.1(individual)-364(drugs)-356.6(and)-361.6(herbs)-357.8(is)]TJ
-1.0137 -1.1174 TD
[(summarized)-241.5(at)-239.6(the)-235(end)-240.6(of)-232.6(these)-238.2(recommendations)-242.5(in)-238.5(Table)-239.5(1.)]TJ
1.0022 -1.7222 TD
.0148 Tc
[(1)14.8(.)-485.1(Evalua)-4.7(te)-338.8(the)-333(m)1(other)-337.6(f)2.2(or)-331.8(m)-4.8(e)1(dica)-4.7(l)-332(c)-4.7(ause)-4.7(s)-331.7(o)-3.6(f)-331.8(l)-3.7(ow)-338.5(milk)]TJ
1.2499 -1.1116 TD
.0178 Tc
[(su)5.2(pp)5.2(ly)5.2(:)-415.4(p)5.2(regn)5.2(an)5.2(cy)5.2(,)-417.6(medi)5.1(c)]TJ
11.0068 0 TD
.0149 Tc
[(ations,)-414.7(p)-3.5(rimary)-418.2(m)1.1(a)-4.6(mma)-4.6(ry)]TJ
-11.0068 -1.1116 TD
-.0159 Tc
[(gla)-15.9(n)9.5(dula)-15.9(r)-330.3(insuf)-15.9()10.9(cien)-15.9(c)9.5(y).3(,)-336.1(b)-15.9(r)10.7(east)-339.7(s)-15.9(u)10.9(rge)-15.9(r)9.6(y).3(,)-341.9(polycy)-15.9(s)10.9(tic)-340.7(ov)-15.9(a)9.5(r).3(-)]TJ
T*
0 Tc
[(ian)-407.8(syndrom)-8.7(e,)-403.1(hypoth)-6.7(yroidi)-6.8(s)-6.7(m)0(,)-403.2(retain)-9.2(ed)-406.5(place)-9.1(nta,)-405.4(in-)]TJ
0 -1.1174 TD
[(gestio)-7.8(n)-323.6(o)0(f)-330.5(place)-9.1(nta)-327.1(capsul)-8.9(es,)-329.1(theca)-331.7(lutein)-336.5(cyst,)-331.5(loss)-326.7(of)]TJ
0 -1.1116 TD
[(prolac)-9(tin)-337.6(s)-6.7(ecreti)-10.3(on)-336.3(follow)-7.7(ing)-337.5(postpa)-7.7(rtum)-345.5(hemor)-7.9(rhage,)]TJ
T*
[(he)19.7(av)19.7(y)-369.7(s)0(m)19.8(o)0(k)20.8(i)0(n)20.7(g)-369.7(or)-353.5(al)19.5(co)19.7(ho)15.1(l)-364.1(u)0(s)21(e)0(,)-357(o)0(r)-359.3(o)0(t)20.7(h)0(e)19.7(r)-369.7(pe)19.7(rt)20.7(in)20.7(en)19.7(t)-369.8(c)0(o)19.7(n)0(-)]TJ
0 -1.1174 TD
[(di)20.7(ti)20.6(on)15.1(s.)-326.9(Tr)19.7(ea)18.5(t)-341(t)0(h)20.7(e)-342.1(co)19.7(nd)20.8(it)20.6(io)20.7(n)-340.9(a)0(s)-331.5(i)0(n)20.7(d)0(i)20.7(c)0(a)18.5(t)0(e)19.6(d)-340.9(if)-330.6(tr)20.7(ea)18.5(tm)19.5(en)19.7(t)-341(i)0(s)]TJ
0 -1.1116 TD
[(av)19.7(ai)19.5(la)19.5(bl)15(e.)]TJ
7.3823 0 0 6.5614 119.1685 104.7685 Tm
(58)Tj
9.843 0 0 9.843 129.6566 100.4031 Tm
[(Fo)21(r)-323.6(m)0(a)18.4(n)0(y)-313.2(o)0(f)-313.2(t)0(h)15(e)0(s)19.9(e)-324.8(wo)20(me)18.4(n,)-309.8(a)-324.8(g)0(a)13.9(l)0(a)19.6(c)0(t)19.5(o)0(g)20.8(o)0(g)20.8(u)0(e)]TJ
-4.8497 -1.1116 TD
[(sh)21(ou)20.8(ld)-313.4(no)15.1(t)-323.8(b)0(e)-314.4(r)0(e)19.7(c)0(o)19.7(m)0(m)18.4(e)0(n)19.7(d)0(e)19.7(d)-323.6(or)-313.2(pr)20.9(es)19.9(cr)19.7(ib)20.7(ed)13.9(.)]TJ
-1.2499 -1.1174 TD
[(2.)-499.9(Assess)-267.1(and)-263.7(increase)-266.8(the)-258(frequency)-266.8(and)-263.7(effectiveness)-267.6(of)]TJ
1.2499 -1.1116 TD
[(milk)-334.2(removal.)-337.3(Use)-339.2(nonpharmacologic)-340.5(measures)-341.4(to)-330.6(in-)]TJ
T*
[(crease)-460.3(the)-453.8(overall)-453.8(rate)-456.1(of)-451.4(breast)-458.1(milk)-455.1(synthesis.)-451.9(For)]TJ
25.504 67.9242 TD
[(women)-244.9(whose)-243.5(infants)-239.3(are)-241.7(not)-239.6(effective)-245.1(at)-239.6(milk)-242(removal)]TJ
0 -1.1174 TD
[(or)-457.2(are)-454.8(unable)-458.3(to)-451.6(feed)-456(at)-452.7(the)-453.8(breast)-458.1(\(e.g.,)-458.2(premature,)]TJ
0 -1.1116 TD
[(hospitalize)-10.2(d,)-620.8(hypotonic,)-625.3(and)-626.5(anatomical)-627.8(problems\),)]TJ
T*
[(regularly)-473.2(expressing)-473.8(by)-468.7(hand)-466.3(and/or)-474.4(breast)-469.6(pump)-466.4(is)]TJ
T*
[(necessary.)-466.8(Ensure)-458(that)-455.1(the)-459.6(expressing)-456.5(technique)-462.9(and)]TJ
0 -1.1174 TD
[(any)-459.5(breast)-458.1(pumps)-461.6(used)-454.6(are)-460.6(effective.)-461.7(Galactogogues)]TJ
0 -1.1116 TD
[(will)-310.9(not)-302.9(increase)-312.9(the)-304.1(milk)-305.4(supply)-306(if)-307.6(there)-307.4(is)-307.4(infrequent)]TJ
T*
[(or)-336.2(inadequate)-338.5(breast)-337.1(drainage.)]TJ
-1.2499 -1.1174 TD
[(3.)-499.9(Although)-741.4(there)-745.2(are)-742.8(more)-738.2(high-quality)-740.6(studies)-746(of)]TJ
1.2499 -1.1116 TD
[(domperidon)-7.8(e)-468.8(and)-471(some)-473.1(studies)-469.5(of)-474.5(herbal)-469.8(galactogo-)]TJ
T*
[(gues)-448.9(since)-451.3(the)-448.1(last)-449.1(revision)-447.7(of)-445.7(this)-448(protocol,)-445.6(current)]TJ
0 -1.1174 TD
[(resear)-9.8(ch)-452.6(of)-457.2(both)-459.6(pharmaceutical)-461.7(and)-459.5(herbal)-458.3(galacto-)]TJ
0 -1.1116 TD
[(gogues)-451.1(is)-451.4(still)-449.3(relatively)-447(inconclusiv)-8.9(e)-445.8(and)-448(all)-448.2(agents)]TJ
T*
[(have)-248.6(potential)-248.9(adverse)-252.9(effects.)-250.6(Therefore,)-248.3(ABM)-248(cannot)]TJ
T*
[(recommend)-338.4(any)-338.5(specic)-333.5(galactogogue)-340.7(at)-331.8(this)-338.5(time.)]TJ
-1.2499 -1.1174 TD
[(4.)-499.9(If)-411.1(the)-407.8(healthcare)-414.5(provider)-407.5(chooses)-412.8(to)-405.5(prescribe)-410.7(a)-411.2(ga-)]TJ
1.2499 -1.1116 TD
[(lactogogue)-469.8(after)-462.9(weighing)-466.1(potential)-462(risks)-466(versus)-462.4(po-)]TJ
T*
[(tential)-310.1(benets)-315.1(of)-307.4(these)-307.3(agents,)-311.8(they)-305.2(should)-311.8(follow)-307.2(the)]TJ
0 -1.1174 TD
[(guidelines)-341.8(below.)]TJ
7.3823 0 0 6.5614 403.4267 532.2329 Tm
[(56,59)-7.8(,60)]TJ
9.843 0 0 9.843 429.3353 527.8676 Tm
(\(lV\))Tj
-9.8376 -1.1116 TD
[(a.)-483.8(In)20.9(fo)20.9(rm)-395.1(wo)20(me)18.4(n)-404.3(a)0(b)19.7(o)0(u)20.8(t)-404.4(av)19.7(ai)19.6(la)19.6(bl)20.7(e)-405.4(d)0(a)19.7(t)0(a)-395.1(c)0(o)19.7(n)0(c)19.7(e)0(r)19.7(n)0(i)20.7(n)0(g)-393.9(e)0(f)19.7(-)]TJ
1.1807 -1.1116 TD
[(c)19.8(ac)18.5(y,)-499.9(ti)20.6(mi)19.5(ng)-497.5(of)-497.5(us)21(e,)-501(an)19.7(d)-507.9(d)0(u)20.8(r)0(a)19.7(t)0(i)14.8(o)0(n)-497.5(o)0(f)-497.5(t)0(h)20.7(e)0(r)19.7(a)0(p)19.7(y)-507.9(of)]TJ
0 -1.1174 TD
[(ga)19.7(la)19.5(ct)19.5(og)20.8(og)20.8(ue)19.7(s.)]TJ
-1.1807 -1.1116 TD
[(b.)-499.9(Inform)-624(women)-625.1(about)-623.1(available)-625.5(data)-623.2(concerning)]TJ
1.2499 -1.1116 TD
[(potential)-341.1(adverse)-333.5(effects)-339.4(of)-330.5(galactogogues.)]TJ
-1.2499 -1.1174 TD
[(c.)-501(Sc)19.8(re)14(en)-314.4(th)20.7(e)-330.6(m)0(o)19.6(t)0(h)20.7(e)0(r)-320.1(f)0(o)20.9(r)-329.4(co)19.7(nt)14.9(ra)19.7(in)20.7(di)20.7(ca)18.5(ti)20.6(on)20.8(s)-329.2(t)0(o)20.7(,)-331.7(al)19.6(le)19.6(rg)20.9(ie)19.6(s)]TJ
1.198 -1.1116 TD
[(to)20.7(,)-372(o)0(r)-365(d)0(r)20.9(u)0(g)-365.1(i)0(n)20.7(t)0(e)19.6(r)0(a)19.7(c)0(t)19.5(i)0(o)20.7(n)0(s)-364.9(w)0(i)19.8(t)0(h)-365.2(t)0(h)20.7(e)-370.9(ch)19.7(os)15.3(en)-360.5(me)18.4(di)20.7(ca)18.5(ti)20.6(on)]TJ
T*
[(or)-313.2(ot)20.7(he)13.9(r)-323.6(s)0(u)21(b)0(s)21(t)0(a)19.6(n)0(c)19.7(e)0(.)]TJ
-2.4018 -1.1116 TD
[(If)-336.2(prescribing)-337(domperidone:)]TJ
1.2038 -1.1174 TD
[(i.)-500(It)-382.4(is)-382.3(particularly)-385.8(important)-381.3(to)-382.5(screen)-384.2(mothers)-384.4(for)-377.6(a)]TJ
1.031 -1.1116 TD
[(past)-287.7(history)-290(of)-284.4(cardiac)-288.9(arrhythmias)-292.1(and)-280.9(conco)-7.8(mitant)]TJ
T*
[(use)-545.7(of)-543.6(medications)-552.7(such)-541(as)-550.3(uconazole,)-549(erythro-)]TJ
0 -1.1174 TD
[(mycin,)-334(and)-338.5(other)-335.1(macrolide)-337.4(antibiotics)-337.4(\(Table)-338.5(1\).)]TJ
-1.031 -1.1116 TD
[(ii.)-501.2(While)-654.3(no)-653(studie)-7.8(s)-651.7(have)-651.8(been)-657.6(undertaken,)-657.4(some)]TJ
