Has anyone taken domperidone to increase supply?

[splatt]

My nearly 5 week old daughter has been ebf and all seemed to be going reasonably well. She latched well straight away, seems to feed well, plenty of wet and pooey nappies. However, weight gain has been poor only reaching birth weight and 4 weeks and only gaining a further 2 oz in the last 5 days.

I've spent a lot of time with a breast feeding counsellor and it seems DD has a posterior tongue tie which makes it difficult for her to feed efficiently because she can't get hold of enough breast. We're now using nipple shields when at home to try to make it easier for her. (BF counsellor said that they wouldnt consider snipping tongue tie on NHS and that with posterior ones it is much more difficult and potentially more problematic)

I've been trying to express for the past week to try to increase my supply and top up DD. However, I get very little. Currently manually pumping though have left a message with NCT to see about hiring an electric pump and see how we get on.

BF counsellor thinks my supply is down because DD hasn't been able to feed effectively and has suggested I see GP & see if they will prescribe domperidone to try to increase my milk suply. Has anyone else been down this route?

I'm desperate to continue breast feeding but it is all getting so hard. DD having cluster feed all morning yestertday, screamed and fussed at the breast all afternoon to the point that we ended up topping her up with Aptamil. Then she slept contentedly for a couple of hours like I've never seen her do in the day. Then I felt desperately guilty feeling that she must be starving hungry so often. I just wonder if it would be best to switch to formula but feel I'd be failing to provide my daughter with what I know to be the best nutrition inthe form of breast milk.

Sorry for very long post and thank you for reading if you'ce got this far. Am just getting to the end of my tether and appreciate any advice / support.

Sorry you're having such a tough time splatt :(

I used domperidone to boost my supply as my ds was premature and in Scbu It was brilliant for me, a true wonder drug but it only worked so well because ds was a good feeder, he was naturally good at it I just wasn't making enough milk because stress/hormones/feeding infrequency. I don't know anything about tongue tie so I'm not sure if it would help.

If your dr won't prescribe domp you can buy it in chemists under the name motillium, it's probably worth trying it :)

Fenugreek is good as a production boost too, and oats are supposed to be but I fever found them much good but were a greet excuse to eat flapjack!

I'm not sure about the recommendation to use nipple shields, do you think they are helping ?

Has your bf councilor showed you how to do breast compression ?

I would get a second opinion on the tongue tie as well, if that is the root of the problem. I'm sure I've heard of people getting posterior tt snipped.

I'm not sure what a posterior TT is, but my daughter had a TT and it was snipped at about 8 weeks, which made a big difference to her being able to latch better and get milk out. Why did they say that they will they not consider it on the nhs? I would also seek a second opinion if possible, or at least ask for a referral to a TT specialist (there was one at our local sick children's hospital).

I think my supply was shot to bits for similar reasons as MiasmARGGG said - stress, hormones and never latching on properly and feeding effectively for such a long time. I also could never express much at all, so had to use formula. Re the domperidone - my Docs weren't keen on prescribing it, despite the BF clinic suggesting it. In my case, I didn't pursue them about it, although sometimes I wish I did as when I did some internet reseacrch it looks like it can work wonders for a lot of people. If you go to the Doctors take along some info about it as they didn't know a lot about it at all - one said she had heard that a side effect of domperidone was unhibited prolactin but had never heard of prescribing it specifically for increasing lactation. The other doc was sceptical about prescribing anything at all. You can get some info about it from Dianne West's Low Milk Supply website (just google her), or Jack Newman's website - print something off or give them the web address to look up themselves.

I'm now mix feeding - I BF twice a day when we're relaxed and at home and can top up if necessary. She gets some breast milk which I'm happy about, and I'm also happy that I know that she's getting enough milk (formula) to grow and feeding isn't such a stress anymore.

Don't feel guilty about whatever happens - I know that's easier said than done sometimes, but having a happy mummy and a thriving baby is what's best, in my opinion. You've done a great job persevering this far, and you never know, getting the TT sorted and domperidone might just sort it all out - I really hope so. And if not, you know you tried your damn hardest and sometimes it just doesn't work out. And that's no one's fault.

I used domperidone and a whole host of other things to get my supply up but nothing really worked, turns out I have hormonal supply issues. Took 41 days for DD to get to birth weight. Hellish. I know lots of others who used it with success though. Like you I felt that formula would be a 'failure' I was so determined to BF - in the end DD was wasting away, she was skin and bone, and DH forced me to give her formula which I HATED but probably she would have been taken into hospital and given formula if I had not. Anyway - I continued to BF with formula top ups and much pumping etc. and stopped formula top ups when she started on solids. I then bf'd for 2 years. This is probably quite extreme, but tbh I've been a hormonal nightmare since the beginning of my pregnancy. But in general DD is v healthy, extremely strong but also v petite at nearly 3. I often wonder if she would be bigger and more laid back if I'd swapped to FF, but then again, I think she's hard work, it's her personality.
I'd def get hold of an electric pump - it is MUCH easier and if you are mixed feeding you are still BFing... so she is getting the anti-bodies etc.etc. from you still. BUT MOST IMPORTANTLY whatever you do, BF or FF, your DD will be absolutely fine. Do whatever gives you the most peace (emotionally as well as physically), go easy on yourself, you've given her the best start (despite the slow weight gain) and you should be really proud of yourself. Whatever you do now will be right for both of you and ignore what anyone says about the 'best' thing for your child. The best thing for your child is a mother who isn't frazzled and stressed out.

