Weaning off Domperidone

I have been taking Domperidone for low milk supply for around 2mths now. It considerably helped my supply and i was then able to stop feeding EBM in between feeds. It was recommended to me to try and wean of the medication, but to gradually wean. I did that and went off the medication but my milk supply dropped again and i had to give EBM in between feeds again. So now i am back on it and my supply has improved. I was wondering if anybody has successfully weaned off it and still BF for sometime (I'm planning on BF for as long as possible, i achieved my 3mths mark and now heading to the 6 mth mark). Maddie has never had formula and i don't want to start giving it to her now just for top ups. Also has anyone successfully stayed on the medication until they finished BF and had nil side effects, (i have had no side effects).
Thanks in advance for your advice
Cheers Angie

Hi,

It sounds like you have done a fabulous job with breastfeeding though you have clearly had some problems. During pregnancy, the levels of prolactin (the hormone which makes milk) increase. But hormones produced by the placenta suppress the action of prolactin, so only a small amount of colostrum is produced. When the placenta is birthed, the hormones which suppress prolactin abate, and prolactin is able to "do it's thing". And, after a day or two your milk comes in. In the early day, milk supply is more driven by these high levels of prolactin, and oxytocin, the hormone that "releases" the milk, or is responsible for the milk ejection or "letdown" reflex. Over time, prolactin levels return to nearer their normal (or pre-pregnancy) levels. Milk supply is controlled by "supply and demand" - ie your baby feeds and removes milk from the breast, and you make milk. Some-times something interferes with the normal process - a difficult birth, early separation etc and prolactin levels get too low too quickly. Domperidone, or motilium, act by increasing your prolactin levels. But, as I mentioned, as breastfeeding is established, prolactin is less important. Therefore, it should be possible to wean off moltilium and still have a good milk supply.
However, some mothers find that, despite the "science" this doesn't work for them, and they have to take motilium throughout their lactation. Many mothers have taken it for months or years (this is often the case with mothers who breastfeed their adopted child) and suffer no side effects.
So, if you need to continue taking motilium and you have no side effects, be reassured that it is fine for you to do so. I wonder, how old is your baby? How many feeds per day is your little one having? What makes you think you don't have enough milk?
Talk soon
Barb

Hi barb:
Thankyou for your advice. I had a very difficult birth, 32 hour labour, failed vaccum extraction and then an EC. I was lucky however that i got to feed Madeline within the 1st hour of birth. I have had problems such as cracked nipples, engorgement (at the beginning), mastitis, low milk supply, breast refusal sitting up (we lie down to feed), thrush (ongoing) so we didn't get off to a good start. I have used nipple sheilds (thankfully i don't have to now), bottles (with EBM)dummy since she was 2 weeks old as she wanted to feed on me as a passifier and i was really sore, nursing supplementer (with EBM, to try and increase flow [was that the reason she was fussing at the breast sitting up?] and to satisfy her at the same time without havening to give EBM via a bottle afterwards).
For the thrush we have used fluconazole (about 5 courses), nilstatin tabs, dactarin gel, nilstat drops and have recently been presribed kenacomb ointment. I have seen many LC including the Royal Womens Hospital in Melbourne.
To be honest i'm a bit exhausted with the whole trying to get rid of the thrush that i'm not taking anything at the moment as its at bay (not getting worse) and i can put up with the slight pain involved. If it gets worse again i'm going to try the gension violet stuff (sorry not exactly sure of the name).
Anyway as for feeding: Madeline is feeding about every 2.5 - 3 hours in the day about 6 feeds a day. She sleeps through the night and has since she was about 4wks old. She sleeps from around 10pm to 6-7am. I had been for a while getting up in the middle of the night and Expressing so that my supply would stay up, i would then top her up with that milk the next day if she needed it. I'm not getting up in the night now as i sleep right through. I know that this can contribute to the supply level but i'm not willing to start waking her up. Normally when i take Domperidone i can wake in the morning very full but when i don't take it there feels like there is nothing there. Also when i'm not on it Madeline is much more unsettled and i can tell that she just isn't getting enough. I have tried to Express in between feeds in the day but this only helps a little. Madeline is 3.5 months old (15wks).

Hi there,

I expressed full time for 12 months as my baby was very sick and unable to feed - nasogastric feeding tube for 26 months!!

I went on the same drug at around 3 months and basically was too scared to come off it in case it upset my supply. I stayed on it until I finished expressing, so all up I was on it for around 9 months without any problems.

Good luck!

Rachel