1.3132 -1.1116 TD
[(practitioners)-346.4(perform)-349.8(an)-343.2(electrocardiogram)-349.8(on)-342(wo-)]TJ
0 -1.1174 TD
[(men)-673.8(of)-676.1(concern)-679.3(before)-677(commencement)-679.5(of)-676(the)]TJ
0 -1.1116 TD
[(medication)-281.1(and)-275.2(at)-274.2(48)-272.9(hours.)-273.7(If)-272.8(there)-278.6(is)-272.8(prolongation)]TJ
T*
[(of)-336.2(the)-332.9(QTc)-334.8(interval,)-337.5(the)-332.9(medication)-338.7(is)-336.2(ceased.)]TJ
-1.3132 -1.1116 TD
-.0217 Tc
[(d)-21.7(.)-521.6(P)-5.4(r).3(ov)-5.5(ide)-254.3(ong)-5.5(oing)-253.2(car)-5.5(e)-248.6(t).1(o)-5.5(,)-249.8(su)-5.5(perv)-5.5(is)-5.3(e)-248.6(ong)-5.5(oin)-5.5(g)-247.4(ca)-6.7(re)-248.6(o)-5.5(f).3(,)-249.8(o).2(r)]TJ
1.2499 -1.1174 TD
[(t)-5.6(r).3(an)-5.5(sfe)-6.7(r)-339.5(care)-340.7(o)-5.5(f)-339.6(bot)-5.7(h)-339.6(m)-1(oth)-5.5(e)-.9(r)-339.6(a)-.9(nd)-339.6(i)-5.6(n).2(fa)-6.7(nt)-339.7(to)-339.6(e)-6.7(n).2(su)-5.5(re)-340.7(ap-)]TJ
0 -1.1116 TD
[(p)-5.5(r).3(op)-5.5(ria)-6.7(t).1(e)-335(f).3(o)-5.5(llo)-5.5(w-u)-5.5(p)-333.8(and)-333.8(a)-6.7(tte)-6.7(nti)-5.6(o).2(n)-333.8(t).1(o)-339.6(a)-.9(ny)-333.8(s)-5.3(i).1(de)-340.7(eff)-5.5(ects)-5.3(.)]TJ
-1.2499 -1.1116 TD
0 Tc
[(e.)-501(Prescribe)-376(galactogogues)-381.9(at)-372.1(the)-373.2(lowest)-371.6(possible)-378.5(do-)]TJ
1.198 -1.1174 TD
[(ses)-407.3(for)-400.7(the)-402(shortest)-407.2(period)-405.3(of)-399.6(time;)-405.7(do)-399.6(not)-400.9(exceed)]TJ
0 -1.1116 TD
[(recommended)-341.8(therapeutic)-339.7(doses.)]TJ
-1.198 -1.1116 TD
-.0166 Tc
[(f)-16.6(.)-516.4(Con)5.3(s)-.2(id)5.3(er)-455.4(g)5.3(r)-.4(adually)-449.7(dis)5.5(c)-1.6(on)5.3(tin)5.3(u)-.4(in)5.3(g)-455.4(t)5.2(he)-456.6(d)5.3(rug)-449.7(\(taperin)5.3(g)]TJ
1.0828 -1.1174 TD
[(the)-347.1(d)-.3(o)5.4(s)-.1(e\))-345.9(rather)-351.6(t)5.3(h)-.3(an)-345.9(abru)5.4(ptly)-345.9(d)5.4(i)-.4(sco)5.4(n)-.3(ti)5.3(nui)5.3(ng)-345.9(th)5.4(e)-352.8(t)5.3(her)5.5(-)]TJ
0 -1.1116 TD
-.0217 Tc
[(a)-6.7(p)-5.5(y;)-437.6(s)-5.3(o)-5.5(me)-438.7(s)-5.3(t)-5.7(ud)-5.5(i)-5.7(e)-.9(s)-437.3(s)-5.3(i)-5.6(m)-1(p)-5.5(l)-5.7(y)-437.5(s)-5.3(to)-5.5(p)-437.5(t)-5.6(he)-438.7(d)-5.5(r)-5.5(u).2(g)-437.5(a)-6.7(t)-437.6(t)-5.6(he)-438.7(c)-6.7(o)-5.5(n-)]TJ
T*
-.0162 Tc
[(clu)5.7(s).2(io)5.7(n)-460.8(o)5.7(f)-460.8(t)5.6(her)5.8(a)-1.2(py)-455(an)5.7(d)-455(o)0(th)5.7(ers)-454.8(graduall)5.6(y)-460.8(d)5.7(isco)5.7(nti)5.6(n)0(u)5.7(e)]TJ
0 -1.1174 TD
-.0165 Tc
[(the)-329.8(dru)5.4(g,)-331(wi)5.3(th)-328.6(no)-334.4(clear)-334.3(a)4.3(dvantage)-329.8(t)-.4(o)-334.4(e)4.3(ith)5.4(e)-1.5(r)-328.6(met)5.3(hod)5.4(.)]TJ
-1.0828 -1.1116 TD
0 Tc
[(g.)-499.9(If)-451.4(milk)-443.6(production)-450.1(wanes)-452(after)-451.4(stopping)-446.6(the)-448.1(drug)]TJ
1.2499 -1.1116 TD
[(and)-275.2(improves)-276.1(again)-272.9(with)-276.2(resumption)-278.4(of)-272.9(medication,)]TJ
T*
[(attempt)-265.1(to)-261.5(gradually)-265.9(decrease)-267.8(the)-263.8(drug)-263.6(to)-261.5(the)-263.8(lowest)]TJ
0 -1.1174 TD
[(effective)-435.2(dose)-431.6(and)-430.7(then)-431.9(discontinue)-435.1(the)-430.8(drug)-430.6(at)-429.7(a)]TJ
0 -1.1116 TD
[(later)-336.4(date)-335.2(if)-336.4(possible.)]TJ
-1.2499 -1.1116 TD
[(h.)-499.9(Co)19.8(ns)15.3(id)20.7(er)-320.1(do)20.8(cu)19.7(me)18.4(nt)20.7(in)20.7(g)-329.4(t)0(h)20.7(a)0(t)-320.3(t)0(h)15(e)0(r)19.7(e)-330.6(ha)19.7(s)-329.2(b)0(e)19.7(e)0(n)-320.1(a)-330.6(di)20.7(sc)19.9(us)21(-)]TJ
1.2499 -1.1174 TD
[(si)15.1(on)-278.7(ab)19.7(ou)20.8(t)-289.2(c)0(o)19.7(n)0(t)15(r)0(a)19.7(i)0(n)20.7(d)0(i)20.7(c)0(a)18.5(t)0(i)20.6(o)0(n)20.8(s)-294.6(an)19.7(d)-289.1(t)0(h)20.7(a)0(t)-280(t)0(h)15(e)-290.2(mo)19.6(th)20.7(er)-279.8(ha)19.7(s)]TJ
0 -1.1116 TD
[(be)19.7(en)-435.3(pr)20.9(ov)20.8(id)20.7(ed)-429.6(wi)19.8(th)-434.3(in)20.7(fo)20.9(rm)19.6(at)19.5(io)20.7(n)-438.8(a)0(b)19.7(o)0(u)15.1(t)-439(th)20.7(e)-440(b)0(e)19.7(n)0(e)19.7()0(t)20.9(s)]TJ
T*
[(an)19.7(d)-323.6(r)0(i)15(s)0(k)21(s)-323.4(of)-313.2(an)19.7(y)-323.6(g)0(a)19.7(l)0(a)19.5(c)0(t)19.6(o)0(g)20.8(o)0(g)20.8(u)0(e)-314.4(b)0(e)13.9(i)0(n)20.7(g)-323.6(pr)20.9(es)19.9(cr)19.7(ib)20.7(ed)19.7(.)]TJ
/F5 1 Tf
8.9663 0 0 8.9663 310.8472 83.9622 Tm
(Conclusions)Tj
/F8 1 Tf
9.843 0 0 9.843 320.8251 67.5212 Tm
[(Before)-223(the)-223.5(use)-223.1(of)-226.8(a)-221.1(galactogogue,)-228.9(a)-226.9(lactation)-227(expert)-222.1(should)]TJ
-1.0137 -1.1116 TD
[(thoroughly)-230.1(evaluate)-226.8(the)-229.2(entire)-233.8(feeding)-229(process)-228.5(and)-229.1(maximize)]TJ
/F5 1 Tf
8.9663 0 0 8.9663 59.7543 749.7069 Tm
[(ABM)-336(PROTOCOL)]TJ
53.0113 0 TD
(311)Tj
ET
endstream
endobj
56 0 obj
<>stream
/GS1 gs
BT
/F8 1 Tf
9.843 0 0 9.843 62.022 725.1588 Tm
0 0 0 rg
0 Tc
0 Tw
[(nongalactogogue)-407.3(management.)-407.6(In)-399.6(the)-402(absence)-403.8(of)-399.6(evidence)]TJ
0 -1.1174 TD
[(for)-308.5(low)-303.8(milk)-305.4(supply,)-309.5(the)-304.1(mother)-308.6(should)-306(be)-308.6(reassured.)-310.1(When)]TJ
0 -1.1116 TD
[(intervention)-419.2(is)-416.8(indicated,)-420.4(modiable)-422.5(factors)-418.8(should)-415.5(be)-418.1(ad-)]TJ
T*
[(dressed:)-298.8(maternal)-301.7(anxiety)-298.3(and)-298.2(mental)-298.4(health)-297.2(issues,)-298.7(comfort)]TJ
T*
[(and)-378.8(relaxation)-377.7(for)-377.6(the)-379(mother,)-375.4(frequency)-382(and)-378.8(effectiveness)]TJ
0 -1.1174 TD
[(of)-278.6(milk)-282.4(removal,)-285.5(and)-280.9(any)-280.9(underlying)-283.1(medical)-283.4(conditions.)]TJ
1.0137 -1.1116 TD
[(Medication)-315.3(should)-311.8(never)-313.1(replace)-317.7(evaluation)-314.4(and)-315.5(counsel-)]TJ
-1.0137 -1.1116 TD
[(ing)-279.9(on)-278.7(modiable)-284.3(factors.)-284(There)-279.7(remain)-281(selected)-284.2(indications)]TJ
0 -1.1174 TD
[(for)-314.3(the)-315.6(use)-315.3(of)-318.9(galactogogues,)-316.2(but)-314.5(the)-315.6(current)-321.1(data)-312.1(are)-316.6(insuf-)]TJ
0 -1.1116 TD
[(cient)-199.1(to)-198.2(make)-203.8(any)-194.5(denitive)-202.5(recommendations.)-205.7(A)-197.8(number)-199(of)]TJ
T*
[(high-quality)-268.3(studies)-267.9(have)-265.9(found)-270.4(domperidone)-269.2(to)-261.5(be)-268.3(useful)-266.9(in)]TJ
0 -1.1174 TD
[(mothers)-303.8(of)-295.9(preterm)-305.1(infants)-302.6(\(Table)-304(1\),)-299.3(although)-298.2(there)-307.4(is)-295.9(con-)]TJ
0 -1.1116 TD
[(cern)-352.3(about)-352.4(rare,)-355.7(but)-354.8(signicant,)-350.9(adverse)-356.6(effects.)-354.3(Herbal)-355.5(ga-)]TJ
T*
[(lactogogues)-257.6(are)-259(problematic)-259.1(because)-259.8(of)-255.6(lack)-254.5(of)-255.6(regulation)-261.4(of)]TJ
T*
[(preparations)-247.1(and)-246.4(insufcient)-244.8(evidence)-244(of)-244.1(efcacy)-248.3(and)-240.6(safety.)]TJ
1.0137 -1.1174 TD
[(Clinicians)-325.7(should)-323.3(prescribe)-324.3(galactogogues)-330.1(with)-322.3(appropri-)]TJ
-1.0137 -1.1116 TD
[(ate)-483.8(caution)-476.8(with)-483.6(regard)-481.2(to)-480.4(drug-to-drug)-479.8(\(or)-481.3(drug-to-herb\))]TJ
T*
[(interactions)-212.8(as)-210.5(well)-208.3(as)-210.5(an)-210.7(overall)-211.9(risk-to-benet)-213.5(approach)-208.1(and)]TJ
