Maximising impact of Domperidone on milk supply

[postingpartum]

Hi,

I am a first time mother of an 8 week old boy with a healthy appetite. To cut a long story short I had a fairly stressful delivery and subsequently my milk never really came in properly. After many weeks of pumping, skin on skin and feeding - all of which made only a marginal difference - I am now on Domperidone which has made a significant difference. (I have gone from only being able to express about 20ml to 100ml.)

I am taking about 12 tablets a day (3 x 4 tablets) which is more than the recommended maximum but it appears to be what my body needs right now for the Domperidone to work. (I have also read on Dr Jack Newman's site that some women take more than this.)

Before I start to wean off the tablets (when I first tried my milk supply took an immediate nosedive), I would be really grateful to know any tips from others who have taken the medicine as to the best way to maximise its impact. For example, the best times of day to take it and how to spread out the dosage over the course of the day.

Any advice will be much appreciated.

I wish I had the answer, but just wanted to add my support, as I'm in almost the exact same situation, except that domperidone hasn't helped me quite that much, but OTOH, I'm not taking quite as much. (I got palpitations at 9 tablets a day, so the most I've taken is 6 tablets a day.)

After being on it at that dose for about 3 weeks, I'm now switching to 3 tablets a day, as the GP doesn't want to give me more refills, but I do think that's reducing my supply. I haven't been pumping since starting the tablets, so I can't say the exact effect. I just feel less full, which I know doesn't necessarily mean less supply. I'll have to see over the next weeks whether DS starts taking more formula again and how his weight goes.

Hi,

It seems like we're both in the dark, but one thing I would say is that I still had to keep pumping to get my supply up. But the pumping had much more of an effect once I started taking the Domperidone. (I'm also taking Fenugreek which I think works a bit, but not as much as the Domperidone.)

I hope someone with more experience picks up this thread because I'd really like to know the answer!

Is there a reason why you are keen to wean yourself off? Domperidone, when taken for its licensed use, is often taken by people for years. It's a very safe medication. Dr Newman says as much.

I'm not sure about OP, but the reason I'm trying to get off domperidone is because my GP says to and doesn't want to prescribe any more. I'm not sure where he's getting his information, but he thinks that for lactation purposes you only take it for up to 8 weeks.

However, I just found Dr Newman's article about how to wean off it and how long you can take it, and I agree that there he says you can take it for much longer. In fact, there is no mention of 8 weeks at all.

Anyway, for those of trying to get off it, here's Dr Newman's article about how to do it. It looks like I've been weaning too quickly: www.breastfeedinginc.ca/content.php?pagename=doc-DS

I was on x3 a day. Went on holiday when ds was 5.5months and forgot my tablets.

Didn't make any difference to my supply.

Don't follow my example though!

I'd follow what Dr Newman says - he knows his stuff. I did notice that in your posting, Amy. Could you point your GP at Dr Newman's pages?

When I was prescribed domperidone at maternity ward, I was told that it only works if you expressing as well. I used to express for 15min directly after each feed, until my supply got established at ~6 weeks. Then I started slowly weaning of domperidone following dr Newman's guidelines and it was fine. I think it was reducing dose by 1 tablet every 3 -4 days. I probably would have continued longer just because I was really worried that weaning of domperidone will reduce the supply and it was such a hard work to establish it, but my GP refused to prescribe saying that only consultants can do it (but haven't referred me to one!), and it is pretty expensive to buy it without prescription.
Take it slowly, and although it maybe ok to take a high dose, it is much nicer, when you don't have to! And well done for establishing your supply!

Thank you for the responses. I'm not keen to wean myself off but I anticipate that my doctor may refuse to continue to prescribe it. I will have Dr Jack Newman's material to hand, but I'm not sure how receptive they will be.

To those with experience of taking it, did you find that it made much difference as to the time of day you took it or how you spread the dose over the day?

I took 2 tablets × 3 times a day, never thought about the effect of the time of the day, just took morning, lunchtime and evening, i think roughly 8am, 2pm and 8pm. But I did not try to vary, don't know whether that would have an effect.

Thanks Daluze. I try to follow roughly similar times so that's useful to know. Though my main problem at the moment is fighting baby brain and actually remembering to take the doses -- at anytime!

I was on 16 tabs a day with my ds ( missed tongue tie totally fucked up my supply, alongside shit bf advice, and a breast reduction which made supply a likely issue anyway). I didn't go off it until he stopped feeding, although I did reduce it as he got older and fed less after he was weaning.

YY to pumping. I've actually taken a few tabs the last couple of days in conjunction with expressing as 12mo dd has upped her feeds again and I needed to quickly increase. It works fairly quickly and effectively for me.

My dr is very receptive to jack newman's research, thankfully.

Hi,

Just wanted to come back and update. I found that dropping the tablets too quickly did hit my supply and it was only after a couple of months that I could drop them easily.

My experience with GPs at my local surgery was that some were very cautious to prescribe domperidone, and others were more relaxed. I believe the reason is that domperidone is not licensed for use as a lactation booster, and technically this means the GPs are legally exposed if they prescribe domperidone outside of license and something went wrong with it. To anyone else wanting domperidone and facing difficulties getting a prescription, I would recommend investing in seeing a lactation consultant (rather than a breast feeding counsellor) who can write a formal recommendation that the GP issue a domperidone prescription. The GPs kept a copy of my letter on file when they prescribed the domperidone to me and seemed to take comfort from it. I get the sense that as long as they have an official looking piece of paper signed by someone else recommending Domperidone, they feel sufficiently protected to prescribe it.

One of the friendlier GPs at my surgery even suggested putting it on repeat prescription, which was a result. I have kept back one of the boxes so I have a head start if I have the same problems next time...

However, the GPs would not prescribe more than the maximum 8 tablets per day (and I was on 12) so I still had to get top ups of Motillium from the internet.

I have stopped bf now but I hope this information is useful to others.

Hi Posting
My milk supply has also gone down and I now have to add domperidone. The problem is that my gp won't prescribe much. I saw that you ordered it online. From where did you order it?? I need to order it myself.
Many thanks
Yasmine