FAQ: Domperidone (Motilium)

[MaryJaneLouise]

Domperidone (brand name Motilium) is a prescription galactogogue, similar to Reglan but with fewer side effects. Since it is a prescription drug, it should only be used as a last resort after it has been determined that you really do have a low milk supply (http://www.kellymom.com/bf/supply/low-supply.html) or failure to thrive (FTT) situation. While it is generally considered safe, most people discuss using it with their family doctor, ob/gyn, or pediatrician before resorting to using this drug.

The best info on this drug is found on the kelly mom site (http://www.kellymom.com/health/meds/prescript_galactagogue.html) and includes info on usage, dosage, politics behind its use and non-use, legality, medical journal articles about its use, etc.

More info is found on the BFAR site (http://www.bfar.org/domperidone.shtml).

Domperidone can be obtained in the US from compounding pharmacies, or on the internet without prescription from:


http://www.inhousepharmacy.com/general/motilium.html

I’m going to be asking that this thread be stickied, so if anyone else wants to add info here please do so.

Edited to remove the globaldrug link. Apparently it is no longer in business.

Edited to add information from Thomas Hale, Ph.D., "Medications and Mother's Milk."

“It is also known to produce significant increases in prolactin levels and has proven useful as a galactagogue. Serum prolactin levels have been found to increase from 8.1 ng/mL to 124.1 ng/mL in non-lactating women after one 20 mg dose (Brouwers JR et al. Plasma prolactin levels after acute and subchronic oral administration of domperidone and of metoclopramide: a cross-over study in healthy volunteers. Clin Endocrinol (Oxf) 1980; 12(5):435-440.) Concentrations of domperidone reported
in milk vary according to dose. But following a dose of 10 mg three time daily, the average concentration in milk was only 2.5 micrograms/L (Hofmeyr GJ et al. Domperidone: secretion in breast milk and effect on
puerperal prolactin levels. Br J Obstet Gynaecol 1985 Feb;92(2):141-4)”

“Recently the US FDA issued a warning on this product stating that it could induce arrhythmias in patients. These claims were derived from data many years old where domperidone was used intravenously as an antiemetic during cancer chemotherapy (20 mg stat followed by 10 mg/kg/24 h). Many of these patients were undergoing extensive chemotherapy and were extremely ill, and hypokalemic to begin with.
Further, intravenous domperidone produced plasma levels many times higher than oral use. Thus far, we do not have any recently published data suggesting that domperidone used orally in breastfeeding mothers
is arrhythmogenic.”

“Lactation Risk Category: L1 (the safest level)
Pediatric Concerns: None reported. Considered the ideal galactagogue.”

Just as a point of reference, Ibuprofen is an L2, and Naproxen is an L3.

Here's a listing of its availability internationally:

Classification status in other countries:
• Australia: prescription medicine
• UK: over the counter (OTC)
• USA: not marketed
• Canada: prescription medicine
• Belgium: OTC
• Ireland: OTC
• Italy: OTC
• Japan: OTC
• Netherlands: OTC
• South Africa: OTC
• Switzerland: OTC

HTTP://WWW.MEDSAFE.GOVT.NZ/DOWNLOADS/MCC34DOMPERIDONE.DOC

More sources of where you can get it, US and worldwide:

http://www.breastfeedingonline.com/domperidonewhere.shtml

ETA

Link to package insert, including contraindications and possible drug interactions:

http://www.medsafe.govt.nz/Profs/Datasheet/m/motiliumtab.htm

[jenny-g]

There are side effects to domperidone, like any drug. It prolongs the QT interval of your heart, basically meaning if you have a heart issue, you should be very careful taking this drug.

Most importantly, taking this with ANOTHER drug that prolongs the interval can be risky. Some of these drugs are common for bf moms to take- like diflucan and some antibiotics.

I take dom (it helps but does not solve my supply problem), and just had to take two weeks of diflucan for a milk duct thrush infection, so I reduced my dom dose to 90 mg/day from 120/day. I think it is important to keep this in mind when taking dom, especially for those people who take more than recommended on the sites we have (kellymom/Dr. Newman's site). Just wanted to give a heads up! -Jenny

[MaryJaneLouise]

Dosage information:

http://www.kellymom.com/newman/19a-domperidone1.html

Using Domperidone

Generally, we now start domperidone at 30 mg (three 10 mg tablets) 3 times a day. In some situations we go as high as 40 mg 4 times a day. Printouts from the pharmacy often suggest taking domperidone 30 minutes before eating, but that is because of its use for digestive intolerance. You can take the domperidone about every 8 hours, when it is convenient (there is no need to wake up to keep to an 8 hour schedule—it does not make any difference). Most mothers take the domperidone for 3 to 8 weeks, but sometimes it is needed longer than that, and sometimes it is impossible for mothers to maintain their milk supply without staying on domperidone. Mothers who are nursing adopted babies may have to take the drug much longer. People taking domperidone for stomach disorders are often taking it for many years.

After starting domperidone, it may take three or four days before you notice any effect, though sometimes mothers notice an effect within 24 hours. It appears to take two to three weeks to get a maximum effect, but some mothers have noted effects only after 4 or more weeks. It is reasonable to give domperidone a trial of at least four, and better, six weeks before saying it doesn’t work.

For more information on how to wean off the domperidone see the handout: Domperidone 2.

[Elowyn]

There are side effects to domperidone, like any drug. It prolongs the QT interval of your heart, basically meaning if you have a heart issue, you should be very careful taking this drug.

Most importantly, taking this with ANOTHER drug that prolongs the interval can be risky. Some of these drugs are common for bf moms to take- like diflucan and some antibiotics.


More to the point, it *can* prolong the QT interval, as can many other drugs. It doesn't in every individual (or even the majority) and of course the effect is seen more often in higher doses & those with preexisting heart arrhythmias.

