Domperidone and milk supply

Newborns & Infants Breastfeeding & Lactation
1

I have been struggling to get my milk supply up- my baby is about 7 weeks old and not a great nurser, plus I think my supply is just low to begin with. I'm seeing a lactation consultant (we're working on improving his latch) and am taking some supplements (fenugreek, More Milk Plus) and pumping with a rented hospital grade pump but my supply is still very low (I do think that pumping and the fenugreek have helped a little, and his latch is improving, but I'm not satisfied with the results yet). I also rented a scale to see how much he's actually transferring (.4 oz of milk vs. 3.8 oz of formula) and when I pump I only get between 1/2 oz to 1 oz usually so it takes several pumps to make one feeding's worth.

We're supplementing with formula so the baby will gain weight, but I'd really like to be providing more milk for him, if possible. I think the next step is to try Domperidone but I'm wondering if anyone else has had similar problems and what they tried, or if anyone has a success/failure story with Domperidone specifically. How long did it take you to increase your supply? What do you think was the most effective intervention? What percentage of your baby's intake is milk vs. formula now? If you weren't able to increase your supply, did you continue breastfeeding anyway even though it was a small amount? I'm not ready to give up on breastfeeding yet, but I am growing weary of how much of a struggle it is and how time consuming feeding plus formula plus pumping can be.

2

Hi there,

I had a very similar situation with my first son. He had a weak latch/suck and was losing weight, so we started supplementing with formula. I tried fenugreek, More Milk Plus, and hospital-grade pump after feeding. And, I also tried Domperidone. Here are my lessons learned, for what it's worth:
- yes, I think Domperidone was helpful. I think it boosted my supply more noticeably than the herbal supplements. I took it for a couple of months (starting around 5 weeks I think), and when I stopped, I think I kept the increase in supply.
- I think the herbal stuff helped as well, just to a lesser degree
- Eating well and getting enough sleep also helped. I was skipping meals because I was so busy with a newborn and the pumping, etc. Bad for milk production. I personally found that high-protein meals would boost my supply (especially red meat). Also, that I could nurse more if I'd had a nap.
- I also found that drinking enough liquid really helped.
- I also never pumped very much milk, but learned that my baby was actually getting more when nursing than I could pump

At some point (maybe when my son was around 8 weeks), I stopped with the pumping. For every feeding, I nursed my son on both sides until it was clear he wasn't getting any more. Then, I topped him off with formula. It became a pretty easy routine (especially without the pumping), and I never skipped a feeding (I always nursed before topping him off). So, he nursed and drank formula and was fine. As he nursed, his latch got better, I got more knowledgeable and relaxed, and my milk production did go up -- but never enough to take him off formula. I weened him when he was 14 months old and I was pregnant with my second. Some people told me I was bound to have trouble with my 2nd, too -- not so. My second was a champion nurser. I had zero troubles with supply or with him gaining weight. Interestingly, I still wasn't able to pump very much.

I hope this helps a bit.

-Deb

3

You sound like you are doing all the right things. Breastfeeding is a parasympathetic process (the relaxed part of our personality) so relax. Get a massage if you can. Find a funny show to watch, sit in a comfortable place and be happy. You are breastfeeding your baby and giving him wonderful immune protection. Just keep going and enjoy it as much as possible. It should help your let-down. You are doing a great job!

4

Have you tried pumping both sides at once. This may help increase how much you get. It helped me produce alot.

5

Hi Pegeen,

I had the same problem when trying to breast feed both my children. I was so disappointed because I wanted so badly to breast feed them but no matter how much I pumped, I just couldn't get more than 1 oz and I knew my baby was hungry for more. I supplemented with formula at about 3 weeks. My mother, apparently had the same problem and had to supplement as well. The good news is that neither of my children have any food allergies and they are both healthy, athletic children. I gave up pumping because it just frustrated me to get so little after an hour of pumping. Didn't know about Domperdome at the time but tried Fenugreek...never worked.

