Domperidone to increase milk supply?

[Cinai2]

My midwives mentioned this to me and suggested to talk to my GP for a prescription…does anyone have experiences?

Yes, did nothing for me sadly.

Did the MWs suggest doing anything else as well as the prescription?

If you really want to continue BF its absolutely worth a try.

My GP wouldn't prescribe it to me, as some babies have had heart issues on it. Those babies were quite ill anyway, so there are some doubts over the quality of studies (as there are with so many things around pregnancy and young kids, as blind studies are generally unethical). It's a grey area at the moment. In the States, they have been more willing to prescribe, including to non-birthing female partners and transwomen, so there might now be more advanced science on this than when I had my son in 2020.

Oats and fenugreek tablets helped me.

In the States, they have been more willing to prescribe, including to non-birthing female partners and transwomen, so there might now be more advanced science on this than when I had my son in 2020.

Babies don’t need whatever biological men can produce when medicated. Don’t need “advanced science” to know that, surely?

please read this www.theguardian.com/lifeandstyle/article/2024/may/30/the-darkest-period-of-my-life-i-struggled-to-breastfeed-then-a-drug-sent-me-spiralling

(My GP's reasoning was that we know that formula, whilst not as optimal as BM, does not actually harm babies, whereas this has not been conclusively demonstrated with domperidone. This reasoning can be applied to so many things in pregnancy and bf and I am not in any way criticising you for wanting to try to bf)

Hi this kept me breastfeeding. Without it I would have had to stop. I had genuine rubbish supply due to breast shap and tissue! Unfortunately GP wouldn’t prescribe for more than a week. In the end I went through a private doctor called the breastfeeding doctor.

@ItTook9Years

I am GC, this really isn't a trans point. I am just telling the OP that the US prescribes domperidone really very widely and so the effects of it might soon be better understood.

I had a lactation consultant advise this and she even write to the GP. But the GP wouldn't prescribe it - lots won't.

Worked well for me and helped maintain supply till DD1 could properly latch.

Have you had a read of the breastfeeding network information? It is useful as it sets out the evidence. There is also a useful piece on the specialist pharmacy service page.

It can be useful but most evidence is around mothers who had a pre term birth. There is less evidence to support it with full term birth but that's not to say it isn't worth a try.

It should only be suggested once everything else is in place such as positioning and attachment, regular breast stimulation, expressing etc. And there needs to be a robust plan for feeding and lactation being supervised by an appropriate professional.

There is evidence that it can have a detrimental impact on mental health, especially when weaning off. The recommendation is to use the lowest dose possible for the shortest time possible.

It is a balance as of course not meeting your feeding goals also has an impact on mental health.

The MHRA recommend it is not prescribed.
No GP I know would touch it now.

If the midwife wants you to have it she can prescribe it….oh wait.

I redirect any midwife back to their own service lead. Not taking the risk.

I disagree that the MHRA warning is quite that clear cut. There are some people for whom it may be higher risk and this should be considered when prescribing.

The GP infant feeding network contains some evidence based guidance.
gpifn.org.uk/galactagogues/

The midwife may not be the prescriber but I think it important to work together as specialists and this would include the infant feeding specialist midwife liaising with them GP around follow up and also with a specialist pharmacist if necessary whether that is a pharmacist in trust with a specialist knowledge of lactation or with the UKDILAS or the Drugs in Lactation service.

Adding this to the forum as I found this article super useful: https://www.sciencedirect.com/science/article/pii/S2376060520301383#:~:text=Prolactin%20levels%20during%20the%20initial,)%20after%20suckling%20(2)

Domperidone should be used with doctors supervision at 30mg daily more than that you need to speak to GP (personally I would go to an endocrinologist as any other doctor wouldn’t have a clue!) From what I hear and have read this medication does not increase milk supply for everyone as increasing prolactin doesn’t necessarily mean more production if the underlining issue is else where.

I am on this journey now and also have low supply plus I have PCOS and insulin resistant. Here is what I’ve done and would recommend:

I would recommend speaking to an endocrinologist someone who understands hormones, they are best to guide you on this drug and what the route cause is.

I’ve had a blood test and have the following values checked: LH, FSH, Oestradiol, Prolactin, TSH and FT4. Check prolactin Baseline 2-3 hours after breastfeeding/pumping and 30 minutes after beginning breastfeeding/pumping and get this checked by the endocrinologist! As a normal doctor will look at the values at face value and again will have no clue.

and take it from there..

I hope this is useful for someone and best of luck ladies you’ve got this whatever you decide to do please try not to stress 💕