It's still safer than Reglan, and far superior to artificial formula.

[tash11]

dont know about anyone else but the global drug link above didnt work for me, here it is with dom as a query: http://www.globaldrug.tv/search.asp?Action=search&Definition=&Keywords=Domperidone

[MaryJaneLouise]

TIMING OF DOSAGE

From http://www.bfar.org/domperidone.shtml


Maximizing Absorption

A study by Heykants (1) has shown that absorption of domperidone increases from 13% to 23% if domperidone is given ninety (90) minutes after eating. This means that the drug will act most effectively when mothers take it an hour and a half after eating.

[MaryJaneLouise]

Good news about Domperidone in US:

http://www.bfar.org/members/fora/index.php?showtopic=2938

A US Federal Judge ruled that compounding pharmacies in the US can make any drug they wish and cannot be restricted by the FDA (Federal Drug Adminstration) -- that the FDA has no jurisdiction over them. This is fantastic news for being able to get domperidone in the US. This means all those drastic warnings from the FDA to compounding pharmacies threatening legal action if they made domperidone are now negated. Any US physician can prescribe domperidone and any US compounding pharmacy can make it LEGALLY.

http://www.iacprx.org/site/PageServer?page...Releases#052606
http://www.aapsonline.org/nod/newsofday294.php

A very big day for domperidone. Please spread the news.

Diana West
(She is the author of Defining Your Own Success and the upcoming Making More Milk: A Nursing Mother's Guide to Milk Supply)

:twothumbs

[MaryJaneLouise]

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[MaryJaneLouise]

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[Shell_Ell]

Wow, I hadn't heard about the compounding pharmacy ruling. That's fantastic! A few months ago when I had an order from New Zealand seized in customs, I was scrambling to go to a compounding pharmacy, and was told there that if the FDA told them to stop, they'd have to stop and destroy all the Domperidone they had- basically that day.. So ultimately, it could have meant for some women (who don't want to buy off the internet) that they can't make the milk their babies need.

Anyway, I'm glad to read that.

[jenny-g]

To the poster who had her dom order customs-zapped: remember, ask on here if that happens again if you need any to tide you over the time it takes to get a new order. I just got a big order for myself in past customs, and I'm happy to help anyone else out who isn't so lucky. Of course, now, with the compounding pharmacy option, that will help people out too! :)

[mfp02]

Is there any way to help your order not get shipped back? I know customs probably stops based on certain criteria, also just randomly I'd guess. I didn't know if there was anything to help your order get through and be shipped?

I plan on ordering dom in the future.

[MaryJaneLouise]

I don't know of any strategies, but I have heard there are more confiscations at the end of the year (November / December). Don't know if they have a quota :rolleyes or if it's just increased mail traffic with the Christian holidays.

[MaryJaneLouise]

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[MaryJaneLouise]

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[lc81002]

How do you know if a pharmacy is a compounding pharmacy? Is there an online list or something to see if there's one near me? I would rather get it by prescription so I would only have to pay a small co-pay for it and I wouldn't have to worry about shipping and customs.

[thekuhlkens]

I called my local pharmacy and asked them if there was a compounding pharmacy in the area, and they had no problem giving me a number of a place just 20 minutes away.

[kands]

This website can also help you find a compounding pharmacy:

http://www.iacprx.org/site/PageServer?pagename=lookup_survey

[lc81002]

Thanks! Now to get my doc to write an Rx...that will be the hard part.

[firefaery]

Just FYI- it was $130 dollars a week to have it compounded, and $150 for almost three months worth when I got it from New Zealand.

[MaryJaneLouise]

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[MaryJaneLouise]

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[MaryJaneLouise]

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[mamaverdi]

Price depends on your area. I got a month's supply for around $120. That is with taking 4x per day..so 80 mg.

Motillium is not the same exactly as compounded dom. If you get compounded domperidone, you can ask for them to put acidophilus in with it. Then it will be dom + acidophilus. That's it. Motillium has other ingredients to prolong it's shelf life.

There is usually a compounding pharmacies anywhere near major cancer treatment centers as well as fertility treatment centers.

[MaryJaneLouise]

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[MaryJaneLouise]

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[MaryJaneLouise]

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[2 in August]

Has anybody had luck with their insurance co paying for it if they have a prescription? Or do you always have to pay out of pocket and from out of the USA?

[nurture]

i just recently shifted from dopergin (http://www.drugdelivery.ca/s3452-s-DOPERGIN.aspx) to motilium (http://www.bbonlinepharmacy.com/product/613/motilium-domperidone/). I was prescribed dopergin as my little baby was born but the doctor fund aftersome weeks that it was not enough boosting the production of milk.
Indeed, that worked in a marvellous way.
Would anyone just tell me of the different side eefects that are caused there?

[MaryJaneLouise]

From what I hear, the main "side effect" of motilium is what is usually prescribed for, faster stomach emptying. I was more hungry all the time when I was on a higher dose, and also gained some weight. Some people get a bit of headache while on higher dosages too. Other than that I think it's pretty well tolerated.

Glad to hear it worked for you to boost your milk :)

[MaryJaneLouise]

:bump:

[DoomaYula]

I have to say I used dpd as a BFAR mom with my dd, and it worked wonders! I'm ttc #4 now and plan to use it again!

[amandacj08]

If I order it online and it is confiscated by the FDA at the border will I be out the money I spent? I anticipate needing a supply in May 07 so should I try and get it ordered now?

[MaryJaneLouise]

If I order it online and it is confiscated by the FDA at the border will I be out the money I spent? I anticipate needing a supply in May 07 so should I try and get it ordered now?