0 -1.1174 TD
[(complete)-278.7(informed)-276.2(consent.)-278.4(Close)-278.3(follow-up)-275.9(of)-278.6(both)-275.2(mother)]TJ
0 -1.1116 TD
[(and)-188.8(infant)-186.5(is)-186.4(essential)-186.2(to)-186.6(monitor)-187.7(the)-188.9(status)-186.2(of)-186.5(lactation)-192.5(as)-181.7(well)]TJ
T*
[(as)-256.6(any)-257.9(adverse)-264.4(effects)-258.7(of)-255.6(the)-258(drug\(s\))-260.8(on)-255.6(the)-258(mother)-256.8(or)-255.6(infant.)]TJ
/F5 1 Tf
8.9663 0 0 8.9663 62.022 484.3274 Tm
[(Recommendations)-337.4(for)-337.3(Further)-334.7(Research)]TJ
/F8 1 Tf
9.843 0 0 9.843 72 467.8865 Tm
[(At)-285.4(present,)-289.8(there)-290.2(are)-293.6(ongoing)-284.3(studies)-291(investigating)-293.6(the)-286.8(ef-)]TJ
-1.0137 -1.1116 TD
[(fects)-318.8(of)-318.9(insulin)-313.2(resistance)-320.8(on)-319(milk)-316.9(supply)-317.6(and)-315.5(whether)-316.3(met-)]TJ
T*
[(formin)-457.2(can)-460.6(act)-460.8(as)-458.2(a)-457.3(galactogogue)-461.6(in)-457.3(women)-458(with)-460.6(insulin)]TJ
0 -1.1174 TD
[(resistance)-349.6(and)-344.3(low)-344.1(milk)-340(supply.)-344(We)-345.4(await)-343(with)-345.4(interest)-345.4(the)]TJ
0 -1.1116 TD
[(outcome)-282.1(of)-284.4(these)-278.5(studies.)]TJ
1.0137 -1.1116 TD
-.0156 Tc
[(Howev)-15.6(e)9.8(r,)-422.2(ex)-15.6(i)10.9(s).8(tin)-15.6(g)-409.5(s)-15.6(t)11.1(udies)-425.4(abo)-15.6(u)11(t)-420(g)-15.6(a)9.8(l).5(acto)-15.6(g)11(ogue)-15.6(s)-410.4(can)-15.6(n)11(o).6(t)-425.8(b).6(e)]TJ
-1.0137 -1.1116 TD
[(con)-15.7(s)11.1(ider)-15.7(e)9.8(d)-293.3(con)-15.7(c)9.7(lusi)-15.7(v)10.8(e)-.7(,)-295.6(a)-.7(nd)-293.3(man)-15.7(y)-282.8(o).5(f)-293.2(t)-15.7(h)10.8(e)-294.4(reco)-15.7(m)9.7(mendat)-15.7(i)10.6(ons)-293.1(a)-15.7(r)9.8(e)]TJ
0 -1.1174 TD
-.0159 Tc
[(bas)-15.9(e)9.7(d)-230.1(primar)-15.9(i)10.6(l).2(y)-230.1(o).3(n)-224.3(e)-15.9(x)9.5(p).3(ert)-230.2(opi)-15.9(n)10.6(i).2(on,)-232.4(small)-230.2(s).5(tu)-15.9(d)10.7(i).2(es,)-232.4(a)-.9(nd)-230.1(stud)-15.9(i)10.6(e)-.9(s)-229.9(i).2(n)]TJ
0 -1.1116 TD
[(whi)-16(c)9.3(h)-380(n).2(o)-16(n)10.6(phar)-16(m)9.4(acolog)-16(i)10.5(c)-381.1(b).2(r)-16(e)9.5(astf)-16(e)9.5(e)-1(ding)-385.7(supp)-16(o)10.6(r).2(t)-380.1(w)-16(a)8.6(s)-379.8(s)-16(u)10.8(bopt)-16(i)10.3(-)]TJ
T*
-.0156 Tc
[(mal)-195.4(an)-15.6(d)-179.1(n)-15.6(o)11(t)-195.4(stan)-15.6(d)11(a)-.6(rdi)-15.6(z)9.7(e)-.6(d.)-197.6(Most)-195.4(st)-15.6(u)10.9(d).6(ies)-195.1(h)-15.6(a)9.8(v).6(e)-196.4(b).6(een)-195.2(co)-15.6(n)11(duct)-15.6(e)9.7(d)-195.2(o).6(n)]TJ
0 -1.1174 TD
[(mot)-15.7(h)10.8(ers)-471.6(o).5(f)-471.8(pret)-15.7(e)9.6(rm)-473(infan)-15.7(t)10.8(s)-471.6(u).5(sin)-15.7(g)-455.6(mec)-15.7(h)9.7(a)-.7(nica)-15.7(l)-456.9(b).5(r)-15.7(e)9.8(ast)-471.9(pump)-15.7(s)]TJ
0 -1.1116 TD
[(rat)-15.7(h)10.8(er)-241.4(th)-15.7(a)9.7(n)-241.4(on)-241.4(mo)-15.7(t)10.8(h).5(ers)-247(o).5(f)-241.4(t).4(er)-15.7(m)-232.2(i).4(nfan)-15.7(t)10.8(s)-241.2(w)-.4(ho)-15.7(s)11.1(e)-242.6(pr)-15.7(o)10.9(b).5(lems)-247(usual)-15.7(l)10.6(y)]TJ
T*
[(ari)-15.6(s)11.1(e)-236.7(i).5(n)-235.6(t).5(he)-236.7(r)-15.6(s)11.2(t)-235.7(few)-236.4(d).6(ay)-15.6(s)-225(t).5(o)-235.6(w)-.3(eeks)-235.4(p).6(o)-15.6(s)11.2(tpar)-15.6(t)10.9(u).6(m.)-237.9(There)-236.7(i).5(s)-235.4(a)-236.7(cle)-15.6(a)8.7(r)]TJ
0 -1.1174 TD
[(nee)-15.7(d)-249.4(fo)-15.7(r)-248.3(w)-.4(el)-15.7(l)10.6(-des)-15.7(i)11(gned)-15.7(,)-250.6(adequ)-15.7(a)9.7(tely)-264.5(powe)-15.7(r)9.8(ed,)-261(r).5(a)-15.7(n)9.7(domiz)-15.7(e)8.6(d)-258.7(co)-15.7(n)10.9(-)]TJ
0 -1.1116 TD
-.0159 Tc
[(tr)-15.9(o)10.7(lled)-264.7(t).2(ri)-15.9(a)9.4(l).2(s)-264.5(u).3(sin)-15.9(g)-248.5(a)-15.9(d)9.5(equat)-15.9(e)-249.8(do)-15.9(s)10.9(e)-.9(s)-264.5(o).3(f)-264.6(g).3(alac)-15.9(t)9.4(ogog)-15.9(u)10.7(e)-.9(s)-264.5(i).2(n)-264.7(popul)-15.9(a)9.4(-)]TJ
T*
-.0156 Tc
[(ti)-15.6(o)10.9(n).6(s)-390.9(o).6(f)-385.3(w)-.3(o)-15.6(m)9.8(en)-385.3(i)-15.6(n)-375(whi)-15.6(c)9.7(h)-385.3(b)-15.6(o)11(t).5(h)-385.3(t)-15.6(h)10.9(e)-386.5(ex)-15.6(p)11(e)-.6(rime)-15.6(n)9.8(t).5(al)-391.2(and)-391.1(c)-.6(ontr)-15.6(o)11(l)]TJ
T*
-.016 Tc
[(gr)-16(o)10.6(ups)-281.8(rec)-16(e)8.3(ive)-283.2(up-t)-16(o)10.5(-dat)-16(e)9.3(,)-278.6(a)-1(pp)-16(r)10.6(opr)-16(i)10.5(a)-1(te)-283.2(lact)-16(a)9.3(tion)-282(s).4(u)-16(p)10.6(port)-16(.)]TJ
1.0137 -1.1174 TD
0 Tc
[(These)-239.2(studies)-239.1(need)-242.9(to)-232.7(be)-239.5(done)-241.7(in)-238.5(mothers)-234.6(of)-238.3(both)-240.7(term)-237.3(and)]TJ
-1.0137 -1.1116 TD
[(preterm)-299.3(infants)-296.9(and)-298.2(need)-294.7(to)-296.1(measure)-300.2(clinically)-297.4(relevant)-300.5(out-)]TJ
T*
[(comes)-291.1(such)-287.6(as)-285.4(infant)-290.2(weight)-291.1(gain,)-285.6(need)-289(for)-291.2(articial)-290.2(feeding)]TJ
0 -1.1174 TD
[(\(supplements)-327.6(other)-317.8(than)-322.5(mothers)-327.9(own)-321(milk\),)-321.4(quantication)]TJ
0 -1.1116 TD
[(of)-422.6(maternal)-428.5(milk)-426.3(production,)-430.5(and)-424.9(adverse)-425.7(drug)-424.8(effects.)-429.2(In)]TJ
T*
[(addition,)-434.3(research)-433.7(should)-432.8(be)-429.6(undertaken)-435.1(investigating)-431.8(cul-)]TJ
0 -1.1174 TD
[(tural)-220(practices)-216.2(and)-217.6(foods)-218.4(that)-218.9(have)-214.1(been)-219.8(used)-212.7(to)-215.4(stimulate)-221.1(and)]TJ
0 -1.1116 TD
[(maintain)-283.5(milk)-282.4(production)-283.1(over)-282(many)-277.5(centuries.)]TJ
/F5 1 Tf
8.9663 0 0 8.9663 62.022 183.4582 Tm
(Acknowledgments)Tj
/F8 1 Tf
9.843 0 0 9.843 72 167.0173 Tm
[(Stephanie)-278.5(Omage)-280.6(and)-280.9(Sara)-283(Whitburn)-276.3(assisted)-281.5(in)-278.8(updating)]TJ
-1.0137 -1.1116 TD
[(the)-281.1(annotated)-284.4(bibliography)-285.5(for)-279.7(this)-280.9(protocol.)]TJ
/F5 1 Tf
8.9663 0 0 8.9663 62.022 134.5323 Tm
(References)Tj
/F8 1 Tf
9.2951 0 0 9.2951 66.6708 118.4882 Tm
[(1.)-500.4(Li)-446.8(R,)-444.1(Fein)-440.1(SB,)-447.2(Chen)-442.6(J,)-444.6(et)-449.2(al.)-443.1(Why)-443.9(mothers)-444.8(stop)-444.4(breast-)]TJ
1.2503 -1.1223 TD
[(feeding:)-279.1(Mothers)-282.3(self-reported)-277.9(reasons)-284.4(for)-273.4(stopping)-279.7(during)]TJ
0 -1.1284 TD
[(the)-333.4(rst)-333.7(year.)]TJ
/F4 1 Tf
5.7577 0 TD
(Pediatrics)Tj
/F8 1 Tf
4.4585 0 TD
[(2008;122\(Suppl)-335.5(2\):S69S76.)]TJ
-11.4666 -1.1284 TD
[(2.)-500.4(Robert)-304.4(E,)-307.1(Coppieters)-307.7(Y,)-306.8(Swennen)-306.7(B,)-303.9(et)-308.9(al.)-302.9(The)-311.5(reasons)-302.7(for)]TJ
1.2503 -1.1223 TD
[(early)-346.3(weaning,)-346(perceived)-349.2(insufcient)-342(breast)-345.6(milk,)-346.7(and)-340.1(ma-)]TJ
27.0074 69.7691 TD
[(ternal)-413(dissatisfaction:)-413.7(Comparative)-416.2(studies)-411(in)-408.4(two)-410.1(belgian)]TJ
0 -1.1223 TD
(regions.)Tj
/F4 1 Tf
3.5315 0 TD
[(Int)-337.6(Sch)-334(Res)-335(Not)]TJ
/F8 1 Tf
6.7945 0 TD
(2014;2014:678564.)Tj
-11.5763 -1.1284 TD
-.0154 Tc
[(3)-15.4(.)-515.8(H)-15.4(a)15.1(u)-15.4(c)10.6(k)-424.2(Y)1.2(,)-424.1(F)-.1(enwick)-424.2(J,)-424.1(D)-15.4(h)13.2(aliwal)-423.6(SS,)-424.1(et)-423.6(al.)-430.2(A)-425.8(W)4.5(e)-1.4(stern)-424.2(A)1.2(u)-15.4(s)15.7(-)]TJ
1.2503 -1.1223 TD
