Has anyone used domperidone or know anything about it?

[JRHartley]

I would be very grateful if anyone could give me any advice or share their experience.

I have posted before about my ds losing weight and I had to give him formula top ups. I am stil topping him up, as my supply is still not enough for him, although thankfully he has now exceeded his birthweight at 6 weeks. The bf coubsellor has suggested perhaps using domperidone. It is my dream to fully be ds, but the idea of taking medication is a bit worrying.

Please could anyone who knows anything about it share their experience, Thankyou!

i think topping up can be a big issue in supply getting established in the early weeks. the more the baby feeds, and goes to the breast, the more the supply will be boosted to meet demand.

why do you feel your supply is not enough?

if i were you , i would drop the top ups and get baby on the breast as much as he wants and needs.

i have heard that domperidone can boost supply, but i also know that nothing is as good at regulating supply of milk than the baby himself

I agree with lulu.

The best way to increase supply is to increase demand.

Could you take a babymoon? Go to bed with DS and let him latch on as much as possible for the next 24-48 hours? Plenty of skin-to-skin and lots of suckling will increase your milk supply better than any drugs.

How often do you feed? How are you topping up? Is it after the feed? Does he stop taking from the breast?

I sympathise. And I have used domperidome. I sat in bed all day long with DS trying everying. There was a steady milk supply, but not much of it. And I got so bloody fed up with people telling me there was no such thing as not enough. So I would off boob (which he would suck dry but still be hungry) then give formula top up. The formula was not su much that he wasn't hungry at the next feed but did keep him from being malnourished (he also had slight jaundice after birth and formula is good for this). So Off I went to the chemist to get my hands on some domperidone. It worked great. I kept taking until DS was about 4 months old and chucked in the whole breast feeding thing.

Hello again, I remember you from another thread, glad to hear you are still seeing a BFC and getting constructive help.

I also had to give FF topups (well tbh in the early days it was more like FF with small BF topups!!) and now DS is 5mo and EBF. Fenugreek was good but still only gave me a partial supply. Adding in Dom (at 8 weeks) enabled me to achieve a full supply. That was my last-ditch attempt before chucking in my dream of EBF.

My lactation consulant said Dom only works well if milk is being removed from the breast efficiently. In my case this meant I had to triplefeed (BF, then pump, then give EBM +/- formula) as without the pumping the Dom would not have worked (because DS milk transfer was not great and because he needed the topups).

The GP would only prescribe 3 weeks of 10mg 3 times/day but that dose did nothing - had to go up to 30mg 3 times/day (against GP advice - she had no experience using Dom for this indication). And still, every time I try and reduce this, my supply drops

Not sure if it was Dom, fenugreek or the combo, but I found a side-effect for me was what you might call intestinal hurry this got better after a few weeks though.

I used Domperidone with great success - partially breastfeeding at six months, which may not sound fantastic but until I started the domperidone my baby may well have fed on blood from a stone.

We tried the skin-to-skin, the constant feeding, the teas, the massages, but basically my milk never came in in sufficient quantity. Just as I was about to quit, a friend suggested domperidone (it is over-the-counter here) and that got me up to 50% breastmilk/50% formula. I was able to stop the domperidone after a while and supply held more or less steady.

I too have used domperidone. I was prescribed by the gp as I was solely expressing, dd was in NICU/SCBU.
Salyforth it may have been the domperidone, its real prescription is for stomach complaints.

I'm not sure if I would use it for normal feeding. I think I would try and up my supply in other ways first. I agree with Lulu on that score.

I started taking domperidone when dd was 4 weeks old... but it didn't work for me. I had big problems with my supply though and it never really got going. I was taking 30mg x 3 times a day which is recommended by Dr. Jack Newman. Although it didn't work, I'm glad I tried it and didn't notice any side effects.
Good luck, I hope your ds keeps gaining weight- sounds like you're doing great and trying everything you can!

I used domperidone for DD2 who I was exclusively expressing for (NG tube fed).

I would say that unless there is good extraction the meds may have a limited effect, so I would also advise less top ups and more direct feeding where possible.

Many GPs are reluctant to prescribe it as a galactagogue so you may need to get the bf counsellor to speak to your GP.

Hi everyone and thanks for your replies.

I have already tried to increase my supply with expressing, using a supplementer, constant feeding etc. I have been told that the prolactin receptors may not have been switched on during the first 2 weeks which would mean that I never produce enough milk.

I was forced to top up as ds had lost 1lb 3oz of his birthweight and was very weak, so did not have the strength to feed effectively. I do bf him as much as he wants, but I m aware that it's not quite enough. Think I will try the domperidone as quite a few people seem to have had a good experience of it.

Thanks again!

i thought it was good too, and sympathies on the bfing front, you must have been trying very hard to use a supplementer. they're the work of the very devil imo.

you know dom's an anti sea-sickness drug, don't you? so if you've booked a car-ferry holiday it's an ideal time to be bfing. my lactation person said (only half-joking) that they found out about the increased lactation when these burly sailors pitched up at the port GP complaining of leaking breasts.

JRH - Good luck with the domperidone - let us know how it goes.

I think the whole prolactin receptor thing is a pile of pseudo scientific hogwash btw. I was told the same (in fact there are many similarities between your story and mine, except I never could figure out how to use the supplementer) but I responded so well to dom (which acts by increasing prolactin levels) that I have to think that I must have had some receptors there.....

NO-ONE IN HISTORY HAS EVER WORKED OUT HOW TO USE THE SUPPLEMENTER, i tell you!

Thanks sallyforth, nice to know i'm not the only one, and also that the dom worked for you - hope it's the same for me!! The bf lady is coming on Thursday so I will let you know then.