From what I hear, if your order gets confiscated, you get a letter from the FDA. You then call or email InHouse pharmacy and somehow send them the confiscation letter. The original package gets returned to InHouse pharmacy, and they refund your money. In the mean time, you have to order again. So you are out (temporarily) for two orders, but you get your money back eventually.

If you are worried, you might go ahead and order at least 2-3 months early, to give time for at least one confiscation. I think it's relatively rare to be confiscated but still :( when it happens.

Here's their email if you want to inquire directly:

customerservices@inhousepharmacy.com

[MaryJaneLouise]

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[Steph1]

Does anyone know anything about this online pharmacy: http://healthcarepharma.com/store/index.php?cPath=57&osCsid=503a5e0eb5e4aabb26f980637f3a69cf. I was told it had the cheapest prices around.

Is anyone concerned about the safety of drugs from non-US online pharmacies? I probably wouldn't be concerned from a Canadian/UK/Australian/NZ pharmacy, but some others make me a bit leery. Did yours come in a bottle of blister pack?

I read that Customs is no longer seizing drugs at the border.

[MaryJaneLouise]

:loveeyes:

[MaryJaneLouise]

Does anyone know anything about this online pharmacy: http://healthcarepharma.com/store/index.php?cPath=57&osCsid=503a5e0eb5e4aabb26f980637f3a69cf. I was told it had the cheapest prices around.

Is anyone concerned about the safety of drugs from non-US online pharmacies? I probably wouldn't be concerned from a Canadian/UK/Australian/NZ pharmacy, but some others make me a bit leery. Did yours come in a bottle of blister pack?

I read that Customs is no longer seizing drugs at the border.

Good news about customs.

My domperidone comes in a box, with the pills inside in a blister pack.

I honestly don't know how to respond about the safety question. I was also very leery, and all I can say is that everything's been OK with me and lots of other people I've "met" on the internet :shrug

[MaryJaneLouise]

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[DoomaYula]

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[Satori]

Can anyone tell me how long it took to see it working? I need it now and not in 2 weeks so umm, if anyone knows of closer US sources please PM me:wink

[MaryJaneLouise]

If you can get a prescription from your health care provider, you can get some from your local compounding pharmacy:

http://www.iacprx.org/site/PageServer?pagename=lookup_survey

http://www.angelfire.com/fl/endohystnhrt/pharmacy.html

[Satori]

If you can get a prescription from your health care provider, you can get some from your local compounding pharmacy:

http://www.iacprx.org/site/PageServer?pagename=lookup_survey

http://www.angelfire.com/fl/endohystnhrt/pharmacy.html

Not in the US you can't.

[caligirl]

I used it for 1 month as a last ditch effort to preserve what breastfeeding relationship I had left with my DD2 (at 6mos old). I had such a struggle with low supply (she became so frustrated with nursing) that I was almost entirely pumping for her except she still nursed laying down to sleep.

Since I was pumping I got a very good idea of how it was working.

after about 2 weeks I went from pumping 1.5oz (on average) every 2-3 hours
to 5oz.

Shortly after that I developed a really bad heart arrythmia (my heart rate was never regular for more than 2 or 3 beats in a row, then would skip all over the place, my heart would stop, and then go back to normal beating only to repeat the process a few seconds later). The Cardiologist couldn't figure it out but I was on several different heart meds (beta blockers) to regulate it, they were nasty drugs and I couldn't feed DD the milk I pumped while on them.

After he researched the Dom (he had never heard of it) He said he couldn't be sure that it was the cause, but couldn't rule it out either, so I weaned myself off of it.
A month after I stopped Dom, my heart went back to normal and I went off of the beta blockers and I have had absolutly no problems since (a year later).

Please be careful when choosing to use this medicine!
Looking back I would not have done it at all because it cost me $50, a lot of problems, and I still had to supplement with formula!

[MaryJaneLouise]

Not in the US you can't.

I was able to get domperidone at a COMPOUNDING pharmacy just 6 months ago. Again, have things changed? The last I heard the FDA had actually loosened up things at COMPOUNDING pharmacies.

[MaryJaneLouise]

On May 28, 2006, a US Federal Judge ruled that the FDA cannot prohibit compounding pharmacies from filling prescriptions issued by US doctors. **This means it is absolutely legal for a US physician to write a presciption for domperidone and for a US compounding pharmacy to fill it.**

http://www.lowmilksupply.org/domperidone-safe.shtml

[maxmama]

Not in the US you can't.

Yes, you can.

I just got and filled a prescription at a local compounding pharmacy a month ago. The key is not to mention why you're taking it.

I love domperidone. I nurse at home, but work a 0.75 FTE, 12 hour shifts and pump then. I went from 3-4 oz/ pumping to 6-7 oz.

I don't take the dom on my off days, only on my work days, and I take the first dose about 2 hours before my first pumping. It works great!

[BCFD]

I took dom to induce lactation for my adopted child. It worked, however, I could never measure my milk supply in oz. Even after 7 or 8 pumping sessions a day I'd have less than 1/2 oz. :(

My first shipment was stopped at the border and Globaldrug just re-sent it. I opted for the quick shipping and it arrived a few days later. I was only out the shipping cost since Globaldrug apparently was used to Customs seizing it. They were great. I figured something was up after 3 weeks and no dom. At the 4 week mark, I received my letter from Customs and was devastated! But again, got a new shipment quickly.

I know Globaldrug is now called something else. They merged? Or were bought out? I forget..but they are still around..just under a different name.

There is a compounding pharmacy in NorCal (near Berkeley? Marin County?) that was pretty cheap...a little more than Globaldrug, but affordable. One of the best websites around is the Jack Newman/Lenore Goldfarb site www.asklenore.com. They work mostly with adoptive mamas, but they are a plethora of information on dom and the protocols.

ETA: Ahh...GD is now IHP. Missed that part.