I think because TT is posterior, and she can latch and feed (just not as effectively), can move tongue and sort of stick it out it's considered vital to snip it as speach won't be affected. Plus posterior is much more complicated to fix.

Health visitor has given GP info and I'm waiting for him to call re domperidone

I disagree theborrower - it isn't the mum's fault, but it is often someone's fault! GPs who don't know what they're talking about, midwives who don't spot problems, HVs giving out mad advice. This forum is full of mums half kiling themselves trying to feed their babies and so-called professionals being more of a hindrance than a help. The NHS puts lots of effort into shiny leaflets and posters telling us Breast is Best and then often completely fails to support women to actually breastfeed.

Well GP is doing me a script to pick up later and is going to do some investigating re posterior tongue tie and if there's anyone reasonably local who will take a look for me and tell me what would be involved. He thinks the next nearest hospital might do it.

MoonUnitAlpha - actually, I think you're right - more eloquently put than me. It's not the mum's or the baby's fault when things don't work out, which is what I was trying to say, so mums shouldn't let guilt eat them up. I'm still a bit angry that our tongue tie wasn't spotted until 5 weeks and fixed until 8 (although, actually the midwives in hospital did spot it and kept disagreeing with each other on whether it was an issue and subsequently nothing was done about it until later when someone else mentioned it and referred us) - I do wonder if things might have turned out differently if we referred straight away. I also wonder if we had prescribed domperidone (and early on) it would have helped. I also remember you supporting me when I first posted on here, so thank you :)

I am pro BF, by the way, but because I felt so bad (and was slipping into PND with the stress of trying to get to EBFing), I don't think it's the be-all-and-end-all when a mother is getting really stressed out about feeding, and I wish more people had said to me that it was ok to FF and that you could mix feed rather than having to BF exclusively or not at all. LIke you said - mumsnet is filled with mums getting so upset and stressed aiming for BFing and I really do think a happy mummy is better :)

Splatt - great news so far! Hope you get it sorted, let us know how you get on. Hang on in there x

Splatt - my DS was diagnosed with mild tongue tie at 4-5 weeks, and BF counsellor (working in local NHS hospital) referred him to get his tongue tie snipped on NHS. So they will do it. The procedure is very quick (takes about 30 secs) and painless for the baby. Can you see if your local NHS hospital has a BF clinic or a counsellor you can see? With DS, it was only part of the problem though as my supply was insufficient even when tongue tie sorted out, and tried every method under the sun incl Domperidone (which didn't really work for me) to increase supply and ended up mixed feeding to make sure DS getting enough milk.

Right so first dose of domperidone taken. First express with hospital grade electric pump yielded 1.5 oz, which given have got NOTHING in afternoons with manual is a definate improvement. DH came home with box of Aptamil :-( but if she's screaming and screaming better that than us both in floods of tears again.

pinkpeony - the BF counsellor I've seen works at the hospital and at local GPs. So she would know that local hospital wouldn't do it but GP thinks one the other way up the road might. Did your DS have a regular TT or a posterior one? I know it's easy to quickly clip the ones at the front but not sure about hers as it is just there is too tissue at the back underneath her tongue to let her stick it forward enough.

TBH, I didn't even know there were different types of TT, was just told it's fairly frequent and easily sorted out at the time (last year).

splatt - When I've tried to increasing yield while expressing these things have really helped :-

Pump/feed at least 8-12 times a day the more milk you remove the more you should make)

Massage breasts before pumping

Pump until milk flow stops can do breast compressions whilst pumping as well)

Hand express after to get the last* of the milk

*there is never really a 'last' to the milk but the more milk you can remove the more you will make.

Try covering the pumps so you don't look at the milk coming out I found the more I looked the less there was coming out. You can usually attach the pumps, then clip the bra cups back up and the pumps stay in place, so you can put your top back down or drape a muslin over them.

You can also try block pumping which is express for 10 minutes from both sides at same time if you have a double pump), then rest/have a shower/do something else for 10 mins, then express for 10 on both sides, rest for 10, express for 10.

This isn't really to get more milk out immediately but to signally to your body to make more milk so don't panic if there isn't much pumped whilst doing this.

Of course not everything works for everyone but combining pumping with domperidone hopefully your supply should soon pick up.

Thanks for advise truthsweet.

The instructions for the pump I have involve turning the cycle down and the vacuum up when milk starts to flow then the reverse when it slows to mimic baby. So have to try to watch what's happening to know when to do this.

Got barely anything this evening on pump but that is probably because I am physically and emotionally drained. Off to bed. Hopefully we'll have improvement tomorrow!

I started domp 2 weeks ago and it changed my life over night. it worked really quickly and I was able to stop.formula top ups just 1 day after taking meds.
good luck and I hope.it works as well for you as it did for me.

Second what Truthsweet said re pumping: frequency of emptying the breasts, also at night (sorry) is essential to increase supply.
DS had posterior TT and, like you, we were told NHS would not do it, so we hired private lactation consultant to do it sat home: best £180 we have ever spent! I was having similar problems to you but after the TT operation and some more BF advice we managed to stop formula top ups at one month and now, at 10 months, DS still bfeeds 3-4 times a day.
Well done on getting this far and do persevere: it does get better!
Ps: DS was hospitalised at 4 days for excessive weight loss and jaundice, both due to the poor latch caused by posterior TT. The lactation consultant at the hospital spotted it and was quite cross nothing would be done on the NHS. Worth asking about private options where you are, it might well be cheaper than here (central London).