6

Congratulations on your new baby!
I have the same problem and I'm using Domperidone with wild success. The only time I actually measured what he ate - before taking anything to help with my supply, he got only 3/10ths of an ounce. Domp. is by far and wide the most effective intervention I've used. Now, I do supplement but only one bottle a day, which I give at night to help my ds sleep.
Pumping even now only gives me about 2oz total, but I don't use a fancy pump, just a Ameda and only when I leave the baby with dad and need to relieve pressure on me.
When I first started taking it, I had to start slowly as I did experience a headache until I was used to it. But that's the only side effect I experience. I've got a friend who didn't have that problem, but needed to be close to the bathroom within and hour of every dose as it kept her regular. (It was originally meant for GI issues.) For my first baby, the headaches lasted about a week, the second, only a couple of days because I knew it was going to happen so I increased doses much slower. It took me a week or two to build up the supply enough to decrease the supplementing. Now I feel it working within 20 minutes every time I take it.
I was told there was a chance that I wouldn't have issues with the second baby, but I did. The difference was that I knew what to watch for with the second and was prepared much earlier with him.
I kept taking it until my daughter weaned herself at 11 months and expect to take it for as long as my son nurses, but it's such a relief to know that I can.
Taking care of yourself by getting plenty of rest, exercise, food (high protein diet) and water to drink are very extremely important.

Don't give up without trying this! The first 8 weeks are the hardest for a new parent without any issues. You need to give yourself a break, and know you are doing everything you can. Cheers to you for supplimenting until you get the rest figured out - baby needs to eat and grow.
You'll be fine - best wishes to you.

7

After trying all sorts of things with each of my 3 babies I found that the two most effective were really drinkg as much water as I possibly could through the day--I mean TONS. Until looking at water made me gag. But I'd find myself really engorged and it made it so much easier to pump. The other that helped was a bowl of slow cooked oatmeal every day--great for milk supply--and a cup of tea right before pumping. Good luck--I know how frustratin it can be!!

8

Hi Pageen,
I produced very little milk with both my children. I tried the herbals with no success. I never tried Domperidone as I am very wary of meds and often am oversensitive. What I found that worked for me was the Supplemental Nursing System (SNS). Ask your lactation consultant about it. I enjoyed it because I was able to nurse and supplement in one step. It is supposed to help increase your supply so you do not need it any more after a while. Which from your description sounds like may work for you. Might help with baby's latch. For me it was a way to nurse my children who did not have trouble latching my body just does not make milk. I gave up pumping with the SNS as well. I felt it was a waste of the very little milk I had. At least with the SNS I knew my children got the milk that I did have. Both my children weaned themselves at 9 months, which I believe is when they figured out mom wasn't really doing it for them. I would have liked to have nursed longer but at least the SNS gave me the time I did have. Just wanted to give you another suggestion in case you had not heard of it yet.

9

My son was on formula from the beginning with supplemental breastmilk because he spent a week in the NICU. I HATED pumping milk, and never got very much either. When my son came home at 1 week old, I kept trying to nurse and pump and still had to supplement with formula. At one month, I gave up pumping and both my son and I relaxed. He got more milk and I didn't have to deal with That Thing anymore! I actually was able to decrease the amount of formula I gave him as he nursed better and longer.

Now at ten years old, he is a champion eater (probably could stand to get more exercise and less food) and is at the top of his class. He rarely/never gets sick and is happy and well adjusted.

My point is, do what you can, and relax about the rest. It will make life much easier for you and your baby and will all work out in the long run.

10

Pegeen,

Oh darlin! Try not to give up. Provided your nipples are not sore or bleeding, try nursing more frequently (I know it's all you do right now)

I had a mountain of grief over the same issue, but did find that it did turn around at about two months.

Hang in there..

Reenie

11

Hi Pageen

You sound just like me with my first child. I did everything you are doing because when she was 2 weeks old the doctor told me she was starving so I had to start supplementing right away. What I learned was really important was the pumping right after you nurse to fool your body into thinking the baby needs more. I know it is super hard to keep this up. I got just a few drops out. But in the end I was able to stop supplementing. If you feel you can't deal with that anymore then just nurse him and finish off with formula. He is still getting all the benefits of breastfeeding. Make sure you are eating right and drinking lots and getting as much rest at possible. My daughter hardly slept but I made sure I slept every time she did. It didn't make for the tidiest house but it gave me results. I was able to feed her only by breastfeeding until she was 6 months. Then I was able to keep breastfeeding her until she was 11 months when she weaned herself. It was truly worth the effort.

On a completely different note, have your thyroid checked. Make sure they test everything. I read on this site of someone suggesting that because if affects breastfeeding, and I'm suggesting it to you because a few years after my daughters were babies I was diagnosed with thyroid problems and take medication for it now. By the way, with my second baby I was only able to nurse her 3 months. I still don't know if the reason the same process didn't work was because I didn't have a hospital grade pump or because my thyroid was to blame.