[MaryJaneLouise]

Here's more info on where to get domperidone, in the US and around the world:

http://www.breastfeedingonline.com/domperidonewhere.shtml

[MaryJaneLouise]

Another :bump:

[MaryJaneLouise]

:bump:

[Jude Rose]

thanks for the bump, Mary Louise. It's a shame the thread isn't stickied.

[MaryJaneLouise]

:loveeyes: :bump:

[ErinBird]

Not in the US you can't.

Actually, you can. You will need to hunt for a sympathetic doctor and your LLL leaders may be able to point you in a direction of someone local. A compounding pharmacy may ask you why you are taking the drug. The correct answer is "reflux."

[maxmama]

Actually, you can. You will need to hunt for a sympathetic doctor and your LLL leaders may be able to point you in a direction of someone local. A compounding pharmacy may ask you why you are taking the drug. The correct answer is "reflux."

Or, as my compounding pharmacy put it (while I was BF my DD)," Oh, don't tell us anything, and we won't ask you anything."

[ErinBird]

Or, as my compounding pharmacy put it (while I was BF my DD)," Oh, don't tell us anything, and we won't ask you anything."

I believe I'm in the same city as you- my daughter's ped called the script in for me (on the advice of the IBCLC) and the pharmacy actually called me to ask what the purpose of me taking the drug was. I had (luckily) read earlier that day that I should not mention breastmilk at all, and that a valid reply was reflux.

Your pharmacist sounds better!

[bdavis337]

I'm curious - is the pharmacist legally allowed to ask about your medical reasons for filling a prescription?

[MaryJaneLouise]

:bump: :D

[MaryJaneLouise]

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[RootSnort]

Here's another reference source for compounding pharmacies:
http://www.pccarx.com/Patients.aspx?sm=Patients

I'm curious - is the pharmacist legally allowed to ask about your medical reasons for filling a prescription?


Yes, and they really should do so to make sure they are treating you correctly. Pharmacists should be making sure that you are on the right dose for the right use of a medication, and should also check for and warn you about any potential interactions. Here in the hospital setting, the official accrediting board for hospitals is demanding that we have an indication (reason for use) for all drugs. Another benefit of this data is to make sure that the doctor has written the right drug name (Celexa is like Cerebyx is like Celebrex, but if I know the patient has seizures, I know what the right drug and dose is).

[mwright]

Hello,

I just got my order of Domperidone in the mail today and took 3 right away. My dd is 11mo old and I have had stinkin supply issues since she was 4mo old and I have had to supplement with bottles or SNS. I have tried everything to increase my supply. Fenugreek, Nettles, Alfalfa, oatmeal, water, nursing with SNS every 2 hrs etc. I just want that full feeling back. I usually latch her on with the SNS on one boob and pump the other and I can get about 1/4oz when I do that every 2 hours.

So can I expect a good increase of supply? After my dd was born and when my milk came in, I had an over abundance and dd was a great nurser! I was horrible sick for the first 5 weeks pp(intestinal infection from antibiotics) and I think that it cause my supply to drop. I wasn't very well educated and started to sup when dd wasn't satisfied at the breast and well it all went downhill after that. I have managed and faught for our bf relationship with all my might and now I am hoping to catch a break with this drug. I just wanted to hear other success stories I guess to give me hope!!

Thanks mama's!

[emmabizo]

I'm just wondering...Because if not it is cheaper to order it elsewhere...

[goodgolly13]

I'm sure this has been asked before.

When can you start the dom? Can I start it after birth? I've had supply issues with my last two pg's, I didnt try to nurse my first. I'd rather just get it going from the begining before having to deal with my new baby not getting enough.

TIA

[JJJJBlue3333]

It's really frustrating that domperidone isn't more available in the US. I pumped for both my boys b/c of cleft palates and with my first domp. was the ONLY thing that kept me making 24oz a day. Without it I would make like maybe 10oz. When ds2 was born I ordered some immediately "just in case" and I still have it. I actually have a month supply laying around that I would love to pass along.

[heathenmom]

I'm just wondering...Because if not it is cheaper to order it elsewhere...
I can't speak for everyone (obviously!), but the compounding pharmacy where I got my dom would NOT accept insurance. It was $50 for 90 10mg capsules.

They told me to take 1 capsule 3x/day, and it seemed to help a little (increased my pumping from 4-5 oz. while at work, to 6-8 oz.), but now my supply is dropping again ... I only got 4 oz. today! I'm wondering if I should try increasing the # of capsules I take? I'd love some advice ... my midwife & her ob partner know NOTHING about dom, so I'm relying 100% on what I'm able to glean from the internet. :o

[JJJJBlue3333]

You should check out the kellymom site. I believe the proper dosage is alot more than your are taking.. I took 3 pills, 3x a day

[waterside]

http://www.clickremedy.com/modules.php?name=Shopping&do=view&pid=266
I placed order from this site.The price is lowest.Service and products are ok.

[MadysonMom]

What dr. would you ask for a Rx? Would it be your OB or pediatrician or general prac?

[ErinBird]

What dr. would you ask for a Rx? Would it be your OB or pediatrician or general prac?

I asked my IBCLC (who is also an RN). She works with my daughter's pediatrician and told him to give me a script for it.

My LLL leader also knew of several physicains in the area that would perscribe it for me.

[ErinBird]

I'm just wondering...Because if not it is cheaper to order it elsewhere...

Like the other commenter, the compounding pharmacy would not accept my insurance. I paid about $80 for 100 pills.

[RootSnort]

I tried to get domperidone at my local compounding pharmacy. They do not make it anymore because of an FDA ruling from June 7, 2004, where they warned compounding pharmacies not to make it anymore.
Thankfully, there are still ways to get it, but this does make it harder.

[Luv2bemommy]

http://www.clickremedy.com/modules.php?name=Shopping&do=view&pid=266
I placed order from this site.The price is lowest.Service and products are ok.