-.015 Tc
[(tralia)5.1(n)-246.9(s)4(urv)-15(e)11(y)-240.8(o)3.2(f)-243.1(b)3.2(reastfee)5.1(d)-15(i)15.8(n)-15(g)]TJ
12.0033 0 TD
-.0162 Tc
[(initiation,)-241.9(p)-16.2(r)11.7(evalence)-246.2(a)3.9(n)-16.2(d)-230(e)-2.3(arly)]TJ
-12.0033 -1.1283 TD
-.0154 Tc
[(cessation)-332.7(p)-15.4(a)16.7(t)-2.8(terns.)]TJ
/F4 1 Tf
7.4838 0 TD
-.0136 Tc
[(Ma)4.6(ter)5.4(n)-330.9(Ch)4.6(il)5.1(d)-330.9(H)3(ea)4.6(lt)5.1(h)-330.9(J)]TJ
/F8 1 Tf
9.3989 0 TD
-.0182 Tc
[(201)-18.2(1)12(;)-5.6(15:)-5.6(260)-18.2()12(2)0(6)-18.2(8)12(.)]TJ
-18.133 -1.1223 TD
0 Tc
[(4.)-500.4(Gatti)-279.2(L.)-276.6(Maternal)-282.6(perceptions)-282.9(of)-277.1(insufcient)-281(milk)-273.5(supply)-280(in)]TJ
1.2503 -1.1284 TD
(breastfeeding.)Tj
/F4 1 Tf
5.9894 0 TD
[(J)-333.7(Nurs)-339.1(Scholarsh)]TJ
/F8 1 Tf
7.3862 0 TD
(2008;40:355363.)Tj
-14.626 -1.1223 TD
[(5.)-500.4(Kent)-396.1(JC.)-388.5(How)-393.9(breastfeeding)-393.4(works.)]TJ
/F4 1 Tf
16.4862 0 TD
[(J)-394.7(Midwifery)-392.5(Womens)]TJ
-15.2359 -1.1284 TD
(Health)Tj
/F8 1 Tf
3.0618 0 TD
(2007;52:564570.)Tj
-4.3122 -1.1223 TD
[(6.)-500.4(Cox)-395.6(D,)-392.1(Owens)-391.4(R,)-395.3(Hartmann)-396.7(P.)-387.4(Blood)-395.3(and)-395(milk)-389.3(prolactin)]TJ
1.2503 -1.1284 TD
[(and)-266.9(the)-260.2(rate)-260.8(of)-264.9(milk)-261.3(synthesis)-264(in)-262(women.)]TJ
/F4 1 Tf
16.6021 0 TD
[(Exp)-262.7(Physiol)]TJ
/F8 1 Tf
5.0929 0 TD
(1996;)Tj
-21.695 -1.1223 TD
(81:10071020.)Tj
-1.2503 -1.1284 TD
[(7.)-500.4(Czank)-343.3(C,)-340.5(Henderson)-342.1(JL,)-336.8(Kent)-341.3(JC,)-339.7(et)-339.4(al.)-339.4(Hormonal)-343.7(control)]TJ
1.2503 -1.1284 TD
[(of)-319.8(the)-321.2(lactation)-322.7(cycle.)-323.9(In:)-319.3(Hale)-321.1(&)-316.9(Hartmanns)-325.3(Textbook)-317.7(of)]TJ
0 -1.1223 TD
[(Human)-341.5(Lactation,)-349.6(Hale)-339.3(TW,)-342.1(Hartmann)-341.8(PE,)-340.6(eds.)-345.4(Amarillo,)]TJ
0 -1.1284 TD
[(TX:)-338.8(Hale)-333.3(Publishing,)-337.3(2007,)-330(pp.)-335.8(89111.)]TJ
-1.2503 -1.1223 TD
[(8.)-500.4(Daly)-341.2(S,)-332.5(Hartmann)-341.8(P.)-332.5(Infant)-338.5(demand)-338.2(and)-334(milk)-334.5(supply.)-334.9(Part)]TJ
1.2503 -1.1284 TD
[(1:)-316.9(Infant)-320.2(demand)-319.9(and)-321.8(milk)-316.2(production)-317.9(in)-316.9(lactating)-322.7(women.)]TJ
/F4 1 Tf
0 -1.1223 TD
[(J)-333.7(Hum)-339(Lact)]TJ
/F8 1 Tf
5.166 0 TD
(1995;11:2126.)Tj
-6.4164 -1.1284 TD
[(9.)-500.4(Daly)-341.2(S,)-332.5(Hartmann)-341.8(P.)-332.5(Infant)-338.5(demand)-338.2(and)-334(milk)-334.5(supply.)-334.9(Part)]TJ
1.2503 -1.1223 TD
[(2:)-506(The)-500.6(short-term)-504.2(control)-506.5(of)-502.7(milk)-499.1(synthesis)-507.9(in)-499.9(lactating)]TJ
0 -1.1284 TD
(women.)Tj
/F4 1 Tf
3.5315 0 TD
[(J)-333.7(Hum)-339(Lact)]TJ
/F8 1 Tf
5.166 0 TD
(1995;11:2737.)Tj
-10.448 -1.1223 TD
[(10.)-500.5(Reisman)-262.4(T,)-252.2(Goldstein)-254.5(Z.)-258.3(Case)-256.9(report:)-252.7(Induced)-255.7(lactation)-261.7(in)-255.9(a)]TJ
1.7505 -1.1284 TD
[(transgender)-340.7(woman.)]TJ
/F4 1 Tf
8.545 0 TD
[(Transgend)-336(Health)]TJ
/F8 1 Tf
7.6667 0 TD
(2018;3:2426.)Tj
-17.9622 -1.1223 TD
[(11.)-500.5(Milsom)-442.9(S,)-436.2(Breier)-439(B,)-438(Gallaher)-443.5(B,)-438(et)-437(al.)-437(Growth)-438.8(hormone)]TJ
1.7505 -1.1284 TD
[(stimulates)-334.7(galactopoiesis)-332(in)-329.1(healthy)-325.4(lactating)-334.9(women.)]TJ
/F4 1 Tf
22.1341 0 TD
(Acta)Tj
-22.1341 -1.1223 TD
(Endocrinol)Tj
/F8 1 Tf
4.8489 0 TD
(1992;127:337343.)Tj
-6.5994 -1.1284 TD
[(12.)-500.5(Gunn)-429.1(A,)-422.6(Gunn)-423(T,)-423(Rabone)-428.8(D,)-422.6(et)-424.8(al.)-424.8(Growth)-426.6(hormone)-421.9(in-)]TJ
1.7505 -1.1223 TD
[(creases)-317.2(breast)-315.1(milk)-316.2(volumes)-314.4(in)-310.8(mothers)-310.6(of)-313.7(preterm)-318(infants.)]TJ
/F4 1 Tf
0 -1.1284 TD
(Pediatrics)Tj
/F8 1 Tf
4.4585 0 TD
(1996;98:279282.)Tj
-6.209 -1.1223 TD
[(13.)-500.5(Milsom)-485.6(S,)-484.9(Rabone)-483.7(D,)-483.6(Gunn)-484(A,)-483.6(et)-485.8(al.)-479.7(Potential)-486.1(role)-488.4(for)]TJ
1.7505 -1.1284 TD
[(growth)-479.9(hormone)-476.8(in)-475.4(human)-474.1(lactation)-481.3(insufciency.)]TJ
/F4 1 Tf
21.6523 0 TD
(Horm)Tj
-21.6523 -1.1223 TD
(Res)Tj
/F8 1 Tf
1.781 0 TD
(1998;50:147150.)Tj
-3.5315 -1.1284 TD
[(14.)-500.5(Shekelle)-412(P,)-405.7(Woolf)-403.3(S,)-405.7(Eccles)-410.4(M,)-402(et)-406.5(al.)-406.5(Developing)-406.7(guide-)]TJ
1.7505 -1.1223 TD
(lines.)Tj
/F4 1 Tf
2.4824 0 TD
[(Br)-330.6(Med)-336.5(J)]TJ
/F8 1 Tf
4.2268 0 TD
(1999;318:593596.)Tj
-8.4596 -1.1284 TD
[(15.)-500.5(Ao)16.4(no)-329.6(T,)-331.5(Ak)16.4(i)-341.1(T)0(,)-331.5(K)0(o)16.4(i)12.6(ke)-333.9(K,)-331.2(et)-333.3(al)20.5(.)-347.7(E)0(f)19.9(f)15.8(ec)15.7(t)-341.1(o)0(f)-332(s)0(u)18.9(l)12.6(pi)18.6(ri)22.4(de)-333.8(on)-335.8(po)24.1(or)]TJ
1.7505 -1.1223 TD
[(pu)18(er)23.7(pe)19.9(ra)17.6(l)-231.3(l)12.6(ac)15.7(t)12.6(a)0(t)20.5(i)0(o)18.6(n)0(.)]TJ
/F4 1 Tf
7.7948 0 TD
[(Am)-223.3(J)-236.1(O)0(b)22.5(s)12.9(te)20.5(t)-231.3(G)0(y)18.3(n)0(e)19.9(c)0(o)19.9(l)]TJ
/F8 1 Tf
8.5389 0 TD
-.018 Tc
[(1)-18(9)0(8)-18(2)6.1(;)-5.4(1)-18(43)-18(:)6.7(9)-18(27)-18()6.1(9)-18(32)-18(.)]TJ
-18.0842 -1.1284 TD
0 Tc
[(16.)-500.5(Ylikorkala)-365.8(O,)-361.6(Kauppila)-369.9(A,)-361.7(Kivinen)-359.4(S,)-363(et)-363.8(al.)-363.8(Sulpiride)-362.8(im-)]TJ
1.7505 -1.1223 TD
[(proves)-335.9(inadequate)-340.4(lactation.)]TJ
/F4 1 Tf
11.741 0 TD
[(Br)-336.7(Med)-330.4(J)]TJ
/F8 1 Tf
4.2268 0 TD
(1982;285:249251.)Tj
-17.7183 -1.1284 TD
[(17.)-500.5(Peters)-683.9(R,)-675.9(Schulze-Tollert)-684.9(J,)-682.4(Schuth)-678.3(W.)-675.5(Thyrotrophin-)]TJ
1.7505 -1.1223 TD
[(releasing)-611.9(hormoneA)-600.8(lactation-promoting)-607.8(agent?)]TJ
/F4 1 Tf
21.9268 0 TD
[(Br)-605.1(J)]TJ
-21.9268 -1.1284 TD
[(Obstet)-340.1(Gynaecol)]TJ
/F8 1 Tf
7.13 0 TD
(1982;98:880885.)Tj
-8.8805 -1.1223 TD
[(18.)-500.5(Tyson)-276.2(J,)-273.8(Perez)-274.7(A,)-276.3(Zanartu)-275.3(J.)-267.7(Human)-274.4(lactational)-277.8(response)-278.5(to)]TJ
1.7505 -1.1284 TD
[(or)15.7(a)14(l)-243.5(t)12.6(h)0(y)18(r)15.8(ot)18.6(ro)21.8(pi)18.6(n)-238(r)0(e)17.6(l)12.6(ea)21.8(si)19.5(ng)-232.1(ho)24.1(rm)16.1(on)24.1(e.)]TJ
/F4 1 Tf
14.1746 0 TD
.2433 Tc
[(JC)243.3(l)263.2(i)255.9(nE)243.3(n)265.5(d)243.3(o)267.4(c)243.3(r)258(i)255.9(n)243.3(o)267.4(lM)243.3(e)266.8(t)243.3(a)261.9(b)]TJ
/F8 1 Tf
-14.1746 -1.1223 TD
0 Tc
[(19)18(76)24.1(;4)18.6(3:)24.7(76)18(0)24.1(76)18(8.)]TJ
-1.7505 -1.1284 TD
[(19.)-500.5(da)-352.1(Silva)-354.3(OP,)-346.4(Knoppert)-350.3(DC,)-354.4(Angelini)-352.9(MM,)-346.5(et)-351.6(al.)-351.6(Effect)-350.7(of)]TJ
1.7505 -1.1284 TD
[(domperidone)-371.2(on)-372.3(milk)-365(production)-372.8(in)-365.7(mothers)-371.6(of)-368.6(premature)]TJ
0 -1.1223 TD
[(newborns:)-300.7(A)-300.6(randomized,)-302.1(double-blind,)-299.4(placebo-controlled)]TJ
0 -1.1284 TD
(trial.)Tj
/F4 1 Tf
2.2079 0 TD
[(Can)-334.6(Med)-336.5(Assoc)-334.4(J)]TJ
/F8 1 Tf
7.563 0 TD
(2001;164:1721.)Tj
-11.5215 -1.1223 TD