Best of luck. All the efforts are well worth it. Anything your baby can get will be better than nothing. And when it actually works breastfeeding can be blissful.

Raquel

12

With my twin girls, I tried everything except Domperidone and I was never able to get my supply up. I continued to give them breast milk, though, until they were 4 months because my husband did some research and found that even with just 3 - 5 oz of breast milk per day, you are still giving them almost all of the benefits that they'd get if you were exclusively breastfeeding. So, keep at it if you think you can give your child 3 - 5 oz per day.

For what it's worth, I was almost 41 when I gave birth so maybe it is an age thing. I ended up pumping exclusively after 2 months of of 20 - 40 minute breastfeeding sessions followed by supplementing with formula. It got to be too much with twins. Basically, we were feeding them constantly in one form or another. I stopped at 4 months when my supply dwindled to nothing.

I know it is discouraging to not be able to have the perfect experience here, but the most important thing is that your baby gains weight and grows. Do what you can but do not beat yourself up about it. Plenty of us were formula babies back in the day and we all grew up healthy, strong and smart. ;0)

13

You can do whatever you want to increase your supply, AND I also want to say that I think you are doing fine, just the way things are. Your baby is getting your antibodies and other good stuff from your milk, plus plenty of calories from the formula. In four short months, you're going to be 'supplementing' with food anyway. So congratulations and don't worry.

14

Hi Pegeen, I don't have personal experience with low milk supply, mine was the opposite, too much milk, which also a curse. But, I did just want to say, 'Way to go momma for trying your best to give your baby the best food in the world!" I can tell that you have a wonderfully giving heart and that will take you far into motherhood. And, yes, if you can keep up the BF and the benefits still outweigh the trouble and stress it causes, every drop of breastmilk is helpful to your baby, as well as this sort of physical closeness!

I hope that things continue to improve and that before you know it, this will just be an event in the past that strengthened and tested you.

Courage, Endurance and a ((((HUG)))) to you,
CM

15

Hang in there Mama! It will get better. It took me a long time to get more than .5-1oz per pump. My son is now 4.5 months old and I am pumping between 4-6 oz each time. The best thing is consistancy. Pump at the same time everyday and let the pump keep pumping even when there is no milk coming out. Drink tons of water (3-4 litres per day). Also try not to stress about it. Stress has been known to decrease supply. I know that is hard to do when it is so frustrating but it really works. Believe it will come and it will. I would also try to supplement as little as possible because our milk works on supply and demand. Keep pumping as much as you can. One thing that really worked for me was pumping while I nursed. The latch thing is hard. I stayed awake and cried sometimes when my son nursed. It took about 4 months to get the latch right and sometimes it still hurts but it is worth it. One thing that really helped me latch him was to use my pointer and index finger to open his lips. Hold your nipple with the two and when the nipple goes in the mouth spread your two fingers apart so that it forces their lip up and on your areola. Good luck!

16

I had the same issue with my 2nd. I had too much then it went to almost nothing by 3 months. It would fluctuate depending on the time of month. I tried everything you did, nothing worked. The worse thing was my baby wasn't taking the bottle and wasn't gaining weight and would wet one diaper a day. Be VERY glad he will take the bottle. You can't get Domperidone in the US, you used to but their are some bad side effects or something. Ask your Dr why they stopped, I forget why exactly. They put me on something else and it still didn't work. Give your self an A+ for effort and just know some mom's just don't ever supply enough milk and it's nothing new (in the olden days they had to use Milk Maids). Now we just have formula. As soon as my baby took the bottle (at 5+ months) I gave up trying, too much stress. I was feeding her with a syringe and nursing what ever I could - it was a hard time. She'll be 1 this week!!

17

Forgive me if I repeat information, I didn't read all the responses. Try calling a local midwife and ask their advice. My girlfriend was in the same situation and after she had given up she had a midwife do cranial sacral therapy on her daughter for other reasons and the midwife told her to call her next time and she can tell her what to take, part of it was fenugreek, and she told her she wasn't taking nearly enough. Give it a shot before you resort to domperidone. Best of luck, and happy mothering!
Karen

18

Hi Pageen,

Congratulations on your little boy! I'm a first time 40 (+3 years) mom too! I will relate my experiences with low milk supply in hopes that you will get some info from it that will help you.