How long did it take you to get that in the mail after you placed the order?? That is cheap!!!!!!!!!

[mwright]

http://www.clickremedy.com/modules.php?name=Shopping&do=view&pid=266
I placed order from this site.The price is lowest.Service and products are ok.

Is it just as good as the Dom I ordered from Inhousepharmacy.com?? I want to make sure its the same stuff since it is working so well! And it so cheap from there!! let me know cause I need to order some more, but hesitant cause I want to get the right stuff!!

[waterside]

How long did it take you to get that in the mail after you placed the order?? That is cheap!!!!!!!!!

It took 10 days from the day I ordered for them to arrive.:duck:

[waterside]

Is it just as good as the Dom I ordered from Inhousepharmacy.com?? I want to make sure its the same stuff since it is working so well! And it so cheap from there!! let me know cause I need to order some more, but hesitant cause I want to get the right stuff!!

I have had excellent results with these pills. They come in blister packs. They're in Thailand. It takes a while, but all seems well..:duck:

[blueridgewoman]

We get ours from Thailand too- SO is trying to induce lactation for a baby I'm carrying and she's never bf before. She's been on 2 pills 4x a day for about a month now and will continue for another three months....

[RootSnort]

Woo hoooo!
Started domperidone last Saturday (mail order). I was at about 30 ounces a day. Today I got 42 ounces, and I may pump 1 more time before I go to sleep. This was using 3 tablets 3 times a day. NO side effects.

Thank heavens I don't have to top off bottles with formula anymore. DS could not tolerate it, even at over a year old, he got monumental gas in the middle of the night.

On the other hand, DS is eating 40 ounces a day, and we're starting to think that at 15 months, he should be accepting more solids. He does have a bony protrusion in the roof of his mouth, and we're going to see a doctor about that. We were previously told that it would go away, but I see no signs of this, and it may be causing swallowing difficulties.

[3cuties]

Is there a Canadian pharmacy that sells domperidone to the US?

Does anyone know of a doctor in the Chicagoland area that writes scripts for Dom?

[3cuties]

Got my answer from a link in this awesome thread:

http://www.breastfeedingonline.com/domperidonewhere.shtml

[MaryJaneLouise]

:bump:

[egfmba]

I posted this question in Breastfeeding, but have gotten no answers. I was in the middle of the bar exam when I posted, so my brain wasn't functioning or I would have known better and posted it here:

So I ordered from ClickRemedy because another mother here mentioned that she got her order in 10 days, lowest price, great service. I ordered dom 17+ days ago, they shipped on the 9th, Thailand Post says the order got 'accepted' but no further tracking info.

So I send an email to ClickRemedy, who responds that it's possible the order got stuck in customs and they'll ship another, but break it out of the blister packs, break it into smaller packages and not put any identifying information (which I thought they didn't, anyway).

Is this all kosher? Anyone know? I've only used companies that another mom on MDC has vouched for, but I'm a bit concerned right now.

Any reassurances? Or advice?

Thanks,
eva

[waterside]

Hi Eva

Just give you some information about clickremedy.com.Maybe it help you feel better.Let's see as this link http://www.asklenore.info/forums/ubbthreads.php?ubb=showflat&Number=8995&page=1&fpart=1

[egfmba]

Waterside,

thanks for responding. I saw that when I googled them a week ago. I'm just concerned because it's been over 20 days, and I ran out of dom a week ago now and my milk supply is really low. I needed the dom. I just don't know what to do now. Do I just ask for my money back and go to inhousepharmacy or wait or what? I'm just really worried.

anyway, thanks again for responding.

eva

[blueridgewoman]

Sometimes, things get sort of "randomly audited" for lack of a better phrase in customs. I'm wondering if this happened to your item and it was hung up or confiscated.

[Hindyg]

How long did it take you to get your inhousepharmacy order?

[egfmba]

It seems mine was one that got randomly hung up! The original order was split into 2 packages: one 600, one 200. I got the 200 today. Had to sign for it. I'm still waiting on the rest of my order, whether it's the original shipment or the second. I'll send the duplicate (if it ever arrives) back as soon as it arrives.

Whenever I ordered from inhouse, it never took more than 10 days to arrive. I think they ship from New Zealand. So, at double the time, I was worried. I ordered in enough time not to run out, but I ran out since it took longer. I figured it would be like ordering from inhouse, especially since I hadn't read anything bad about clickremedy.

Seems like it's just one of those random things, though.

Thanks for all the responses. I was really very worried, and I knew you ladies would understand! :)

eva

[Electra375]

Subbing
Come back later...

[MaryJaneLouise]

:bump:

[Happily Blessed]

I ordered, received and have started! I started it on Thursday and Friday I was able to pump 1-2 more oz. than my usual "Friday." I didn't really keep up with it this weekend because I don't pump on the weekends, he is only nursed.

I am taking 3 pills twice a day about an hour and a half after eating. Does this sound right?

laural

[RootSnort]

I ordered, received and have started! I started it on Thursday and Friday I was able to pump 1-2 more oz. than my usual "Friday." I didn't really keep up with it this weekend because I don't pump on the weekends, he is only nursed.

I am taking 3 pills twice a day about an hour and a half after eating. Does this sound right?

laural

I would take them before eating and then nurse or pump after eating. They will up the prolactin, and the food will up the insulin, which you need to support milk production.

[Electra375]

I ordered, mine came in, I've been taking 1 tablet 3X to 4X per day. Maybe I read something wrong....

I haven't seen any huge increase, but then again this is the week of sore nipples and low supply before AF. And I've been able to pump 3oz at each session or more which I was not able to do the past 2 AF cycles.

And when baby is done nursing, he has not emptied the breast, he is full before I'm empty which has not happened before.