[(20.)-500.5(Ka)18.3(up)18(pi)24.7(la)-382.1(A,)-373.8(Ki)17(vi)24.7(ne)19.9(n)-390.5(S)15.3(,)-390.4(Y)0(l)23.1(i)0(k)18.6(o)0(r)21.8(k)0(a)19.9(l)12.6(a)-388.6(O)0(.)-379.9(M)0(e)20.6(t)0(o)18.6(c)14(lo)18.6(pr)21.8(am)20.3(id)18.6(e)-388.6(i)12.6(n-)]TJ
1.7505 -1.1284 TD
[(cr)17.6(ea)21.8(se)20.8(s)-407.9(p)0(r)15.7(o)0(l)24.7(a)0(c)21.8(t)0(i)19.2(n)-408.8(re)17.6(l)12.6(e)0(a)21.8(s)0(e)-400.1(a)0(n)19.9(d)-408.8(m)12.5(i)12.6(lk)-396.2(se)20.8(cr)17.6(et)20.5(i)12.6(o)0(n)-396.7(i)0(n)-402.3(p)0(u)24.1(e)0(r)17.6(p)0(e)26(r)0(i)16.3(u)0(m)]TJ
0 -1.1223 TD
[(wi)17(t)12.6(h)0(o)18(u)0(t)-323(s)12.9(t)12.6(i)0(m)19(u)0(l)18.6(a)14(ti)19.2(ng)-323.5(t)12.6(h)0(e)-321.7(s)0(e)20.8(c)0(r)17.6(e)0(t)20.5(i)12.6(on)-323.5(of)-325.9(t)12.6(h)0(y)18(r)15.8(ot)18.6(ro)21.8(pi)18.6(n)-329.5(a)0(n)19.9(d)-335.6(t)12.6(h)0(y)18(r)15.8(oi)18.6(d)]TJ
0 -1.1284 TD
[(ho)18(rm)22.2(on)24.1(es)14.7(.)]TJ
/F4 1 Tf
4.4341 0 TD
[(J)-327.6(C)13.4(li)19.2(n)-323.4(E)0(n)22.2(d)0(o)18(c)14(ri)19.5(no)24.1(l)-322.8(M)0(e)17.4(t)12.6(ab)]TJ
/F8 1 Tf
10.3687 0 TD
[(19)18(81)24.1(;5)18.6(2:)18.6(43)24.1(6)24.1(43)18(9.)]TJ
-16.5533 -1.1223 TD
[(21.)-500.5(Donovan)-287.4(TJ,)-281.9(Buchanan)-286.9(K.)-288.5(Medications)-285.3(for)-285.6(increasing)-288.8(milk)]TJ
1.7505 -1.1284 TD
[(supply)-377.6(in)-377.9(mothers)-383.8(expressing)-375.8(breastmilk)-381.2(for)-383.2(their)-378.1(preterm)]TJ
0 -1.1223 TD
[(hospitalised)-378.1(infants.)]TJ
/F4 1 Tf
8.5206 0 TD
[(Cochrane)-373.3(Database)-371.4(Syst)-375.4(Rev)]TJ
/F8 1 Tf
12.3936 0 TD
(2012;3:)Tj
-20.9143 -1.1284 TD
(CD005544.)Tj
-1.7505 -1.1223 TD
[(22.)-500.5(Bazzano)-345.9(A,)-337.2(Hofer)-334.4(R,)-340.5(Thibeau)-340.1(S,)-332.5(et)-339.4(al.)-339.5(A)-337.2(review)-342(of)-332(herbal)]TJ
9.2951 0 0 9.2951 329.329 118.4315 Tm
[(and)-889(pharmaceutical)-887.4(galactagogues)-893.1(for)-883.4(breast-feeding.)]TJ
/F4 1 Tf
T*
[(Ochsner)-338.6(J)]TJ
/F8 1 Tf
4.5012 0 TD
(2016;16:511524.)Tj
-6.2517 -1.1284 TD
[(23.)-500.5(Grzeskowiak)-408.6(L,)-398.6(Smithers)-404.6(L,)-398.6(Amir)-406(L,)-398.6(et)-400.4(al.)-406.5(Domperidone)]TJ
1.7505 -1.1223 TD
[(for)-450.3(increasing)-453.5(breast)-449.3(milk)-450.3(volume)-449.3(in)-451(mothers)-450.9(expressing)]TJ
0 -1.1284 TD
[(breast)-370(milk)-358.9(for)-364.9(their)-366(preterm)-366.8(infants:)-364.9(A)-361.6(systematic)-370(review)]TJ
/F5 1 Tf
8.9663 0 0 8.9663 62.022 749.6502 Tm
(312)Tj
46.3849 0 TD
[(ABM)-336(PROTOCOL)]TJ
ET
endstream
endobj
60 0 obj
<>stream
/GS1 gs
BT
/F8 1 Tf
9.2951 0 0 9.2951 76.0252 725.1588 Tm
0 0 0 rg
0 Tc
0 Tw
[(and)-260.8(meta-analysis.)]TJ
/F4 1 Tf
7.7399 0 TD
(BJOG)Tj
/F8 1 Tf
2.7569 0 TD
[(2018)-256.7([Epub)-261.1(ahead)-263.4(of)-258.8(print];)-260.1(DOI:)]TJ
-10.4968 -1.1223 TD
(10.1111/1471-0528.15177.)Tj
-1.7505 -1.1284 TD
[(24.)-500.5(Jantarasaengaram)-405.7(S,)-393.5(Sreewapa)-402.9(P.)-393.5(Effects)-398.7(of)-393(domperidone)]TJ
1.7505 -1.1223 TD
[(on)-262.6(augmentation)-268.4(of)-258.8(lactation)-261.7(following)-265.7(cesarean)-267.6(delivery)-260.8(at)]TJ
0 -1.1283 TD
[(full)-337.2(term.)]TJ
/F4 1 Tf
4.1597 0 TD
[(Int)-331.5(J)-333.7(Gynaecol)-338(Obstet)]TJ
/F8 1 Tf
9.3501 0 TD
(2012;116:240243.)Tj
-15.2603 -1.1223 TD
[(25.)-500.5(Knoppert)-374.7(DC,)-378.8(Page)-371.7(A,)-373.8(Warren)-378.1(J,)-371.4(et)-376(al.)-369.9(The)-372.5(effect)-377.4(of)-374.7(two)]TJ
1.7505 -1.1284 TD
[(different)-344.9(domperidone)-346.8(doses)-338.6(on)-341.8(maternal)-350(milk)-340.6(production.)]TJ
/F4 1 Tf
0 -1.1223 TD
[(J)-333.7(Hum)-339(Lact)]TJ
/F8 1 Tf
5.1661 0 TD
(2013;29:3844.)Tj
-6.9165 -1.1284 TD
[(26.)-500.5(Ingram)-326.4(J,)-322.6(Taylor)-325.9(H,)-325.1(Churchill)-328.1(C,)-322.2(et)-327.2(al.)-321.2(Metoclopramide)-329.4(or)]TJ
1.7505 -1.1223 TD
[(domperidone)-298(for)-297.8(increasing)-301(maternal)-295.1(breast)-302.9(milk)-291.8(output:)-298.2(A)]TJ
0 -1.1284 TD
[(randomised)-290.9(controlled)-284.9(trial.)]TJ
/F4 1 Tf
11.4788 0 TD
[(Arch)-286.4(Dis)-281.1(Child)-284.9(Fetal)-286.2(Neonatal)]TJ
-11.4788 -1.1223 TD
(Ed)Tj
/F8 1 Tf
1.4516 0 TD
(2012;97:F241F245.)Tj
-3.2021 -1.1284 TD
[(27.)-500.5(Asztalos)-471.8(EV,)-473.5(Campbell-Yeo)-472.8(M,)-469.1(da)-468(Silva)-470.2(OP,)-468.4(et)-467.5(al.)-467.5(En-)]TJ
1.7505 -1.1284 TD
[(hancing)-673.7(human)-675.4(milk)-669.9(production)-671.7(with)-671.9(domperidone)-676.2(in)]TJ
0 -1.1223 TD
[(mothers)-335(of)-332(preterm)-336.3(infants.)]TJ
/F4 1 Tf
11.4971 0 TD
[(J)-333.7(Hum)-332.9(Lact)]TJ
/F8 1 Tf
5.1661 0 TD
(2017;33:181187.)Tj
-18.4136 -1.1284 TD
[(28.)-500.5(Wan)-484.7(EWX,)-478(Davey)-480.4(K,)-477.5(Page-Sharp)-481.9(M,)-481.3(et)-479.7(al.)-479.7(Dose-effect)]TJ
1.7505 -1.1223 TD
[(study)-249.3(of)-246.6(domperidone)-243.1(as)-247.6(a)-248.3(galactagogue)-253.4(in)-243.7(preterm)-250.9(mothers)]TJ
0 -1.1284 TD
[(with)-238.9(insufcient)-238.3(milk)-236.9(supply,)-237.4(and)-236.4(its)-236.3(transfer)-240.7(into)-237.3(milk.)]TJ
/F4 1 Tf
22.2927 0 TD
[(Br)-239.2(J)]TJ
-22.2927 -1.1223 TD
[(Clin)-333.6(Pharmacol)]TJ
/F8 1 Tf
6.8433 0 TD
(2008;66:283289.)Tj
-8.5938 -1.1284 TD
[(29.)-500.5(Doggrell)-270.4(SA,)-261(Hancox)-267(JC.)-266.5(Cardiac)-264.1(safety)-266.3(concerns)-271.4(for)-261.2(dom-)]TJ
1.7505 -1.1223 TD
[(peridone,)-420(an)-419.2(antiemetic)-418.1(and)-419.4(prokinetic,)-413.1(and)-419.4(galactogogue)]TJ
0 -1.1284 TD
(medicine.)Tj
/F4 1 Tf
4.1048 0 TD
[(Expert)-168.3(Opinion)-160(On)-166.5(Drug)-165.9(Safety)]TJ
/F8 1 Tf
12.5583 0 TD
(2014;13:131138.)Tj
-18.4136 -1.1223 TD
[(30.)-500.5(Leelakanok)-294.1(N,)-288.5(Holcombe)-296.8(A,)-288.5(Schweizer)-292.7(ML.)-288.2(Domperidone)]TJ
1.7505 -1.1284 TD
[(and)-492.6(risk)-489.4(of)-484.4(ventricular)-492.9(arrhythmia)-488.7(and)-492.6(cardiac)-489.2(death:)-490(A)]TJ
0 -1.1223 TD
[(systematic)-467.6(review)-470(and)-462.1(meta-analysis.)]TJ
/F4 1 Tf
16.041 0 TD
[(Clin)-461.6(Drug)-464.8(Investig)]TJ
/F8 1 Tf
-16.041 -1.1284 TD
(2016;36:97.)Tj
-1.7505 -1.1223 TD
[(31.)-500.5(Smolina)-366.4(K,)-361.7(Mintzes)-366.5(K,)-361.6(Hanley)-364(GE,)-363.7(et)-363.8(al.)-357.7(The)-366.4(association)]TJ
1.7505 -1.1284 TD
[(between)-527(domperidone)-523.7(and)-517(ventricular)-523.4(arrhythmia)-525.3(in)-518.1(the)]TJ
0 -1.1223 TD
[(postpartum)-322.7(period.)]TJ
/F4 1 Tf
7.9534 0 TD
[(Pharmacoepidemiol)-322.5(Drug)-318.4(Saf)]TJ
/F8 1 Tf
12.4607 0 TD
(2016;25:)Tj
-20.4141 -1.1284 TD
(12101214.)Tj
-1.7505 -1.1223 TD
[(32.)-500.5(Grzeskowiak)-365.9(LE.)-357.9(Domperidone)-360.6(for)-364.9(lactation:)-358.9(What)-362.3(health)]TJ
1.7505 -1.1284 TD
[(care)-412(providers)-411.2(really)-406.9(should)-408.1(know.)]TJ
/F4 1 Tf
14.9248 0 TD
[(Obstet)-407.2(Gynecol)]TJ
/F8 1 Tf
6.7702 0 TD
(2017;)Tj
-21.695 -1.1223 TD
(130:913.)Tj
-1.7505 -1.1284 TD
[(33.)-500.5(Lewis)-391.2(PJ,)-386.6(Devenish)-387.8(C,)-383.2(Kahn)-384.5(C.)-389.3(Controlled)-383.1(trial)-389.8(of)-386.9(meto-)]TJ
1.7505 -1.1223 TD
[(clopramide)-466.2(in)-457.2(the)-461.5(initiation)-465.7(of)-460(breast)-461.5(feeding.)]TJ
/F4 1 Tf
19.8774 0 TD
[(Br)-464.8(J)-455.7(Clin)]TJ
