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Domperidone? Increasing supply?
Help for worried FTM please....


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#1 eleven

Posted 05 February 2013 - 05:46 PM

Hi All,

I'm having trouble with my supply and the LC has suggested taking Domperidone to increase my supply. I'm really not keen but starting to feel desperate about it. My baby is 18 days old now and I'm not producing anywhere near enough to satisfy him. He was over 5kg at birth and then spent 10 days in special care for respiratory and digestion issues. I wasn't allowed to touch him for 5 days but started hand expressing and then pumping by the 4th day. He had a feeding tube and the nursery gave him what little I had expressed but he was basically formula fed.
I'm pumping every 2 hours now and 4 hours at night but getting only 20-50mls at a time. (combined from both breasts).
Our bub is supposed to eat 120mls every 3 hrs ( based on birth weight) but he's not getting anything close to it. He's a sleepy baby and eats a maximum of 100mls (ebm or formula) every 3 hrs. I try to keep him awake but whether it's breast or bottle he falls asleep by about 50 mls.
I'm starting to feel very teary about not being able to provide for my child. All I've ever wanted was to be a mum and this whole experience has been totally different to what I imagined...
Don't get me wrong- I'm totally in love with my baby but stressed and worried that I'm not able to give him what he needs.
Has anyone tried Domperidone ? Were there side effects? Did it work for you?

Thanks...

#2 CharliMarley

Posted 05 February 2013 - 06:02 PM

The baby can get more milk out than a pump can, so please try to not worry too much. If you breastfeed your bub about every 2 hours around the clock, your supply will increase. The more milk you get out, the more you make and suckling the breast by your baby is better than a pump. Some mums are able to increase their supply with Domperidone, but feeding more frequently is really the solution.
Was the lactation consultant an International Board Lactation Consultant, because these women are the best and have been trained very thoroughly, unlike some others who have not had the training. How many times in the 24 hour period are you breastfeeding your baby, because many babies at this age are having 17 feeds, with the average being 11 feeds.

#3 CharliMarley

Posted 05 February 2013 - 06:04 PM

I just re-read your post and it looks like your are feeding your baby every 3 hours. Could you feed him every 2 hours around the clock and see how you go. Your body starts to make more milk, while you are feeding him what you have.

#4 eleven

Posted 05 February 2013 - 06:59 PM

Hi, thanks for your replies... I've tried feeding every 2 hrs but he won't stay awake. The formula makes him want to sleep for 4 hours!

#5 lucky 2

Posted 05 February 2013 - 07:52 PM

I get the point that he is sleepy, still try to offer the breast as much as possible but I know there are limits, ie he falls asleep and doesn't drink! So no point having him on the breast when he is asleep, that wont boost supply!
How about increasing the expressions (ie 2-3 hourly/after feeds), are you expressing each breast at least twice, ie switching from side to side when the flow slows?
Are you using a hospital grade electric pump? These are the most suitable for your needs.
When baby is feeding are you stripping him off, using touch and breast squeezes to help stimulate him to drink more before falling asleep? This can help.
Using domperidone is considered when you are doing everything you can to boost supply and it's not working.
I've put in a link to the RWH website (Melb) about supply and domperidone, I hope it answers some of your questions.
Could you call up your LC for a chat about it if you are nervous.
Ideally it's best to do whatever you can to boost supply now rather than keeping it dragging along with no improvements.
All the best.
http://www.thewomens.org.au/Domperidonefor...reastmilksupply
http://www.thewomens.org.au/Lowmilksupply

#6 axiomae

Posted 05 February 2013 - 07:55 PM

No side effects when I was taking it - found it a godsend, honestly. Helped me continue breastfeeding when my supply was so low DD was basically all on formula. With expressing, frequent feeding etc I only need a few formula top ups a day. Well worth it original.gif

#7 sakura73

Posted 05 February 2013 - 07:56 PM

Oh OP, that feeling of not being able to nourish your child is so heartbreaking, I know. Remember there is no shame in comp feeding: every bit of breast milk helps and it doesn't matter if he gets some breast milk and some formula.