So, while I have not seen dramatic increases, I believe it has increased some. I do have low prolactin blood levels, in the lower 30s for a nursing mom!!! Maybe more would do it, but I don't "need" more at this time. Or if I went back to pumping more, I might need more.

I have a friend who might like some donated milk, but I don't know if she will be intrested in Domperidone milk!

[DoomaYula]

I ordered, mine came in, I've been taking 1 tablet 3X to 4X per day. Maybe I read something wrong....

Most people take 3 or 4 tablets 3x to 4x/day. That's probably where you're going wrong. Although I'm sure every little bit helps. I plan to start with 120 mg/day when this baby is born.

So, question mamas, do I start taking it the day I give birth, or do I wait til my milk comes in?

[Electra375]

So is the information on the first page of this thread not correct in stating start with 30mg or 40mg?
:dizzy:
It would be nice to pump a couple of times a day rather than every 3 to 4 hours and get more than 3.5 oz if I'm lucky.

[MomInFlux]

So is the information on the first page of this thread not correct in stating start with 30mg or 40mg?
:dizzy:
It would be nice to pump a couple of times a day rather than every 3 to 4 hours and get more than 3.5 oz if I'm lucky.

I think the info on page 1 suggests 30 mg 3 times per day...

[DoomaYula]

In post #3 it says:

Generally, we now start domperidone at 30 mg (three 10 mg tablets) 3 times a day. In some situations we go as high as 40 mg 4 times a day.

So that's 90 mg a day, up to 160 mg a day.

I had a great supply with 160 mg a day.

[MaryJaneLouise]

:bump:

[booklady1178]

I'm so glad I saw this thread! I just came here to ask about buying dom. I still have 12 boxes left from nursing DS #1 (bought from globaldrug.tv a couple of years ago- but doesn't expire until the end of '08) and my LC said I might have trouble getting more. I have insufficient glandular tissue, so I need to take the dom long term to help maximize milk production. It's good to hear I should still be able to get more.

Thanks, ladies!

[DoomaYula]

So, what day do I start it? Should I start immediately after giving birth (I'm due in early Oct) or wait until my milk comes in?

[booklady1178]

So, what day do I start it? Should I start immediately after giving birth (I'm due in early Oct) or wait until my milk comes in?

I started taking it this time on day 4 PP - once my milk was in and it was clear I was having supply problems again. I'm not sure if there is any benefit to starting it before milk comes in or not. I did start on More Milk Special Blend right away, though. I know Jack Newman says dom tends to work best when started a few weeks out, but I didn't have the luxury of waiting.

HTH,

[DoomaYula]

Thanks! Yeah, I think Diane West says 4 days, I just wanted to hear what others said. I'm hoping that since I'm homebirthing, my milk will come in sooner...

[bobbirs]

bump

[anewmama]

haven't read the whole thread but just adding that eating grapefruit is contraindicated with domperidone.

[MaryJaneLouise]

:wave :bump: :loveeyes:

[Steph1]

I am currently trying to wean down my dosage of dom, to see if it makes any difference (I was taking 150 mg/day, kinda uncomfortable with taking so much for a long period of time). I produce ~1oz/feeding.

Does anyone know about this site: http://healthcarepharma.com/store/index.php?cPath=57&osCsid=503a5e0eb5e4aabb26f980637f3a69cf

ALthough that ClickRemedy is a little cheaper.

I'm currently waiting on a shipment from Inhouse...grrr... come on, come on. I'm sure I waited too long to order it, I always do. I do get a Rx from a compounding pharmacy while I'm waiting, but it's $40 for 30 pills!

[Softheart]

I have a question...I'm due in a few months, and had low supply with my last dc...

Would there be any good or harm in starting some dom right after the birth, or a few days after anyway?

I WOULD just start it to be preventative since low milk supply feels SO stressful to me with an infant, BUT would starting the dom have any negative effect on my "natural" supply? Like would taking the dom in the beginning mean that maybe I would have had an ok supply without it, but now since I took the dom my supply which might have been normal will forever be crippled by a dependency on dom? Or can I just wean off the dom in a few months and maybe have the best supply ever!? I know that sounds dramatic, but trying to figure out if I can try the dom from the start with no bad milk supply consequences later...Thanks!

[DoomaYula]

You can always start with dom and then wean off.

From what I've read and what my local LC says, the first 2 weeks are ESSENTIAL in getting a good supply. I want to ensure that I have a good supply, so I'll be taking it and then maybe slowly wean off and see what happens.

GL!

[Softheart]

Oooohhhhh....so upping my supply with the dom the first few weeks could actually mean a higher potential permanent supply! Would you start immediately after birth, or a few days after...?

[DoomaYula]

Apparently it's best to start when your milk comes in, so like Day 2-5 ish.

And a bump!

[MaryJaneLouise]

:moon :lol :bump:

[WilliamsMama]

Just a few questions for anyone who might know.

When should you wean yourself off of domperidone?

How should I do it?

I've been taking it for about 2 1/2 months now and have seen an increase in supply, although ds still gets 4 oz of supplement at the end of the day (he cries and fusses A LOT by the end of the day, and when I try to hand express, barely anything comes out of my breasts. So, I supplement at the end of the day. Ds originally got about 32 oz a day! Now, he's down to 4oz).

I am spending way too much money on dom. and am also concerned about the possibility of heart arrhythmia (as someone mentioned) since it does run in my family.

So how (and should I???) wean myself off of domperidone?

Will I still be able to successfully continue to breastfeed my ds after discontinuing dom.?

[Electra375]

I don't specifically know the answer to your weaning off question.
I can tell you I ran out and my supply plummetted. I went from pumping all his needs to barely 1oz. And it's been slow to get it back and I've had to increase my Dom to get 3oz.