-19.8774 -1.1284 TD
(Pharmacol)Tj
/F8 1 Tf
4.7818 0 TD
(1980;9:217219.)Tj
-6.5323 -1.1223 TD
[(34.)-500.5(Hansen)-345.4(W,)-340(McAndrew)-343.7(S,)-338.6(Harris)-339.2(L,)-343.7(et)-339.4(al.)-339.5(Metoclopramide)]TJ
1.7505 -1.1284 TD
[(effect)-414(on)-402.8(breastfeeding)-411.7(the)-406.6(preterm)-409.5(infant:)-402.3(A)-410.4(randomized)]TJ
0 -1.1223 TD
(trial.)Tj
/F4 1 Tf
2.2079 0 TD
[(Obstet)-340.1(Gynecol)]TJ
/F8 1 Tf
6.6238 0 TD
(2005;105:383389.)Tj
-10.5822 -1.1284 TD
[(35.)-500.5(Sakha)-396.3(K,)-398.2(Behbahan)-396.7(A.)-392.1(Training)-392.7(for)-395.4(perfect)-402(breastfeeding)]TJ
1.7505 -1.1223 TD
[(or)-460(metoclopramide:)-463.4(Which)-466.2(one)-456(can)-460.2(promote)-464(lactation)-463(in)]TJ
0 -1.1284 TD
[(nursing)-337.3(mothers?)]TJ
/F4 1 Tf
7.3435 0 TD
[(Breastfeed)-342.4(Med)]TJ
/F8 1 Tf
6.7397 0 TD
(2008;3:120123.)Tj
-15.8336 -1.1223 TD
[(36.)-500.5(Seema,)-345.2(Patwari)-344.4(AK,)-339(Satyanarayana)-348.9(L.)-337.6(Relactation:)-349.8(An)-337.3(ef-)]TJ
1.7505 -1.1284 TD
[(fective)-399.1(intervention)-394.4(to)-396.2(promote)-396.9(exclusive)-396.1(breastfeeding.)]TJ
/F4 1 Tf
23.5247 0 TD
(J)Tj
-23.5247 -1.1223 TD
[(Trop)-338(Pediatr)]TJ
/F8 1 Tf
5.6174 0 TD
(1997;43:213216.)Tj
-7.3679 -1.1284 TD
[(37.)-500.5(Fife)-381.5(S,)-375.2(Gill)-378.6(P,)-375.2(Hopkins)-379.3(M,)-377.6(et)-376(al.)-376(Metoclopramide)-384.2(to)-377.9(aug-)]TJ
1.7505 -1.1284 TD
[(ment)-296.5(lactation,)-292.3(does)-290.6(it)-291.9(work?)-295.5(A)-294.5(randomized)-289.9(trial.)]TJ
/F4 1 Tf
20.2861 0 TD
[(J)-297.1(Matern)]TJ
-20.2861 -1.1223 TD
[(Fetal)-335(Neonatal)-338.4(Med)]TJ
/F8 1 Tf
8.5816 0 TD
(2011;24:13171320.)Tj
-10.3321 -1.1284 TD
[(38.)-500.5(Kauppila)-424.8(A,)-422.6(Anunti)-422.1(P,)-424(Kivinen)-420.4(S,)-424(et)-418.7(al.)-424.8(Metoclopramide)]TJ
1.7505 -1.1223 TD
[(and)-309.6(br)21.8(ea)15.7(s)12.9(t)-298.4(fe)23.7(ed)19.9(in)18.6(g:)-286.4(Ef)19.9(c)23.1(ac)15.7(y)-292.9(a)0(n)19.9(d)-299(an)19.9(t)12.6(e)0(r)17.6(i)12.6(or)-289.3(pi)24.7(tu)18.6(i)12.6(t)0(a)20.5(r)0(y)-289.3(r)0(e)17.6(s)12.9(po)24.1(ns)18.9(es)]TJ
0 -1.1284 TD
.0118 Tc
[(of)-381(th)5.6(e)-382.9(m)-.1(o)5.6(t)0(her)-381(a)1.4(nd)-378.7(chil)11.8(d)-6.2(.)]TJ
/F4 1 Tf
10.7286 0 TD
.0136 Tc
[(Eur)-376(J)-375(Obst)13.6(e)-8.6(t)-376.3(G)5.8(y)-2.9(n)7.4(e)3.2(co)7.4(l)]TJ
/F8 1 Tf
9.6124 0 TD
.0122 Tc
[(1)6(985)6(;19:)]TJ
-20.3409 -1.1223 TD
[(19)6.1(22.)]TJ
-1.7505 -1.1284 TD
0 Tc
[(39)18(.)-488(E)0(r)19.9(t)12.6(l)-274(T)0(,)-258.3(S)0(u)21.2(l)12.6(yo)18(k)-268.5(E)0(,)-258.3(E)0(z)18(e)0(r)-263(E)0(,)-258.3(e)0(t)-260.1(a)0(l)20.5(.)-274.5(M)12.8(e)0(t)20.5(o)0(c)19.9(l)12.6(op)18(ra)23.7(mi)19(de)-260.7(on)-262.6(t)12.6(h)0(e)-260.7(c)0(o)19.9(m)12.5(-)]TJ
1.72 -1.1223 TD
[(po)24.1(si)19.5(ti)19.2(on)-244.3(of)-240.5(hu)18(m)12.5(a)0(n)-242.4(b)0(r)21.8(e)0(a)15.7(s)12.9(t)-255.7(m)12.5(i)12.6(l)0(k)18.6(.)]TJ
/F4 1 Tf
12.3266 0 TD
[(Ac)24.1(ta)-243.7(Pa)22.2(ed)19.9(ia)18.6(t)12.6(r)-255.4(Hu)22.5(ng)]TJ
/F8 1 Tf
8.1913 0 TD
[(19)18(91)24.1(;)12.6(3)0(1)18(:)]TJ
-20.5178 -1.1284 TD
[(41)24.1(5)18(42)24.1(2.)]TJ
-1.72 -1.1223 TD
[(40.)-500.5(de)-333.8(Gezelle)-335.4(H,)-325.1(Ooghe)-335.9(W,)-327.8(Thiery)-332(M,)-328.8(et)-333.3(al.)-327.3(Metoclopramide)]TJ
1.7505 -1.1284 TD
[(and)-334(breast)-339.5(milk.)]TJ
/F4 1 Tf
6.9409 0 TD
[(Eur)-330.8(J)-333.7(Obstet)-340.1(Gynecol)]TJ
/F8 1 Tf
9.2342 0 TD
(1983;15:3136.)Tj
-17.9257 -1.1223 TD
[(41.)-500.5(Guzman)-364.2(V,)-361.6(Toscano)-370.3(G,)-361.6(Canales)-364.6(E,)-362(et)-363.8(al.)-363.8(Improvement)-360.9(of)]TJ
1.7505 -1.1284 TD
[(defective)-586.5(lactation)-578.9(by)-573.6(using)-578.7(oral)-579.9(metoclopramide.)]TJ
/F4 1 Tf
22.1341 0 TD
(Acta)Tj
-22.1341 -1.1223 TD
[(Obstet)-340.1(Gynecol)-331.8(Scand)]TJ
/F8 1 Tf
9.405 0 TD
(1979;58:5355.)Tj
-11.1555 -1.1284 TD
[(42.)-500.5(Kauppila)-504(A,)-495.8(Kivinen)-499.7(S,)-503.2(Ylikorkala)-500(O.)-495.8(A)-501.8(dose)-497.9(response)]TJ
1.7505 -1.1223 TD
[(relation)-406.6(between)-411.1(improved)-403.1(lactation)-408.1(and)-401.1(metoclopramide.)]TJ
/F4 1 Tf
0 -1.1284 TD
(Lancet)Tj
/F8 1 Tf
3.0618 0 TD
(1981;1:11751177.)Tj
22.2012 69.7752 TD
[(43.)-500.5(Toppare)-330.8(M,)-328.8(Laleli)-338.8(Y,)-331.2(Senses)-333.7(D,)-331.2(et)-327.2(al.)-333.4(Metoclopramide)-335.5(for)]TJ
9.2951 0 0 9.2951 327.118 714.7274 Tm
[(breast)-333.4(milk)-334.5(production.)]TJ
/F4 1 Tf
9.832 0 TD
[(Nutr)-333.3(Res)]TJ
/F8 1 Tf
3.9462 0 TD
(1994;14:10191029.)Tj
-15.5286 -1.1284 TD
[(44.)-500.5(Ehrenkrantz)-526.4(R,)-517.3(Ackerman)-529.6(B.)-523.4(Metoclopramide)-524.5(effect)-523.8(on)]TJ
1.7505 -1.1223 TD
[(faltering)-323.7(milk)-328.4(production)-324(by)-323.5(mothers)-322.8(of)-325.9(premature)-328.6(infants.)]TJ
/F4 1 Tf
0 -1.1283 TD
(Pediatrics)Tj
/F8 1 Tf
4.4585 0 TD
(1986;78:614.)Tj
-6.209 -1.1223 TD
[(45.)-500.5(Gupta)-493.9(AP,)-498.9(Gupta)-493.9(PK.)-498.9(Metoclopramide)-500.1(as)-491.5(a)-498.4(lactogogue.)]TJ
/F4 1 Tf
1.7505 -1.1284 TD
[(Clin)-333.6(Pediatr)]TJ
/F8 1 Tf
5.4039 0 TD
(1985;24:269272.)Tj
-7.1544 -1.1223 TD
[(46.)-500.5(Tolino)-459.1(A,)-459.2(Tedeschi)-459.5(A,)-465.3(Farace)-462.1(R,)-456.3(et)-461.4(al.)-461.4(The)-457.9(relationship)]TJ
1.7505 -1.1284 TD
[(between)-258.6(metocolpramide)-256.5(and)-254.7(milk)-255.2(secretion)-258.2(in)-255.9(puerperium.)]TJ
/F4 1 Tf
0 -1.1223 TD
[(Clin)-333.6(Exp)-335.9(Obstet)-334(Gynecol)]TJ
/F8 1 Tf
10.5822 0 TD
(1981;8:9395.)Tj
-12.3326 -1.1284 TD
[(47.)-500.5(Sewell)-384.7(CA,)-384.9(Chang)-381.8(CY,)-384.9(Chehab)-380(MM,)-383.1(et)-388.2(al.)-382.1(Domperidone)]TJ
1.7505 -1.1223 TD
[(for)-474.7(lactation:)-480.8(What)-478.2(health)-483.9(care)-479.1(providers)-478.3(need)-478.6(to)-481.5(know.)]TJ
/F4 1 Tf
0 -1.1284 TD
[(Obstet)-334(Gynecol)]TJ
/F8 1 Tf
6.6238 0 TD
(2017;129:10541058.)Tj
-8.3742 -1.1284 TD
-.0178 Tc
[(4)-17.8(8)-17.8(.)-518.3(US)-325.8(Food)-329(and)-329(D)-1.2(rug)-329(A)-1.2(dminis)-4.9(tration.)-328.9(How)-336.7(t).9(o)-329(r)-2(equest)-328.4(dom)-5.3(per-)]TJ
1.7505 -1.1223 TD
-.018 Tc
[(idone)-357.8(for)-362(e)2.1(xpanded)-365.8(acces)-5.1(s)-358.8(u).2(se.)-359.6(2018.)-359.6(Avail)-5.4(a)2.1(ble)-363.9(a)2.1(t)-365.2(w)4.7(ww.fda)]TJ
0 -1.1284 TD
.0242 Tc
[(.)42.4(g)-.3(o)5.8(v)-.3(/Drugs/DevelopmentAp)5.8(p)-.3(rovalProcess/HowDrug)5.8(s).6(are)]TJ
0 -1.1223 TD
-.0231 Tc
[(Develop)-4.9(e)3(d)-4.9(a)3.1(n)-4.9(d)1.2(App)-4.9(r)-1.2(oved/)-4.4(Appro)-4.9(v)1.2(alApp)-4.9(l)1.7(i)-4.4(c)3(at)-4.4(ions)-4(/In)-4.9(v)1.2(est)-4.4(i)1.7(gati)-4.4(onal)]TJ
0 -1.1284 TD
.007 Tc
[(N)7(e)-5.2(w)7(D)-2.5(rug)7(I)-1.7(ND)7(Appl)7(i)-4.3(c)7(at)7(i)-4.3(on/)7(u)-4.9(c)7(m36873)7(6.ht)7(m)-248.4(\()-1.6(a)7(c)-1.7(c)7(e)-7.8(s)7(s)-3.7(e)7(d)-247.6(Apr)7(i)-1.1(l)]TJ
0 -1.1223 TD
.0066 Tc
[(21)6.6(,)-335.2(201)6.6(8\).)]TJ
-1.7505 -1.1284 TD
0 Tc
[(49.)-500.5(Kim-Godwin)-446.1(Y.)-453.1(Postpartum)-447.6(beliefs)-448.9(and)-449.9(practices)-451.5(among)]TJ
1.7505 -1.1223 TD
[(non-Western)-255.4(cultures.)]TJ