I took the domperidone eagerly after I realised at 2 weeks that DS was going backwards in weight because my supply was low. I felt like a failure having to give formula, and cried many many tears.  I was fortunate to have access to a great lactation consultant who helped me increase my supply.

As a PP said, the baby can get more out than a pump, but you sound like you definitely need to up your supply if you are only getting 50mls. I was the same: could get very little out with a pump. My baby was also sleepy, because he was actually undernourished and lacked energy.

I was told to give him the breast, then 30ml formula, then the breast again, so that he got his nourishment overall but was encouraged to get as much as possible from the breast. A bottle requires a different sucking action from the breast, so you need to make sure he learns to suck both ways. See a lactation consultant for sure. After my supply was up I stopped supplementing every feed and only supplemented a few times and then, finally, once a day.

So - to the drugs. I took 2 pills 3 times a day, plus 3 fenugreek tablets 3 times a day (available most cheaply from Chemist Warehouse). Within a couple of weeks I had gone from being able to express 20ml to being able to express more than 100 ml at a time (I only have one functioning breast). So I really really urge you to get the prescription. Don't get them give you 1-3 tablets a day, you really need the 6 to make a difference. I did not really notice any side effects from the domperidone. The fenugreek makes your wee smell sweet and your sweat a bit onion-y. Small price to pay!

Even with the drugs I still never had quite enough and ended up giving one bottle of formula (Bellamys) a day just before bed. That way I knew he was getting enough food but all but one of his feeds was from me.

One great thing about comp feeding is that your baby learns to take a bottle early, so you will be glad later on when you are able to express milk for him and leave him with his dad or other family. I could never have believed I would ever look back on the early weeks and be grateful DS needed formula supplementing, but I am glad now because he was able to transition easily to expressed breast milk once I went back to work.

Best of luck to you. It is hard work but for me it was really worth it. Please feel free to PM me or ask other questions. I am definitely a domperidone fan!

#8 chrisl

Posted 05 February 2013 - 08:00 PM

I used it with my first child and it worked and there were no side effects. It was prescribed by a paed, I took the medical advice over the 'well meaning' advice about round the clock feeding. Baby gained weight quickly, I weened her completely off formula (I had to give her formula as well as BF because my supply was so low). She's now a healthy six year old.

#9 ZCE

Posted 05 February 2013 - 08:11 PM

Domperidone is the only thing that kept my DD in breast milk for the first 7 months of her life (mastititis killed my supply at 7 months).

DD lost 12% of her birth weight by day 3 as she was a sleepy baby and a terrible feeder. By 4 weeks i'd given up feeding from the breast as she'd fall asleep or feed for an hour only to down a full bottle of expressed milk because she was starving and hadn't taken much out. I was feeding for 40 - 60 minutes, giving a expressed milk top up after, then possibly a formula top up if it wasn't enough then i'd have to sit and express.

My supply was ridiculously low so by 4 weeks i was solely expressing and bottle feeding and on domperidone. It allowed me to make enough to only supplement with 1 bottle of formula a day.

#10 lucky 2

Posted 05 February 2013 - 08:14 PM

QUOTE
Don't get them give you 1-3 tablets a day, you really need the 6 to make a difference.

I can't remember the details but I think the dosage recommendations are changing, lowering, if I remember correctly there was a notification about domperidone.
So you can't do more than take medical advice about the dosages of domperidone, which should be based on current knowledge.
I'm trying to find the source of that information, can't find it yet.

#11 Feral-as-Meggs

Posted 05 February 2013 - 08:16 PM

I took Motillium which I think is the same - similar story to you, we were in separate hospitals for 3 days (both in isolation due to shingles/chicken pox) and although I managed to get to see him, it wasn't ideal as I had to wait for a hospital porter and midwife to take me over (actually sneak me in as I was officially banned from there) and by the time I got there he was asleep again so my milk took a long time coming in and he hadn't regained his birthweight by the time he was supposed to.  

I'm not sure I actually needed it - I was taking a very low dose - but it was sort of a confidence trick and let me relax.  Without it I might have panicked and started comping which might have started a downwards cycle.   Actually I think he sorted the supply issue out himself by going all crazy shark baby with cluster feeding and many overnight feeds.