So, when this round is gone, I'm going to be saying that it is done. He will be almost a year old. I'll still comfort nurse, but nourishment will have to come from his love of solid food and formula. My freezer stash is gone from the supply plummett.

I know that isn't encouraging, I'm sorry. I've forgotten to take my DOM and noticed a dramatic difference, so I did freak out when I ran out without my next shippment having arrived. And it is an expense, plus timing it w my other meds has been difficult.

[MaryJaneLouise]

Just a few questions for anyone who might know.

When should you wean yourself off of domperidone?

How should I do it?...

Will I still be able to successfully continue to breastfeed my ds after discontinuing dom.?

That's a hard decision to make. I've read a few of your previous posts, and it sounds like you've had a hard time with low supply. :twothumbs to you for sticking with bfing!

Where are you getting your dom? It seems to be cheaper overseas that at a US compounding pharmacy. As far as the heart arrhythmias goes, that is also hard to say. Do you have an open minded family physician or ob/gyn that you can ask? Do you have insurance to pay for any diagnostic tests to see if you personally have any irregularities or long-qt syndrome.

You might try slowly weaning off the drug. Personally, I did notice a dip in pumping volume each time I dropped a 10mg pill each day, then after a few days a small rebound effect. Now that I am completely off the domperidone, I definitely do not pump as much as before. But my LOs are 2 years, not 4 months, so there's a big difference in the cost/risk/benefit calculation.

As far as being able to continue to bf -- even if you quit dom -- absolutely yes! Again, I would wean slowly so as not to shock your babe, but there's a good chance the bfing relationship can continue strong, even if he is not getting as much milk as previously. Breastfeeding is more than just milk!

[mmm0708]

It prolongs the QT interval of your heart, basically meaning if you have a heart issue, you should be very careful taking this drug.

This was in post #2. I haven't read through the entire thread (YET) so forgive me if this has been asked.

Does the drug pass through breastmilk to the baby at all? If DD has questionable heart issues (tests coming up next month to determine if she outgrew the concerns and will be discharged from the ped cardioligist's care or if she needs further treatment), should I stay away from the drug? Thoughts? TIA!

[mommyto3girls]

From what I have read, and it has been a few months so look into it further, it was IV doses of the drug that caused the heart issues not oral.

[DoomaYula]

From what I have read, and it has been a few months so look into it further, it was IV doses of the drug that caused the heart issues not oral.

:yeah: I've read it was VERY HIGH IV doses that caused heart issues -- never from anyone who has taken dpd orally.

[delphiniumpansy]

I have a question and forgive me if this has already been discussed. I searched and did not find an answer.

I read recently that it is actually illegal to dispense or compound domperidone for lactation.

http://www.fda.gov/cder/news/domperidone.htm

So, how do you get it? I was thinking of recommending a friend ask her doc about it but then I read the above. So, what do you do?

[SarahLi]

I'm allergic to dom, unfortunately. I did even see an increase in my supply after two doses, but my adenoids and tonsils swell up and I can't breathe through my nose, which is more important to me than making milk... I talked to Dr. Newman about this, he said he has NEVER heard of anyone else being allergic to this! I am also allergic to Reglan, same reaction. I had to stop after a few doses, so now I have a bunch leftover.
BTW... As a nurse, I used to give oral Reglan all the time to kids with heart problems, some severe. I've also given IV Reglan to preemies with heart issues. It depends on specifically the heart issue your child might have, either way I'd have a Dr. evaluate if they do have a heart problem and Dom will be going through your milk to see if it is safe.

[MaryJaneLouise]

See post #46 for a link to the "legality" and politics behind the domperidone statement by the FDA. It IS legal to obtain from a compounding pharmacy. Additionally, you can get it from several overseas pharmacies without prescriptions. There are many previous posts in this thread with links, including post #1.

To reiterate, see this link for a good explanation;

http://www.lowmilksupply.org/domperidone-safe.shtml

[MaryJaneLouise]

This was in post #2. I haven't read through the entire thread (YET) so forgive me if this has been asked.

Does the drug pass through breastmilk to the baby at all? If DD has questionable heart issues (tests coming up next month to determine if she outgrew the concerns and will be discharged from the ped cardioligist's care or if she needs further treatment), should I stay away from the drug? Thoughts? TIA!

Dr. Thomas Hale lists domperidone as an L1 drug, the safest category for nursing babies (Medications and Mother's Milk). Having said that, I would bring in all the info I had to the ped cardiologist and ask his/her opinion, then decide from there.

[delphiniumpansy]

Thanks, MJL. I also found this


http://www.breastfeedingonline.com/OfficialDomStatements.shtml

[fishface]

I have a question and forgive me if this has already been discussed. I searched and did not find an answer.

I read recently that it is actually illegal to dispense or compound domperidone for lactation.

http://www.fda.gov/cder/news/domperidone.htm

So, how do you get it? I was thinking of recommending a friend ask her doc about it but then I read the above. So, what do you do?


I've been wondering the same thing. If it's illegal for pharmacists to sell, who is selling it?

[SarahLi]

See post #46 for a link to the "legality" and politics behind the domperidone statement by the FDA. It IS legal to obtain from a compounding pharmacy. Additionally, you can get it from several overseas pharmacies without prescriptions.

So... Is it "legal" to sell my leftovers?

[SleepyMamaBear]

we buy it from new zealand. no Rx needed.

[MaryJaneLouise]

So... Is it "legal" to sell my leftovers?

:shrug: I don't know. It's not a controlled substance, like a narcotic. Is it legal to sell anything like a prescription drug?

[Electra375]

:shrug: I don't know. It's not a controlled substance, like a narcotic. Is it legal to sell anything like a prescription drug?

It is illegal to sell prescription drugs to someone without a script, that for sure I do know.