/F4 1 Tf
9.1062 0 TD
[(MCN)-256.4(Am)-253.8(J)-254.4(Matern)-256.1(Child)-254.4(Nurs)]TJ
/F8 1 Tf
12.5827 0 TD
(2003;)Tj
-21.6889 -1.1284 TD
(28:7478.)Tj
-1.7505 -1.1223 TD
[(50.)-500.5(Kim)-385.3(M-K,)-381.8(Shin)-387.1(J-S,)-383(Patel)-389(RA,)-384.9(et)-382.1(al.)-388.2(The)-384.7(effects)-388.9(of)-380.8(pigs)]TJ
1.7505 -1.1284 TD
[(feet)-462.1(consumption)-460.8(on)-457.7(lactation.)]TJ
/F4 1 Tf
13.2414 0 TD
[(Ecol)-457.4(Food)-459.9(Nutr)]TJ
/F8 1 Tf
7.1666 0 TD
(2013;52:)Tj
-20.408 -1.1223 TD
(223238.)Tj
-1.7505 -1.1284 TD
[(51.)-500.5(Thaweekul)-291.3(P,)-283.7(Thaweekul)-291.3(Y,)-288.5(Sritipsukho)-290.9(P.)-283.7(The)-293.2(efcacy)-291.4(of)]TJ
1.7505 -1.1223 TD
[(hospital-based)-599(food)-600.6(program)-601.1(as)-595.2(galactogogues)-608.3(in)-597.4(early)]TJ
0 -1.1284 TD
[(period)-330.1(of)-338.1(lactation.)]TJ
/F4 1 Tf
8.112 0 TD
[(J)-333.7(Med)-336.5(Assoc)-334.4(Thai)]TJ
/F8 1 Tf
7.7277 0 TD
(2014;97:478482.)Tj
-17.5902 -1.1223 TD
[(52.)-500.5(O)]TJ
1.9457 .2257 TD
()Tj
.5245 -.2257 TD
[(zalkaya)-395.4(E,)-398.6(Aslandog)]TJ
8.1486 .0427 TD
()Tj
.4147 -.0427 TD
[(du)-396.7(Z,)-398.6(O)]TJ
2.8544 .2257 TD
()Tj
.5245 -.2257 TD
[(zkoral)-395.3(A,)-398.2(et)-400.4(al.)-400.4(Effect)-399.5(of)-399.1(a)]TJ
-12.662 -1.1284 TD
[(galactagogue)-570.6(herbal)-566.1(tea)-563.3(on)-567.5(breast)-565.2(milk)-566.2(production)-568(and)]TJ
0 -1.1223 TD
[(prolactin)-382.4(secretion)-386.3(by)-378.4(mothers)-383.8(of)-380.8(preterm)-385.1(babies.)]TJ
/F4 1 Tf
20.8594 0 TD
[(Niger)-386.4(J)]TJ
-20.8594 -1.1284 TD
[(Clin)-333.6(Pract)]TJ
/F8 1 Tf
4.6232 0 TD
(2018;21:3842.)Tj
-6.3737 -1.1223 TD
[(53.)-500.5(Mortel)-310.5(M,)-316.6(Mehta)-312.8(SD.)-315.9(Systematic)-318.9(review)-317.6(of)-313.7(the)-309(efcacy)-321.9(of)]TJ
1.7505 -1.1284 TD
[(herbal)-334.3(galactogogues.)]TJ
/F4 1 Tf
9.1672 0 TD
[(J)-333.7(Hum)-332.9(Lact)]TJ
/F8 1 Tf
5.166 0 TD
(2013;29:154162.)Tj
-16.0837 -1.1223 TD
[(54.)-500.5(Haastrup)-256(MB,)-254.5(Pottega)]TJ
10.2955 .0305 TD
()Tj
.3842 -.0305 TD
[(rd)-258.8(A,)-251.9(Damkier)-256.3(P.)-253.2(Alcohol)-255.7(and)-254.7(breast-)]TJ
-8.9293 -1.1284 TD
(feeding.)Tj
/F4 1 Tf
3.5071 0 TD
[(Basic)-255.4(Clin)-248.2(Pharmacol)-251.5(Toxicol)]TJ
/F8 1 Tf
12.418 0 TD
(2014;114:168173.)Tj
-17.6756 -1.1223 TD
[(55.)-500.5(Koletzko)-455.2(B,)-450.2(Lehner)-452.6(F.)-448.4(Beer)-455.2(and)-456(breastfeeding.)]TJ
/F4 1 Tf
22.1463 0 TD
[(Adv)-451.8(Exp)]TJ
-20.3958 -1.1284 TD
(Biol)Tj
/F8 1 Tf
2.0066 0 TD
(2000;478:2338.)Tj
-3.7571 -1.1223 TD
[(56.)-500.5(Anderson)-325.5(PO.)-322(Herbal)-329.8(use)-320.9(during)-325.9(breastfeeding.)]TJ
/F4 1 Tf
21.4327 0 TD
(Breastfeed)Tj
-19.6822 -1.1284 TD
(Med)Tj
/F8 1 Tf
2.1103 0 TD
(2017;12:507509.)Tj
-3.8608 -1.1223 TD
[(57.)-500.5(Tiran)-368.4(D.)-367.7(The)-372.5(use)-369.7(of)-368.6(fenugreek)-372.3(for)-371(breast)-370(feeding)-371(women.)]TJ
/F4 1 Tf
1.7505 -1.1284 TD
[(Complement)-333.8(Ther)-336.2(Nurs)-332.9(Midwifery)]TJ
/F8 1 Tf
14.3393 0 TD
(2003;9:155156.)Tj
-16.0898 -1.1223 TD
[(58.)-500.5(Lawrence)-353.1(R,)-352.7(Lawrence)-359.2(R.)-346.6(Breastfeeding:)-361.1(A)-349.4(Guide)-353.6(for)-352.7(the)]TJ
1.7505 -1.1284 TD
[(Medical)-603.4(Profession,)-608.7(8th)-603.7(ed.)-602.3(Philadelphia,)-606.7(PA:)-608.2(Elsevier)]TJ
0 -1.1223 TD
[(Mosby,)-334.6(2015.)]TJ
-1.7505 -1.1284 TD
[(59.)-500.5(Anderson)-374.3(PO.)-376.9(The)-372.5(galactogogue)-377.3(bandwagon.)]TJ
/F4 1 Tf
20.8045 0 TD
[(J)-376.4(Hum)-375.6(Lact)]TJ
/F8 1 Tf
-19.054 -1.1284 TD
(2013;29:710.)Tj
-1.7505 -1.1223 TD
[(60.)-500.5(Grzeskowiak)-329.3(LE,)-327.4(Amir)-326.7(LH.)-327.1(Pharmacological)-331.3(management)]TJ
1.7505 -1.1284 TD
[(of)-252.7(low)-251.5(milk)-255.2(supply)-255.6(with)-251.1(domperidone:)-261(Separating)-256(fact)-254.7(from)]TJ
0 -1.1223 TD
(ction.)Tj
/F4 1 Tf
3.1411 0 TD
[(Med)-336.5(J)-333.7(Aust)]TJ
/F8 1 Tf
5.0136 0 TD
(2014;201:257258.)Tj
-9.9052 -1.1284 TD
[(61.)-500.5(Campbell-Yeo)-363(ML,)-355.3(Allen)-359.1(AC,)-360.5(Joseph)-357.1(KS,)-358.6(et)-357.7(al.)-357.7(Effect)-362.9(of)]TJ
1.7505 -1.1223 TD
[(domperidone)-346.8(on)-341.8(the)-345.6(composition)-350.4(of)-344.2(preterm)-348.5(human)-340(breast)]TJ
0 -1.1284 TD
(milk.)Tj
/F4 1 Tf
2.4275 0 TD
(Pediatrics)Tj
/F8 1 Tf
4.4585 0 TD
(2010;125:e107e114.)Tj
-8.6365 -1.1223 TD
[(62.)-500.5(Turkylmaz)-329.7(C,)-334.4(Onal)-329.1(E,)-331.5(Hirfanoglu)-334(IM,)-325.2(et)-333.3(al.)-333.4(The)-329.8(effect)-334.7(of)]TJ
1.7505 -1.1284 TD
[(galactagogue)-570.6(herbal)-566.1(tea)-563.3(on)-567.5(breast)-565.2(milk)-566.2(production)-568(and)]TJ
0 -1.1223 TD
[(short-term)-278.5(catch-up)-283.9(of)-277.1(birth)-276.4(weight)-280(in)-280.3(the)-278.5(rst)-278.8(week)-278.9(of)-277.1(life.)]TJ
/F4 1 Tf
0 -1.1284 TD
[(J)-333.7(Altern)-334.3(Complement)-339.9(Med)]TJ
/F8 1 Tf
11.1311 0 TD
(2011;17:139142.)Tj
-12.8816 -1.1223 TD
[(63.)-500.5(Damanik)-443.1(R,)-444.1(Wahlqvist)-446.4(ML,)-446.8(Wattanapenpaiboon)-447(N.)-447(Lac-)]TJ
1.7505 -1.1284 TD
[(tagogue)-338.2(effects)-346.2(of)-338.1(Torbangun,)-339.2(a)-339.8(Bataknese)-344.7(traditional)-338.8(cui-)]TJ
0 -1.1223 TD
(sine.)Tj
/F4 1 Tf
2.1957 0 TD
[(Asia)-336.5(Pac)-335.9(J)-333.7(Clin)-333.6(Nutr)]TJ
/F8 1 Tf
9.0208 0 TD
(2006;15:267274.)Tj
-12.967 -1.1284 TD
.0197 Tc
[(6)19.7(4)19.7(.)-480.8(Khan)-413.5(TM,)-413.4(W)3(u)-413.5(D)-.3(B-C,)-407.3(Dolzhenko)-413.5(AV.)-413.4(E)5.5(ffectiveness)-406.5(o)-4.8(f)]TJ
1.7505 -1.1223 TD
[(fenug)-4.9(reek)-401.4(as)-406.6(a)-405.6(g)1.2(alactag)-4.9(ogue:)-406.9(A)-403(network)-407.5(m)1.6(eta-analys)-4(is.)]TJ
/F4 1 Tf
0 -1.1284 TD
.0182 Tc
[(Phyt)-5.8(other)-334.8(R)-2.1(es)]TJ
/F8 1 Tf
9.2951 0 0 9.2951 385.6818 76.5921 Tm
.0184 Tc
[(20)-6.1(18;32:)-5.6(40241)-6.1(2.)]TJ
/F5 1 Tf
8.9663 0 0 8.9663 59.7543 749.7069 Tm
0 Tc
[(ABM)-336(PROTOCOL)]TJ
53.0113 0 TD
(313)Tj
ET
endstream
endobj
64 0 obj
<>stream
/GS1 gs
BT
/F8 1 Tf
9.2951 0 0 9.2951 62.022 725.1588 Tm
0 0 0 rg
0 Tc
0 Tw
[(65.)-500.5(Re)21.2(ed)19.9(er)-482.6(C,)-486.8(Le)18(gr)21.8(a)14(n)0(d)-488.2(A)0(,)-483.6(O)0()20.2(C)13.4(on)18(no)24.1(r-)19.5(Vo)22.5(n)-494.2(S)0(K)19.6(.)-494.1(Th)22.2(e)-498.4(e)14(ff)19.5(ec)15.7(t)-493.6(o)0(f)]TJ
1.7505 -1.1223 TD
[(fe)17.6(nu)24.1(gr)21.8(ee)21.8(k)-238(o)0(n)-219.9(m)12.5(il)19.2(k)-231.9(p)0(r)21.8(o)0(d)18(u)0(c)19.9(t)12.6(i)12.6(o)0(n)-226(a)14(nd)-226(pr)21.8(ol)24.7(ac)15.7(t)12.6(i)12.6(n)-238(l)12.6(e)0(v)19.9(e)0(l)20.5(s)-231(in)-225.4(m)12.5(o)0(t)18.6(h)0(e)19.9(r)15.8(s)]TJ
0 -1.1284 TD
[(of)-313.7(pr)21.8(et)20.5(er)23.7(m)-323(i)0(n)18.6(f)0(a)17.6(n)0(t)24.7(s)0(.)]TJ
/F4 1 Tf
7.7521 0 TD
[(Cl)19.9(in)-316.9(L)15.3(a)0(c)19.9(t)]TJ
/F8 1 Tf
4.0926 0 TD
[(20)18(13)24.1(;)12.6(4)0(:)18.6(1)0(5)18(9)0()24.1(1)0(6)24.1(5)0(.)]TJ
-13.5952 -1.1223 TD
[(66.)-500.5(Fenugreek.)-397.4(Lactmed)-398.8(2018.)-397.1(Available)-398(at)-394.3(https://toxnet.nlm)]TJ
1.7505 -1.1283 TD
(.nih.gov/cgi-bin/sis/search2/f?./temp/)Tj
/F11 1 Tf
14.9675 0 TD