I did all the other stuff people suggest like drinking lots of fenugreek tea, getting rest, lots of skin to skin etc too.

When he started gaining it was about 400 - 500 grams a week and he went from 50th centile to somewhere off the top of the chart so that was good.  

I didnt have any side effects at all.

Hope everything goes well.

#12 Chocciecake

Posted 05 February 2013 - 08:21 PM

Great stuff, what's your concern aboit taking it? I was on 2, 4 times a day for about eight months. Enabled me to breastfeed premmie twins original.gif no side effects except I found it hard to lose the pregnancy weight - I was hungry all the time due to gastric emptying!!! Please don't even think twice about taking it - brilliant stuff!!! (and of course all the other things everyone has said!)

#13 FeralFemboside

Posted 05 February 2013 - 08:37 PM

I took 2 tablets 3 times a day and it made a huge difference to my supply. My experience was like foxy77 in that I also had massive appetite while on and I actually gained weight. I didn't know about that side effect at the time, I wish I had because I think I would have been able to curb myself better.

In your situation I would definitely use it the Domperidone. Talk to your LC and get your questions answered though.

#14 Aimo1

Posted 05 February 2013 - 08:44 PM

I was worried about taking domperidone, but in the end was so glad i did. I think it, along with a great lactation consultant was the only way I breastfed to 15 months. i ended up with only a couple of weeks supplementing with formula until I started on the domperidone and it started working. At the hospital I fed DS every 2 to 3 hours but he was so tired and wouldn't feed because he didn't have any energy left. I also pumped after every feed but that wasn't enough to get milk to feed DH exclusively for me personally.



#15 Oilucy

Posted 05 February 2013 - 08:57 PM

Just thought I'd also throw in a couple of other suggestions...
Lactation Cookies (they're the best and believe me they work). You'll need to source some of the ingredients through your health food store/possibly health section of Woolies. These are sooo yummy that I'd make them tomorrow except that I'm trying not to eat biscuits!!! I recall eating about 8 in one sitting and boy did they work!!

http://www.essentialbaby.com.au/forums/ind...howtopic=561382

Also I found taking Fenugreek, Brewers Yeast and Blessed Thistle capsules were also really beneficial (again available from the health food store and I found worked best when taken together). And lots of water - huge amounts.

#16 bryce's-mummy

Posted 05 February 2013 - 09:00 PM

I took domperidone and it did work a little. I was like you- unable to produce milk for any of my babies. I was also getting about the same amount as you. You can measure how much a baby suckles from you directly (I went into a breastfeeding facility and this is what they did)- bare weigh baby before a feed, then give a normal feed, then bare weigh again. However many grams more baby is= how much milk they have received (if they use their bowel or bladder or vomit slightly then the results won't be accurate). You may find you have more milk at the evening times than during the day (hormones are to blame for this!)

What also increased my supply with DD was using Fenugreek (avail from health food shops and chemists)- a natural herb. And perhaps talk to your LC about the use of a 'supply line'- this is a great device! It wasn't until I had DD and saw a lactation nurse/GP who informed me I would be unable to make enough milk for my babies to survive solely on due to a condition I have (insufficient glandular tissue or IGT). I am not saying that you should think you are not making enough or have a similiar condition- what I have is very, very rare apparently. But if you do not 'succeed' please don't beat yourself up for it. What a wonderful thing you are doing giving your baby the amount of BM you do have.

Good luck x

#17 eleven

Posted 06 February 2013 - 11:03 AM

Thanks Ladies.... Do you just take the medication to establish supply or is it necessary to continue to take it th whole time you're breast feeding?

#18 sakura73

Posted 06 February 2013 - 12:45 PM

I took it for about 4 months, from memory. Or maybe until 6 months? After that I stopped, and the milk stayed. At 18 months I am still doing one breast feed a day.

#19 noi'mnot

Posted 06 February 2013 - 12:51 PM

I took it for about six months, and continued to feed my child for over two years. It was brilliant for us.

Good luck, OP.

