when to start galactagogues?

[sanguine_speed]

I have had supply problems in the past and am wondering whether it would be helpful to start using galactagogues in advance of the birth of my baby, or whether I should wait? Is there harm in starting now?

I have easy and affordable access to Domperidone, which I took at a dose of 160mg/day with my last baby. I'm wondering if I should start this preemptively.

Also, Brewer's yeast, fenugreek, blessed thistle, etc...

Start before birth, at birth, a few days postpartum?

Given my past several experiences, it is highly likely I will need supply help. I have always had supply problems, despite seeking expert help (IBCLC, Jack Newman, midwife, etc., pumping with a double electric pump after every feed for months, nursing on demand, skin-to-skin, thyroid testing, breast compressions, chiro and craniosacral therapy, SNS, etc.).

So my question is whether it is helpful to start galactagogues before birth or not.

[Megan73]

Hmm. I have been there, done that with my first nursling and wonder what I'll do to boost supply from Day 1 if I'm ever lucky enough to have another.
I presume your low supply is unexplained?
My gut reaction would be to start at birth OR when your milk comes in but I'd e-mail Dr. Newman and ask him for an opinion. Have you asked at bfar.org whether mamas are starting at birth?
Have you read "Making More Milk"? I think it has a discussion of what you can do during pregnancy.
I'd also line up your at-the-breast supplementer of choice and hospital-grade pump and baby scale rentals, too, but I bet you've already done that!
I'm rooting for you, mama. I've read that every pregnancy builds more breast tissue and the chance of a better supply.
Have a wonderful birth

[sanguine_speed]

Thanks mama.
My low supply is only unexplained as far as it 'appears' I have insufficient glandular tissue (tubular breast syndrome).

[mariposa77]

Hi Mama,


I don t have a response for you, but
I was wondering, what best worked for you to increase production.
just had Arie Thursday and he lost already 14ozs. I have been worried about my angel,I not getting enough milk.
I previously bf for 5 years total with my other children w/o issues. But I got breast implants 10 years ago, not thinking that I would have more babies. Of course I am so regretting this.
We are going to lactation consultant tomorrow.
So far I am doing skin to skin, breast massage, bf on demand.
Any help or advice is greatly appreciated.

Thanks

[Megan73]

Originally Posted by sanguine_speed

Thanks mama.
My low supply is only unexplained as far as it 'appears' I have insufficient glandular tissue (tubular breast syndrome).

"Making More Milk" suggests progesterone therapy throughout pregnancy may help with IGT but given that you're about to have that baby ANY SECOND that may not be an option.
It also suggests that some women have had luck with goat's rue or alfalfa during the last trimester. There's a success story of a woman who started goat's rue at 36 weeks and experienced breast changes and leaking colostrum within days and was able to EBF. Obviously it's not evidence-based but it couldn't hurt.
There are no references to taking dom before birth, though.
Good luck, mama.

[sanguine_speed]

Originally Posted by mariposa77

Hi Mama,


I don t have a response for you, but
I was wondering, what best worked for you to increase production.
just had Arie Thursday and he lost already 14ozs. I have been worried about my angel,I not getting enough milk.
I previously bf for 5 years total with my other children w/o issues. But I got breast implants 10 years ago, not thinking that I would have more babies. Of course I am so regretting this.
We are going to lactation consultant tomorrow.
So far I am doing skin to skin, breast massage, bf on demand.
Any help or advice is greatly appreciated.

Thanks

Mama,

I think everyone's situation is unique and you're doing the best thing by seeking the professional advice of a LC. I was never able to exclusively breastfeed and used donated milk to supplement. I did everything all the time so I can't really say what worked 'best' for me.

Best of luck. I know it can be so hard.

[sanguine_speed]

Originally Posted by Megan73

"Making More Milk" suggests progesterone therapy throughout pregnancy may help with IGT but given that you're about to have that baby ANY SECOND that may not be an option.
It also suggests that some women have had luck with goat's rue or alfalfa during the last trimester. There's a success story of a woman who started goat's rue at 36 weeks and experienced breast changes and leaking colostrum within days and was able to EBF. Obviously it's not evidence-based but it couldn't hurt.
There are no references to taking dom before birth, though.
Good luck, mama.

Hmm, is there any reason that these things wouldn't work now though? Or is there only the window of opportunity during pregnancy for some reason relating to pregnancy hormones? If I want to breastfeed for years, it would make sense to work on whatever could help my supply longer-term even if it takes a few weeks or months to help...

[UberMama]

Many galactogogues are not recommended for use during pregnancy. I don't know what is and is not okay off of the top of my head.

I had unexplained low supply after my first birth as well. Yet after my second and third births, I had oversupply. :/

I would say to have some things on hand just in case you feel you need them. This is what I am doing (and did before). That way I am not scrambling to try and find things while fretting over my supply.

Though you are near delivery, I do know that you can take More Milk Two (sold by Motherlove) during pg. http://www.motherlove.com/mm5/mercha...oduct_Code=320

[earthmommy2]

Originally Posted by UberMama

Many galactogogues are not recommended for use during pregnancy. I don't know what is and is not okay off of the top of my head.

I had unexplained low supply after my first birth as well. Yet after my second and third births, I had oversupply. :/

I would say to have some things on hand just in case you feel you need them. This is what I am doing (and did before). That way I am not scrambling to try and find things while fretting over my supply.