(*)Tj
/F8 1 Tf
1.0003 0 TD
[(jReBbc:1)-371.7(\(accessed)]TJ
-15.9678 -1.1223 TD
[(March)-334(13,)-335.8(2018\).)]TJ
-1.7505 -1.1284 TD
[(67.)-500.5(Di)-239.2(Pierro)-237.7(F,)-241(Callegari)-238.9(A,)-239.7(Carotenuto)-241.5(D,)-239.7(Tapia)-242.2(MM.)-236.8(Clinical)]TJ
1.7505 -1.1223 TD
[(efcacy,)-389.1(safety)-394.4(and)-388.9(tolerability)-387.2(of)-393(BIO-C)-388.6(\(micronized)-389.3(Si-)]TJ
0 -1.1284 TD
[(lymarin\))-246.3(as)-247.6(a)-242.2(galactagogue.)]TJ
/F4 1 Tf
11.2653 0 TD
[(Acta)-250.1(Biomed)]TJ
/F8 1 Tf
5.3978 0 TD
(2008;79:205210.)Tj
-18.4136 -1.1223 TD
[(68.)-500.5(Jellin)-612.4(J,)-609.3(Gregory)-609.2(P,)-613(Batz)-610.9(F,)-606.9(et)-613.8(al.)-607.8(Natural)-616(Medicines)]TJ
1.7505 -1.1284 TD
[(Comprehensive)-410.1(Database.)-408.5(Stockton,)-409.7(CA:)-402.7(Therapeutic)-411.8(Re-)]TJ
0 -1.1223 TD
[(search)-338.2(Faculty,)-334.5(2009.)]TJ
-1.7505 -1.1284 TD
-.0223 Tc
[(6)-22.3(9)-22.3(.)-522.8(Serrao)-284.7(F)-.9(,)-278.5(C)-2.8(ors)-3.3(e)-2.2(l)-3.6(l)2.5(o)-284.7(M)2.7(,)-284.6(R)-2.8(om)-3.7(agno)-4.1(l)-3.6(i)-278(C,)-278.5(et)-284.1(al.)-284.6(T).1(h)-4.1(e)-282.8(lo)-4.1(ng)-4.1(-term)-284.3(e)-2.2(f-)]TJ
1.7505 -1.1284 TD
-.0217 Tc
[(cacy)-509.8(of)-512.1(a)-507.9(g)-3.5(alactagogue)-514(containing)]TJ
14.5894 0 TD
-.0208 Tc
[(Sylima)5.4(rin-Phosphatidyl-)]TJ
-14.5894 -1.1223 TD
[(serine)-342.4(and)-344.3(G)1.8(alega)-348.5(o)3.4(n)-344.3(m)-2.3(ilk)-344.3(p)3.4(rodu)]TJ
13.0341 0 TD
-.0194 Tc
[(ct)5.4(io)4.9(n)-348.9(o)4.9(f)-345.1(m)5.3(ot)5.4(hers)-341.9(of)-339(pret)5.4(erm)]TJ
-13.0341 -1.1284 TD
-.0192 Tc
[(in)5.1(fant)5.6(s.)]TJ
/F4 1 Tf
3.0557 0 TD
-.0209 Tc
[(Breastfeed)-252.8(Med)]TJ
/F8 1 Tf
6.2944 0 TD
-.0183 Tc
[(20)6(18)6(;1)6(3:)6.5(67)6(6)6(9)6(.)]TJ
-11.1006 -1.1223 TD
0 Tc
[(70.)-500.5(Zecca)-373.2(E,)-368.1(Zuppa)-366.7(A,)-367.7(DAntuono)-366.1(A,)-367.7(et)-369.9(al.)-369.9(Efcacy)-368.4(of)-368.6(a)-370.3(ga-)]TJ
1.7505 -1.1284 TD
[(lactogogue)-732.6(containing)-727.9(silymarin-phosphatidylserine)-734.4(and)]TJ
0 -1.1223 TD
[(galega)-397.2(in)-390.1(mothers)-389.9(of)-393(preterm)-397.3(infants:)-389.3(A)-392.1(randomized)-399.6(con-)]TJ
0 -1.1284 TD
[(trolled)-335.2(trial.)]TJ
/F4 1 Tf
5.1661 0 TD
[(Eur)-336.9(J)-333.7(Clin)-333.6(Nutr)]TJ
/F8 1 Tf
6.8433 0 TD
(2016;70:11511154.)Tj
-13.7599 -1.1223 TD
[(71.)-500.5(Low)-394.2(Dog)-386.3(T.)-392.5(The)-390.8(use)-394.1(of)-393(botanicals)-395.7(during)-386.9(pregnancy)-394.4(and)]TJ
1.7505 -1.1284 TD
(lactation.)Tj
/F4 1 Tf
4.0499 0 TD
[(Altern)-340.4(Ther)-330.1(Health)-334.9(Med)]TJ
/F8 1 Tf
10.2406 0 TD
(2009;15:5458.)Tj
-16.041 -1.1223 TD
[(72.)-500.5(Doyle)-274.3(M,)-273.9(Grossman)-275.4(M.)-273.9(Case)-275.1(report:)-271(Domperidone)-281.3(use)-272.1(as)-272(a)]TJ
1.7505 -1.1284 TD
[(galactagogue)-381.5(resulting)-377.3(in)-377.9(withdrawal)-379.6(symptoms)-376.1(upon)-378.7(dis-)]TJ
0 -1.1223 TD
(continuation.)Tj
/F4 1 Tf
5.5259 0 TD
[(Arch)-255.9(Womens)-258.3(Ment)-256.7(Health)]TJ
/F8 1 Tf
11.1433 0 TD
[(2017)-256.7([Epub)-255(ahead)]TJ
-16.6692 -1.1284 TD
[(of)-332(print];)-333.3(DOI:)-340.9(10.1007/s00737-017-0796-8.)]TJ
-1.7505 -1.1223 TD
[(73.)-500.5(Dj)23.1(ed)19.9(di)-237.6(D,)-233.6(Ko)22.5(ng)24.1(ol)18.6(a)-242.2(G)0(,)-233.6(L)0(e)18(f)0(a)23.7(i)0(x)-237.6(C)13.4(,)-244(e)0(t)-235.7(a)14(l.)-237.5(Ef)19.9(f)15.8(e)0(c)15.7(t)-243.5(of)-234.4(do)24.1(m)12.5(p)0(e)19.9(r)0(i)16.3(d)0(o)24.1(n)0(e)]TJ
1.7505 -1.1284 TD
[(on)-311.3(QT)-314.8(i)12.6(n)0(t)18.6(e)14(rv)15.7(a)14(l)-322.8(in)-310.8(ne)19.9(on)18(a)14(t)0(e)20.5(s)0(.)]TJ
/F4 1 Tf
11.369 0 TD
.3215 Tc
[(JP)321.5(e)339.5(d)321.5(i)346.2(a)321.5(t)340.1(r)]TJ
/F8 1 Tf
4.0377 0 TD
-.018 Tc
[(2)-18(0)6.1(0)-18(8)0(;)-5.4(1)-18(53)-18(:)6.7(6)-18(63)-18()6.1(6)-18(66)-18(.)]TJ
9.843 0 0 9.843 323.0361 725.1588 Tm
0 Tc
[(ABM)-190.4(protocols)-189.7(expire)-193.3(5)-185.4(years)-191.9(from)-189.9(the)-188.9(date)-191.2(of)-192.2(publication.)]TJ
0 -1.1174 TD
[(The)-408.8(co)19.7(nt)20.7(en)19.7(t)-392.9(o)0(f)-382.3(t)0(h)20.7(i)0(s)-382.3(p)0(r)15.1(o)0(t)20.7(o)0(c)19.7(o)0(l)-382.5(i)0(s)-382.3(u)0(p)-382.3(t)0(o)-388.2(d)0(a)19.7(t)0(e)-383.6(a)0(t)-383.6(t)0(h)20.7(e)-393.9(ti)20.6(me)-384.7(of)]TJ
-1.0137 -1.1116 TD
[(pu)15.1(bl)20.7(ic)19.6(at)19.5(io)20.7(n.)-194.6(Ev)19.6(id)20.7(en)19.7(ce)18.5(-b)15.1(as)19.9(ed)-193.4(re)19.7(vi)20.7(si)15.1(on)20.8(s)-202.5(a)0(r)19.7(e)-209.6(ma)18.4(de)-193.4(wi)19.8(th)20.7(in)-198.2(5)-202.7(y)0(e)19.7(a)0(r)19.7(s)]TJ
T*
[(or)-261.4(so)15.3(on)20.8(er)-256.8(if)-261.5(th)20.7(er)14(e)-267.2(a)0(r)19.7(e)-273(si)20.9(gn)20.8(i)15.1(ca)18.5(nt)-255.8(ch)19.7(an)13.9(ge)19.7(s)-265.8(i)0(n)-261.5(t)0(h)20.7(e)-273(ev)19.7(id)20.7(en)19.7(ce)18.5(.)]TJ
1.0137 -1.1116 TD
[(Previous)-222.8(versions)-222.8(of)-215.3(this)-217.6(protocol)-223.3(were)-220.7(authored)-218.6(by)-221.1(Nancy)]TJ
-1.0137 -1.1174 TD
[(Powers)-284.7(and)-280.9(Anne)-282.9(Montgomery.)]TJ
0 -2.4767 TD
-.0156 Tc
[(T)-15.6(h)9.8(e)-259.8(A)-.3(ca)-15.6(d)9.8(emy)-258.6(o)-15.6(f)-248.2(Bre)-15.6(a)8.7(stfe)-15.6(e)8.7(d).6(ing)-264.4(M)-.3(edic)-15.6(i)9.7(n).6(e)-259.8(P)-15.6(r)11.2(o).6(toco)-15.6(l)-248.3(C)-.4(ommi)-15.6(t)10.7(t).4(ee)]TJ
/F4 1 Tf
7.4473 -1.1116 TD
0 Tc
[(Sarah)-333.6(Reece-Stremtan,)-343.6(MD,)-335.9(Chairperson)]TJ
-4.5732 -1.1116 TD
[(Larry)-334.4(Noble,)-339.6(MD,)-330.1(FABM,)-340.8(Translations)-335.4(Chairperson)]TJ
12.8787 -1.1174 TD
[(Melissa)-338.1(Bartick,)-331.5(MD)]TJ
-3.5825 -1.1116 TD
[(Wendy)-331.5(Brodribb,)-335.7(MD,)-335.9(FABM)]TJ
-1.4802 -1.1116 TD
[(Maya)-334.9(Bunik,)-334(MD,)-335.9(MSPH,)-333.5(FABM)]TJ
6.5315 -1.1174 TD
[(Sarah)-333.6(Dodd,)-331.3(MD)]TJ
-3.98 -1.1116 TD
[(Megan)-336(Elliott-Rudder,)-333.9(MD)]TJ
3.3003 -1.1116 TD
[(Cadey)-337.2(Harrel,)-334.4(MD)]TJ
-5.0225 -1.1174 TD
[(Ruth)-339.8(A.)-334(Lawrence,)-333.2(MD,)-335.9(FABM)]TJ
-1.5724 -1.1116 TD
[(Kathleen)-340.7(A.)-334(Marinelli,)-332.7(MD,)-335.9(FABM)]TJ
5.4084 -1.1116 TD
[(Katrina)-337.1(Mitchell,)-332.9(MD)]TJ
-7.3206 -1.1116 TD
[(Casey)-331.2(Rosen-Carol)-9.5(e,)-334(MD,)-330.1(MPH,)-338.2(MSEd)]TJ
6.7273 -1.1174 TD
[(Susan)-333.6(Rothenberg,)-334.7(MD)]TJ
-.864 -1.1116 TD
[(Tomoko)-336.8(Seo,)-330.4(MD,)-335.9(FABM)]TJ
2.3845 -1.1116 TD
[(Rose)-334.9(St.)-334.1(Fleur,)-333.8(MD)]TJ
-.0749 -1.1174 TD
[(Adora)-334.8(Wonodi,)-333.8(MD)]TJ
-3.0411 -1.1116 TD
[(Michal)-337.4(Young,)-331.3(MD,)-335.9(FABM)]TJ
/F8 1 Tf
-4.291 -1.7221 TD
[(For)-331.4(correspondence:)-344.8(abm@bfmed.org)]TJ
/F5 1 Tf
8.9663 0 0 8.9663 62.022 749.6502 Tm
(314)Tj
46.3849 0 TD
[(ABM)-336(PROTOCOL)]TJ
ET
endstream
endobj
68 0 obj
<>stream
8;X]O>EqN@%''O_@%e@?J;%+8(9e>X=MR6S?i^YgA3=].HDXF.R$lIL@"pJ+EP(%0
b]6ajmNZn*!='OQZeQ^Y*,=]?C.B+\Ulg9dhD*"iC[;*=3`oP1[!S^)?1)IZ4dup`
E1r!/,*0[*9.aFIR2&b-C#soRZ7Dl%MLY\.?d>Mn
6%Q2oYfNRF$$+ON<+]RUJmC0InDZ4OTs0S!saG>GGKUlQ*Q?45:CI&4J'_2j$XKrcYp0n+Xl_nU*O(
l[$6Nn+Z_Nq0]s7hs]`XX1nZ8&94a\~>
endstream
endobj
70 0 obj
<>stream
h,=N0 F
p&