Motilium - how much effect, and how fast?

[Sanguine]

I have a 12 day old baby and I am having serious milk supply problems. I'm permanently in a cycle of feed/express/top up and the milk just doesn't seem to increase. We're getting my baby's tongue tie snipped this week in the hope it will help, but the midwife recommended I try taking motilium to boost things artificially. Is it realistically going to make a lot of difference? I read it isn't so good at boosting a supply that was never there in the first place. If it is going to work, how long should I give it to take effect? I'm hating every second of expressing, my boobs feel bruised and wrung dry, I'm at the end of my tether but I really wanted to be able to breast feed. When do I call it a day and give up on the idea? Emma

Sorry not used motilium but have used this. Hopefully once the tongue tie is sorted your LO will take more milk which will in turn boost the supply. It's still early days, keep at it, make sure you keep badgering the HV for support, can you try and find a breast feeding counsellor locally?

Also, expressing isn't going to be as efficient at boosting supply as your baby.

Good luck

signs that milk supply isn't good - baby is ravenous and looking for breasts everywhere! He dropped 20% of his birth weight and ended up in SCBU at which point we had to supplement him with DBM and now we're home, formula. he's latching beautifully and doesn't make me sore. after he's done, breasts feel empty and it's hard to express any milk. The breastfeeding practitioner in SCBU said the toungue tie or maybe my horrendous long labour interfered with the milk coming in. It's been playing catchup ever since, baby is now taking everything he can of me, plus 20 ml expressed, plus 60 ml formula every 2.5 - 3 hours (he's doing well on the top-ups and is almost back up to birth weight - plenty of wet nappies!) I'm double pumping after every feed and rarely get any more than 20 ml. If I try to go without topping up, just roots around everywhere instead of going to sleep. The midwife I saw yesterday agrees there are definite supply issues (after examining him closely while he was feeding) and suggested motilium.

All the books and my NCT class go on endlessly about breast engorgement, and never mention the possibility of under-supply. My breasts have never once felt full, or leaked, or become engorged. I feel like a dry old prune.

Sanguine, I'd say you probably need expert advice to get your supply up - I know nothing about motilium. But 80mls from various bottles every 2.5-3 hours for a 12 day old might not be enough stimulation for your breasts to build up a supply?

Do you need to give such large top ups? Could you gradually decrease the size so that he needs to feed from you more frequently perhaps and that way should increase your own supply? If you got him to feed from your breasts every 2 hours instead of 20+60, I bet that would help. Yup he might be ravenous and fussy for a day or two but babies at that age normally are anyway, especially when they're upping the supply. If the tongue tie is going to be sorted and he's latching on well and getting some milk in the meantime, don't really see why you need to top up so much? Perhaps you/the HCPs are worried about his birthweight? But please get advice from a BFCounsellor on this since I'm not sure him getting most of his calories from a bottle, even if a part of it is EBM, is going to help up your supply...?

Perhaps put out a call for Tiktok who's the expert here to advise you or call the NCT/LLL/BFN lines?

I'm doing what I've been told by the BF practitioner at SCBU, then had a community midwife out who was a lactation advisor too - they both recommended motilium as well as this regime of feed/pump/top up. I'm a bit worried there's something fundamentally wrong with my milk supply and if i drop the top ups he'll get sick again. Before he went to SCBU I had him feeding at the breast absolutely constantly (really seriously 24 hour a day stuff) and nothing happened apart from him getting dehydrated and me getting knackered. His feeding has been examined by millions of people now, and pronounced to be good. It has to be me, surely?

Ah that phrase 'it has to be me/my milk' makes me really sad. I dunno Sanguine. The original situation sounds like it was serious and like I said I don't know what is for the best, but FWIW I wasn't advocating dropping the top ups since your littly is so little and of course you don't want anymore dehydration...

...but would changing the cycle, rhythm or modifying the amounts perhaps help you out?

Maybe reduce the topups by only 5ml per session for 24 hrs and see how you get on? and then drop another 5mls formula a couple of days later?

And when you say literally 24 hours what do you mean? Sorry to be detailed but it might help to know if what you're going through is to be expected anyway - for example feeding every hour for 24 hours IS often normal to build up the supply and if you;ve only had 12 days to do this and some of that was in SCBU then it might be normal for it to happen again for a few days...

The birthweight/dehydration/motilium issue no doubt best left to the experts but I think you need a bit of a boost from someone to help with that milk supply who has very detailed BF knowledge. Not suggesting that the people who've seen you don't have that but the regime you're on doesn't seem to be conducive for supply to my amateur eyes (though have BF 2 babies and am currently on the 3rd)

When I say 24 hr stuff I mean I couldn't put him down at all without him yelling and trying to eat his blanket, babygro, hand, or anything else that came into range. I was just swapping sides every time he came off, and changing a nappy periodically. He was latched on most of the time, but it's hard for me to tell how much of the time he was properly feeding because I was drifting in and out myself, being completely knackered after horrid labour. My milk took on the right appearance - not colostrum any more - but I just never got very much of it, and my breasts stayed resolutely floppy.

Today I am trying to restrict the amount of formula he gets to get him to feed more often. Tomorrow morning is his tongue tie snip - I really hope that'll boost his ability to feed and therefore the stimulation to my breasts. I'm feeling a little better because he's had some impressive feeding sessions today. No sleep though!

I'm on motilium aka domperidone and it's helped me.

Due to anaemia issues my milk just never came in- only in dribs and drabs. never got the 'fullness' or leaking or anything. my dd isn't gaining properly so bf counsellor put me on various things including 3 fenugreek tabs 3 times a day, 10mg domperidone 3 times a day, increased to 20mg 3 times a day. it's building up slowly but you have to express as well to stimulate the nipple- or use a supplementer when you feed baby.

it took a week of being on 10mg 3 times a day and then increased to 20mg 3 times a day for 3 or 4 days before i felt any difference. i still don't get the fullness i got with dd1 but i have got more milk

Sanguine

I have to say on that specific issue - the 24hr feedathon - it sounds exactly like what happened to me and to lots of other women on day 2-3 after birth. After a sleepy start, babies often cluster feed like mad to build up the supply and the second or third night is often when it starts, only to settle down 2 days later when the supply is up.

And then they often do it again periodically, maybe at 10 days, 3 weeks, 5-6 weeks etc etc.. So leaving aside all the other things, the tongue tie, the dehydration, the weight issue - the constant feeding sounds, I'm afraid to say, normal! The thing is, your baby NEEDS to do it since that is how the milk is made - then when your breasts are producing a larger amount, feeds will settle down into a more regular and spaced out pattern.

Perhaps have the tongue tie snipped will make it lots better - it might be (I guess - you really need Tiktok) that feeding will become much more 'efficient' then and you should get a better feed into him/her...

My '2nd day' has been like this with each baby: feeding for 10 mins each side, change, scream, sleep for 10 mins, wake again, start all over again. With perhaps the odd 45-60 minute sleep in the middle of the day. And this went on for about 36 hours. And then after that I had breasts engorged with milk. some days later this then settled down again and it was much more manageable and comfortable.

But this constant feeding is NOT a sign of a problem with your body, but that the right things are going on. And unfortunately for you, if you have had to delay that feedathon because top ups got in the way, if you want to rebuild your supply, one way or another I think you're going to have to add in feeding more frequently to all the other things you're trying?

/hope you do decide to move over to more BF and get enough support to do so - would definitely suggest you get in touch with a LLL or NCT or BFN counsellor since, honestly, they are (usually) much more expert than most medical staff

Should have also said a big 'brilliant' for how it's been going today - sounds like its moving in the right direction already!