My daughter wasn't able to nurse successfully (I saw numerous lactation consultants to no avail) and after 6 weeks of pain I finally changed her over to a bottle. I bottle fed her with what I could pump with a hospital grade pump. However, I noticed a dramatic drop in supply after changing to pumping and using a bottle. I tried several things to increase my milk supply; Fenugreek, More Milk Plus, oatmeal, Mother's Milk Tea, increasing water intake, Barley Water, power pumping (basically pumping more often), and finally Domperidone.

The herbs made a difference for a few days, but not much of a difference (maybe a 1/2 ounce for the whole day). Water helped and so did more pumping. However, when you're already feeding your baby 6+ times a day and pumping 5+ times a day it's really hard to find the time to pump extra. The most I've ever pumped in one day was 13 ounces (in the beginning) and when my milk supply started to decrease I got as low as only 6 ounces per day! I continued pumping this little amount for a few months, knowing that the little she was getting was at least helping develop her immune system. In my 4th month of pumping breast milk and supplementing with formula I decided to try the Domperidone. In 48 hours I had an increase of a couple ounces and in 3 days I doubled my milk production! This was without any of the other supplements.

I am sensitive to meds so I started out slow and still take less than the 3 3x day suggested. I also noticed, at least for me, that it was better taken on an empty stomach (I'd have to run to the bathroom otherwise :) )

A group of local breast feeding mothers order the Domperidone from a UK pharmacy (see link below) and it is much less expensive than getting it from the US and no prescription is needed. If you're concerned about the safety of Domperidone you can read up on the safety of taking it while breast feeding on the Jack Newman website (see link below).

I wish you all the best and want you to know that all your hard work is really worth it--Good job mom!

Sending you lots of positive energy,

Kristen

Here are some links to websites that may be of use to you:

http://drjacknewman.com/help/Domperidone%20Getting%20Started.asp

http://www.mobimotherhood.org/MM/portal-lowmilksupply.aspx

http://www.inhousepharmacy.com/general/motilium.html

19

I had a hard tie with my milk supply, and my son wasn't gaining much weight, especially right at the beginning. I had no luck with the pump - 1/2 oz at a time, and it was so frustrating and confusing. I think that things started to get better when I accepted the formula as a ligitimate food source. Things started to get better when I saw that he was eating (the formula). I think we have a instinctive fear that goes like this: if the baby isn't nursing well then something horrible will happen. Luckily, today, we do have formula. My suggestion is this: give yourself a break and feed him formula and nurse him as well. You can let him nurse and then follow up with a bottle, or whatever you think makes sense. Get to the point where you can RELAX and get some sleep - let your husband feed him overnight with the formula and get some sleep - that's a big help with milk supply. If you hate the pump then I would say to get rid of it. I think it was counterproductive for me - I would sit there and cry and feel like a failure.

I ended up actually being able to ditch the formula after a few months and nursed him until he was over three, so I'm not an anti nursing person. I just think that every situation is different and that it is really important that you be able to ENJOY the baby instead of having to just try to survive. You can use formula as a tool and then stop when you don't need it or want it. Or you can just switch totally to formula and be done with the worry and hassle. YOU HAVE MY PERMISSION!!!

Good luck!
Margaret

20

I don't have experience with Domperidone, bur I wanted to respond because I wish I had tried it. I also had a low milk supply (baby gaining slowly, never pumped more than an ounce or two). It was a very confusing and stressful time because he was very happy and alert and having lots of wet & dirty diapers, but he was skinny as can be and his dr. was very worried. My heart goes out to you and I applaud you for working so hard to give your child the best start in life! Anyway, I pumped, took fenugreek, and nursed 'round the clock without much change, so I really wish my dr. or lactation consultant had recommended domperidone. I have one friend who had a lot of succcess with it.

For a couple months we were supplementing with just a few ounces of formula a day. Even then he didn't gain weight very fast. But we started solids at 5 months and that kid LOVED to eat! Immediately he started filling out and we never had another problem. He is now 27 months old and still breastfeeding. It is a wonderful bond between us and I am so glad that I persevered even when it was difficult. It is completely worth how hard it was in the beginning. I know every day seems like an eternity when all you do is nurse, pump, and give bottles, but really he will be starting solids before you know it and this time will seem so short.

If you do need to keep supplementing with formula long term, you should look into getting a supplemental nursing system (SNS). I believe Medela makes them. It has a bag you put the milk in to wear around your neck, and a thin flexible straw that you put on your nipple so baby gets the supplement at your breast. This keeps your supply up and eliminates nipple confusion. If I'd had to supplement more I was going to get one.

Let me know if you have any other questions or just want to talk. You are doing a great job!