ExterminAitch I agree about the supplementer being the work of the devil. Even at this stage when i've had several midwives squeezing my nipples without invitation, and used a double electric breast pump in front of my mum and dh, and various other breast-related indignities, it's a step too far.

Thanks again

JR you are not the only one! I had a similar experience to yours, tried expressing, constant feeding, supplementer, herbs, domperidone, the lot. It's amazing how all-consuming it can get. You're doing really well- it sounds like you're doing all you can and that's the best for your baby.

Eating lots of food with oats in is supposed to help too

jrhartley i had big trouble getting supply established - very bad latch, underweight ds, concerned hv, bfc visits. in short, the lot. all overcome and am still feeding 40months on.

i did try domperidone, but it didn't make half the difference that feeding A LOT did (as in constantly). a weekend in bed made a big boost. feed! feedfeedfeed.

I have never heard of that prolactin receptors, sounds like rot to me.

(oh and domperidone makes you do huge poos)

Prolactin receptors is not 'rot' or a lot of hogwash - it's a fairly widely-known and academically-respectable explanation of how the first days of breastfeeding can affect breastfeeding long term.

www.kellymom.com/bf/supply/milkproduction.html#prolactinreceptors gives a good explanation of a theory that is well-supported in animal studies and which fits with what we know of human lactation.

It's not the whole story by any means, but it does explain why some mothers whose bf does not get off to a good start may be playing 'catch up' for a long time afterwards, and who may have serious problems in building up and maintaining a milk supply when the baby gets a little older. However, other mothers overcome the difficult start, and domperidone is certainly useful - as well as ensuring frequent and effective removal of milk from the breasts.

There are situations where formula top ups are needed to rescue a serious situation, but as ever, the best option is for healthcare workers to recognise early on when bf needs fixing - before the baby becomes too weak to bf effectively.

Hope things get better for you, JR.

thank you tiktok, that is really interesting. would it also explain why i never leaked and could not express any milk?

Dunno, fishie - lots of perfectly-normal breastfeeding experiences include a lack of leaking and a difficulty with expressing. So no conclusions to be drawn at all

Thanks so much tiktok that's v interesting! Sorry if I sounded rude before, I've just heard too many pseudoscientofic "facts" from HVs/midwives over the last few months! Please could you post some references to the primary literature? I'm interested now!

And can you explain how domperidone worked for me when I was one of those "sleepy baby/baby not feeding enough" people for the first 10 days - I'd be a prime candidate for non expression of PRL receptors, wouldn't I? Did I just not make enough receptors, and need artificially high PRL levels to make enough milk? What is the time window for expression of prolactin receptors, do we know?

(sorry - I teach human biology and am genuinely interested! - I just like to read the primary literature when I can)

Primary refs are in the kellymom link, sally, or search PubMed for Hartmann's work. Very sensible to go back to these studies, I agree.

I would have to refresh my memory of how dom. works, except to say it 'stimulates' prolactin manufacture, which in its turn promotes milk production.

Not sure of the 'window' - but IIRC, the research indicates days rather than weeks.

JRHartely wanted to express my sympathy with what you are going through, I'm in a similar position for the second time with my second baby. Nightmare. Wanted to say 2 things.

1. I never managed to get a doc to prescribe dom, so I bought it in bulk online at www.inhousepharmacy.com. They are very reliable, it will be with you in 2 weeks. But it is expensive that way.

1. I found the SNS to be utterly soul destroying last time, but the LC I saw this time showed me how to use a homemade one with an NG tube and a syringe, and after an awful 24 hours Ive got the hang of it and am finding it easier than the bottle top ups I gave last time. Might be worth a try. You can buy syringes, the tubes would have to come from a doc or LC.

To those who commented about babymooning etc, that's all good, but there are some of us whose boobs for some reason just never kick into gear no matter how many times we pump, feed the baby, do skin to skin, have hypnotherapy or acupuncture or cranial osteopathy etc. It's worth just knowing this the next time you reply to a thread like this as it can be utterly misery-making to just keep on being told you're not feeding enough when you are killing yourself to feed your baby and nothing is working and you know your baby is HUNGRY.

On the science point, dom increases prolactin levels, doesn't affect the receptors AFAIK, so presumably what it does is just ensure any receptors you do have are constantly getting the message. May explain why ppl like me don't ever get a full supply no matter how much dom I take, even though it does help - presumably the receptors aren't enough in the first place or there is some other error in the pathway.

I agree with everything tiktok says, on principle!
Have you tried fenugreek? I was taking a couple of teaspoons of it a day and really can tell the diff. Apparently it's far better making an infusion with it, and it's a bit gross eating a teaspoonful of it, but I swear it works.

I read up on domperidome on kellymom ages ago, and can't remember exactly why, but I did decide that ity was a route I would consider if needs be.

Good luck

Er....this thread is a year old!

Doesn't matter how old the thread is, it's still relevant.

I had domperidone for my first for 15 months after trying everything above. It was soul destroying doing everything you can and STILL not seeing the weight gain. It too DD1 5 weeks just to get back to birthweight and that was with a supplemental formula feed a day. She had a tongue tie which although we had snipped at 2 weeks, seemed to mean that she wasn't effective in those crucial early days to stimulate my supply enough to get going to support her. Domperidone was a wonder although I did have to take it for a while and pump a lot to get it going.

Imagine how depressed I was when I discovered at birth that our 5 week old also had a tongue tie. We had it snipped asap but that took 2 weeks... So now I'm told that he's dropping off the weight curve and I should get Domperidone again if I want to EBF... All those hours of pumping - I can hardly face it and now I have a 3 year old to manage as well...

That said, back to the OP - Domperidone: highly recommended if you've tried everything else. I found La Leche League were very helpful in finding out what those other things were.