Though you are near delivery, I do know that you can take More Milk Two (sold by Motherlove) during pg. http://www.motherlove.com/mm5/mercha...oduct_Code=320

I know that some galactogogues are unsafe during pregnancy, for example Fenugreek and Mother's Milk Tea both are part of those. Mother's Milk Tea actually says it on the box.
Also, recently with friends who have a history of supply issues with previous pregnancy and found out they were actually drinking too much water. Can you believe that is possible?? I never thought that, but yes too much water can waterlog you and cause severe supply decrease.
I hope you have success with this nursling and not suffer too much with supply issues. Hugs and thoughts with you!!

[ColwynsMommy]

Can't believe I almost missed this post..

During pregnancy, you can take progesterone, but I couldn't get anyone to prescribe it since my levels weren't low (and my HB midwife, who has IGT herself, didn't feel it was worth pursuing). There is a point at which you're supposed to stop it because I think taking progesterone can interfere with labor starting (which I know you don't want to do!).

You can take alfalfa, goat's rue, shatavari, nettle, red clover.. um.. I forget what else. You can also try taking Metamucil. I had a micro supply with all three of my babies thus far with no apparent cause.. I've had pretty much every blood test under the sun, never found anything. My breasts don't really look typical of IGT, but I'm also quite overweight which could be masking the problem. I've talked with Jack Newman a bit, and also with Lisa Marasco who wrote Making More Milk. None of the LCs I've been able to get in touch with have a clue what to do beyond what I've already done. So, anyway.. here's what I'm doing now:

Alfalfa, nettle, RRL, and red clover tea daily (about 4 cups)
Metamucil daily (3 cups)
Shatavari daily (1 pill)
Hand expressing colostrum starting at about 38 weeks (as many times per day as I can remember)

Immediately after the baby's born, I'll stop the shatavari and switch to domperidone. I won't wait to see how low my supply is, because I know it'll be low. I'll start at 90mg and go from there. I'll also keep up the alfalfa, nettle, red clover, and Metamucil. With Fiona, alfalfa, Metamucil, and shatavari helped the most, so that's what I'm going with (minus the shatavari since I'll be trying dom for the first time).

I'll keep hand expressing colostrum for the first few days and evaluate whether I should get a pump.. my guess is that I'll be more successful with hand expressing because there's no real set-up and it'll be easier to fit in a few minutes here and there throughout the day. I've never had much luck with a pump, anyway.

I have two Lact-Aids ready to go and will use those to supplement.

Are you on the MOBI Yahoo Group? I've found them to be so supportive and helpful, and they're always coming up with good ideas to try.

[boobs4milk]

you can look at some info here: www.lowmilksupply.org that's the book megan spoke of, too.

[Megan73]

Originally Posted by sanguine_speed

Hmm, is there any reason that these things wouldn't work now though? Or is there only the window of opportunity during pregnancy for some reason relating to pregnancy hormones? If I want to breastfeed for years, it would make sense to work on whatever could help my supply longer-term even if it takes a few weeks or months to help...

I see references to taking goat's rue and alfalfa during pregnancy AND after.
But I haven't seen any references about women taking dom during late pregnancy to prepare for lactation. I presume it's safe because I've seen some references to it being prescribed for hyperemesis, but I wonder if it would work. Doesn't prolactin rise after the placenta detaches? I would want to know if taking dom could somehow interfere with labour or that hormonal shift.
The reference in "Making More Milk" has the woman taking progesterone in pregnancy weaning off of it at 8 months but doesn't say why.
Have you e-mailed Dr. Newman and asked his opinion? I've found he gets back to you fast.

[InfoThirsty]

Hi ladies,

I'm actually on progesterone support throughout my pregnancy (rather than just the first trimester). @ Megan73: It's not clear why, in the example given, the patient was weaned off the progesterone support at 8 months, but I'll give you some guesses from my own treatment so far.

I actually found out about my progesterone issues and LPD through the Creighton Method and was forwarded to a NaPro Technology doctor (the Creighton Method and NaPro Technology work together). Otherwise, I wouldn't have been able to conceive and keep the baby. I'd had one miscarriage in the past. I started progesterone supplements 3 days after "peak" ("peak" roughly equals ovulation in this method), and once I got my BFP my NaPro Doctor continued to check my progesterone levels every week for the first twelve weeks. Baby always has a good strong heartbeat, but I still needed support. While most doctors assume that by 12 weeks the placenta has taken over and they don't need to worry about progesterone anymore, this is seriously incorrect - low progesterone has been linked to preterm labor in NaPro Technology research. So my NaPro doctor continued to take my progesterone levels past 12 weeks but every two weeks instead.

Well, I had been on one progesterone suppository at 400mg throughout my first trimester, and she called my house one day and told me my progesterone levels were low and weren't escalating as they should, so she upped my dosage to two progesterone suppositories at 400mg each per day. Till this point, I'd seen no breast changes at all, and I was getting worried. Not to worry - once this treatment started my breasts got much larger, tender, and I noticed a lot of changes at the areola/milk ducts.

Essentially, I'm lucky that the concerns about preterm labor are also correcting another problem. My NaPro doctor is still checking my levels every two weeks, (I'm 24 weeks preggo now) and she said that in the NaPro method, if a woman's progesterone levels escalate to zone 3, they wean her off the suppositories, but in my case, this hasn't happened - I'm still at zone 2. So this means I'm on these suppositories until my levels naturally go to zone 3. If they don't, then I've still got to take them.

Sooooo a long answer, but my best guess is that they probably did progesterone bloodwork on this patient, discovered that her levels at 8 months were now in "zone 3", knew that nature was taking over and weaned her off the progesterone support. Even if a doctor is not a Na Pro doctor, it would be unethical to have a patient on progesterone support without regularly monitoring levels for changes via bloodwork, so I'm guessing the bloodwork must have signaled that this patient could stop progesterone support.....


Hope this helps. I'm in Canada, but there are NaPro doctors all over the USA too.