#20 karen13

Posted 09 February 2013 - 10:33 PM

I took the medication for 2 months until my GP refused to prescribe any more. Interestingly, The hospital where I had DD would only allow it to be taken for a couple of weeks. I was only able to express 20-60 mls from both sides (combined). I felt that my supply increased a bit while on the medication, but it could have been the regular pumping and feeding that helped also. I had some mild headaches when taking double the dose initially recommended, so just stick to what they recommend. Despite my lack of success, I have a friend who dramatically increased her supply after only using it for one week (her low supply was due to poor attachment however).
Good luck!

p.s. I would use the medication in the future again!

Edited by karen13, 09 February 2013 - 10:34 PM.


#21 lucky 2

Posted 09 February 2013 - 10:54 PM

http://www.tga.gov.au/hp/msu-2012-06.htm#domperidone
Two of the major Maternity Hosps in Melb apparently have or will reduce the dosages prescribed for lactation because of the TGA medicine safety update above.
The dosage will be capped at 30mg per 24 hrs (one tablet 3 times a day).
It still can help at that dosage but will it be as effective as the higher doses?
Only time and further studies will tell.


#22 bronhilda

Posted 09 February 2013 - 11:05 PM

I have been using it for the last few weeks. I am exclusively expressing for my DD due to her initially being too sleepy to feed efficiently amongst other things. I have certainly seen an increase in my supply. I would think it doubles my output of each express. I was prescribed one tablet 3 times a day - at the moment I am taking them twice a day to try to extend the amount of time my DD will be receiving breast milk. From my previous children I know my supply will dry up very quickly once I stop taking the medication.

I have had side effects - there are headaches. and I find that if I don't eat within 30 mins of taking the tablet, I am inclined to have an upset tummy. I am not taking a large dose, my understanding is side effects would be more if I was.

My OB was happy for me to use these until this script ran out and then gradually progress to formula. She was concerned about the long term use and side effects.

It is the first time I have actually used it although it is my third child and low supply. In the past I preferred to supplement with formula rather than medicate myself to make it happen. I have no issue with formula at all, my older children were happy and healthy even though they were mostly formula fed from an early age. This child has reflux however, and I feel I should give her as much breastmilk as possible which is easier for her to digest.

#23 bailee

Posted 09 February 2013 - 11:26 PM

I have used domperidone both times while breastfeeding for over 2 years each time. I was in the situation where I didn't start to produce breastmilk without it so I started on it and had success. I am currently weaning off it after 2.5 years and my supply is holding up.

QUOTE (lucky 2 @ 09/02/2013, 11:54 PM) <{POST_SNAPBACK}>
http://www.tga.gov.au/hp/msu-2012-06.htm#domperidone
Two of the major Maternity Hosps in Melb apparently have or will reduce the dosages prescribed for lactation because of the TGA medicine safety update above.
The dosage will be capped at 30mg per 24 hrs (one tablet 3 times a day).
It still can help at that dosage but will it be as effective as the higher doses?
Only time and further studies will tell.

My GP refused to prescribed me anymore domperidone based on this 'update'. Really her reason was because she doesn't believe that I should be breastfeeding after 12 months - she said that and that I should wean. I no longer see her because in addition to her parenting judgements, she also failed to discuss what risks there were with continuing the medication and if they were relevant to me or if i had already done damage. I rang Rodney White at Monash Medical Centre (expert in breastfeeding & medication) and was told that this is not new information at all and that only a certain section of the population is at risk and this can be assessed by the dr if they bother (and put their judgements to one side - my words). They did an assessment for me over the phone - looked at my medications, health issues and family history and stated that it would be safe for me to continue with the meds at the higher dosage if I wanted to. They also offered to speak with my GP but I decided I wouldn't waste anymore time or money on her.


#24 lucky 2

Posted 10 February 2013 - 10:44 AM

Even if the research is older the changes have happened recently and many GPs will look to them for guidence on this.

There could be the possibility of starting on the 30mg and having an ECG done if the dosage is not sufficient to boost supply optimally, to see if there are any problems with a view to increasing the doses.
But it will be up to the Drs discretion whether they will do this or no, as per usual.

Sorry to hear your GP wasn't very bfing friendly bailee, great you found a new one.
I've also received some great advice from the Monash Medical Centre Drug information service about drugs and breast feeding, the service is linked in the pinned thread about resources, at the top of this forums front page.




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