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Insulin Resistance/Low Supply/Domperidone Q/Please Help

post #1 of 6
Thread Starter 
I have lurked in this forum ever since my baby girl was born in March, but this is my first post.

I have struggled with low supply since my baby was born. It was a case of insulin resistance/obesity (though no PCOS) combined with IGT. (Baby's tongue tie, which we clipped at four weeks, probably also contributed.) With the assistance of a lactation MD and an IBCLC, I managed to get my supply to a place where the baby only needed 6-8 ounces of supplement a day. This took 1) domperidone, 2) fenugreek/goats rue/blessed thistle, 3) pumping after every feeding, with some power pumping to boot, and 4) a lot of hard work and many tears. I worked very hard to get to that place.

However, now that the baby is 5 months old, my supply has waned to the point where the baby is getting the vast majority of her food from formula. I am back at work now, and am trying to figure out what to do going forward. I pump once a day at work and get 1.5 ounces (if I'm lucky); I also breastfeed mornings and evenings (1-2 times).

I have considered going back on the domperidone. (Domperidone seemed to help a lot; my decrease in supply seemed to coincide with weaning my way off the domp.) My concerns with this are that the domperidone seemed to make me gain weight (on a very heavy body to begin with) and that I won't be able to pump enough to manually create additional supply. Has domperidone prevented you from losing weight or caused weight gain?

I have also considered going back on the goats rue/fenugreek/etc. It's expensive, though, and never seemed to do much for me. I've read that goats rue can successfully create tissue for breastfeeding success with a second baby. Has this worked for anyone?

At this point, I'm not trying to EBF (obviously). But I would love to have enough supply to continue nursing the baby morning and night, and I worry that if I don't take action, I'll lose the supply I have -- and I've worked so hard for it that it makes me sad to think of losing that nursing relationship. I would really love thoughts and suggestions from you.
post #2 of 6
Hi....Do know that you are AMAZING for doing what you have done to breastfeed. Your story brings up some memories.

To answer your first question....does dom equal weight gain or the prevention of weight loss? I would say YES. For me I gained 60 pounds after DD was born. It may be different for all, but it was certainly true for me. Domperidone affects your prolactin level and if the lack of prolactin isn't the problem behind breastfeeding then you may have too much prolactin and maybe that equals weight gain. I am learning about this as we speak and if anyone has any information on it I would love to hear more feedback. In fact the weight gain may be a reason I dont turn to it this time. I know it may sound vain, but I am overweight as it is and DO NOT WANT to gain more. Obesity can be dangerous too.

I am 25 weeks pregnant with DC2 and am curious as well what will happen with my second child and breastfeeding. I will keep this thread posted.

"It was a case of insulin resistance/obesity" ....does this mean diabities? or being overweight?? I dont know anything about insulin resistance and breastfeeding.

"I pump once a day at work and get 1.5 ounces (if I'm lucky);"...I would think that you would need to increase your pumping to bring supply back up. I know that can be a pain and perhaps not even possible if your work doesnt allow it.

I wish you luck and hope to hear more from you and how things go.
post #3 of 6
nak

i have heard of milk increasing after starting metformin. not sure if you have considered it.

good luck
post #4 of 6
Thread Starter 
Thanks for the responses

My lactation MD, Mona Gabbay, said that insulin resistance is sometimes correlated with low supply. There's a good article here: http://www.mobimotherhood.org/MM/article-pcos.aspx. I did try Metformin, but had terrible GI side effects. Am considering going back on the Met and the goats rue, because I've read somewhere or other that those can help reduce breastfeeding problems in anticipation of a second pregnancy.

I'm so glad to hear that the dom caused weight gain in someone besides me. I was starting to feel so terrible about myself -- I looked worse 4 months post-partum than I did immediately post-labor. It was really hard. Now that I'm totally off the dom, I'm starting to look more like myself again. But I really don't want to go through that again.

I agree with you that probably, pumping is required to really increase supply. Pumping just kills me, though -- it's like, every half-hour I spend pumping is a half-hour that I'm at work and not with my baby. I know breast-milk is important, but is it so much more important than time with the baby?
post #5 of 6
Yes, Dom made me gain. TBH, Met also made me gain. It also made me sick as a dog. I won't be doing that again.

Are you supplementing at the breast or with a bottle? I'm sure she gets a bottle during the day, but when you're home is she taking any supp or is it completely mama? If at any point she's getting a bottle from you, I'd recommend discontinuing that immediately and switch to a LA or SNS system to supp at the breast. It is a pain and there is a learning curve, but it can really help maintain what supply you have.

Also, it sounds like you've stopped pumping after each feeding in the morning/evening? It's a pain, yes, but that is one way to increase/maintain supply.

But goats rue/fenugreek/etc., never really seemed to do anything for me either. I'm IR with PCOS.
post #6 of 6
Yep. DPD has made me gain. Both times I've taken it. At this point I'm just trying to stop the gain and not worry about losing. That said, I gained 35lbs on it after my first was born and I lost 20lbs while off it and pg with my second and now have gained another 30lbs on dpd again. I plan to keep taking it until at least 18mos so right now I just want to keep from gaining more and hope that I can lose when I stop taking it.
For me, the dpd made it so that I could fully breastfeed my second and it was worth it to me to stay on it so that this could happen. I knew the risks going in and made the choice to do it anyway. It does suck, though.
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