[MaryJaneLouise]

:bump:

[MaryJaneLouise]

:bump: again! :moon:

[MaryJaneLouise]

Hi again! :bump:

[maxmama]

I've been wondering the same thing. If it's illegal for pharmacists to sell, who is selling it?

No, it's legal for pharmacists to sell, because domperidone can be legally compounded for other conditions (decreased gastric motility, for example). It jsut can't be (legally) used for lactation.

[SleepyMamaBear]

ok i heard something once a while ago about dpd and licorice, anyone know?

[heyitstwins]

ok i heard something once a while ago about dpd and licorice, anyone know?

looking for info now on this now, and bumping. I just got my order. I have been struggling w/BF'ing since the twins were 6 weeks old.

Now that I'm working again, my supply has crashed and I have had to supplement, which I am so, so heartbroken about.

Anyway, I will post my results with a bump!!!!

[PatioGardener]

:bump:

[MaryJaneLouise]

Someone was asking about Domperidone during pregnancy for low supply. Specifically for pregnancy, there is very little data whether it's good or bad. Dr. Hale does not list any risk category for it during pregnancy, but Domperidone is considered an L1 safetest category for breastfeeding.

This is from the manufacturer's data safety sheet. Though it sounds :eek: this is actually a very mild warning.

http://www.medsafe.govt.nz/Profs/Datasheet/m/motiliumtab.htm

Use in Pregnancy

There are limited post-marketing data on the use of domperidone in pregnant women. A study in rats has shown reproductive toxicity at a high, maternally toxic dose. The potential for humans is unknown. Therefore, MOTILIUM should only be used during pregnancy when justified by the anticipated therapeutic benefit.

I would consider taking it during pregnancy, but I am afraid it probably wouldn't do much good. Most of the low supply there is due to high levels of estrogen. If anyone tries it, I would be intereseted to know the results.

[MaryJaneLouise]

:bump:

[saydit]

I just started taking dom, got it from a compounding pharmacy, since they could get it to me faster than the overseas options I found.

But, I think it's upsetting my stomach (gas, belching--lovely!) Anyone else experience this and develop any good strategies? (Take on a full stomach, instead of empty? Divide the doses differently? --I've been taking 30mg/3x day)

A previous post got me thinking about whether I could/should take it with acidophilus.


Motillium is not the same exactly as compounded dom. If you get compounded domperidone, you can ask for them to put acidophilus in with it. Then it will be dom + acidophilus. That's it.

Thanks,

Sarah

[maxmama]

It increases gastric motility, so I'm not surprised you have those side effects. You can try dividing the daily dose to see if that helps.

[SleepyMamaBear]

i take 14 a day.
3 in the am, 3 at bedtime and two at a time divided ebtween the hours i am up. it helps me if i am taking it through the day rather than in big chuncks, since i have to take so much for my supply to have ANY increase, it works best that way for me.

[saydit]

Thanks for the advice about dividing the doses. Unfortunately I got 30mg capsules, since the compounding pharmacy was more expensive and I was taking 3 anyway and 1 30mg capsule was cheaper than 3 10mg. Oh well, I have some 10mg's on their way from In House Pharmacy, so then I can try splitting up the dose differently. Today I tried taking it w/ food, which helps a bit.

BTW, the patient information sheet that came w/ my order was about taking Dom for milk production, not gastric issues, lol!

--Sarah

[cc4npg]

Help! I'm on Reglan (4 weeks now) and it's making me super depressed but I can't find a doc to prescribe the Motilium or a pharmacy to make it!

Who else has been on Reglan and can you compare the Reglan to Motilium?

How can I get my hands on some Motilium to try it? Anyone in Ohio? I feel like I'm going crazy. My milk supply is low, even lower since my stupid doctor put me on a combo birth control pill over a week ago. I only took it for 4 days before realizing what happened (prior to that, my milk supply was good, but I was still on Reglan). I started Fenugreek a couple days ago and have Blessed Thistle on the way. Also taking Mother's Milk tea 3x day. What else can I do? I've been feeding non-stop to boost supply. My depression is really bad right now though and all I seem to feel like doing is feeding baby, but then that gets me more down when I realize I don't have enough milk!!

CC

[cc4npg]

I forgot to add... my baby is 10 weeks old now and about 8 lbs. My goal is to breastfeed for 6 months. I'm 41 and prone to anxiety. DS was born 5 lb 6 oz, dropped to 4 lb 14 oz 4 days later due to low milk supply and sucking problem (sleepy baby). I had to start supplementing with formula to get his weight up. My doc prescribed Reglan when he was 6 weeks old. He WAS gaining an ounce a day prior to being put on the combo birth control pill (STUPID DOC!)... it was same doc who put me on Reglan so he should have known better!

So from 6 to 10 weeks I've been on Reglan, now my supply is low and my depression is great and I NEED to find someone who can help direct me to finding this motilium soon so I can get the heck off this Reglan.

CC again

[MaryJaneLouise]

See the first page for ordering information. Most people get it oversease from inhousepharmacy.com

[cc4npg]

I found some Dom, and have some ordered, but I don't know if I will have enough to tide me over until it comes in.

DOES ANYONE OUT THERE HAVE SOME EXTRA THEY AREN'T USING NOW?

My main question is... how much can I take? I'm currently taking 3 pills 3 times a day, but have read instances on here where some of you are taking way more than that. This is the second day of taking it, and so far not much has happened. My right side is actually really bad, while my left is producing more but still not like it was.

I am having to give supplements. I know I'm not producing enough for him. However, I'm still hopeful that the dom works and I can wean off of most, if not all, supplements.

CC

[MaryJaneLouise]

There is dosage information on the first page, and the link to kellymom discussed this further.

[MaryJaneLouise]

:bump:

[buckeye_bebe]

I have a few boxes leftover. It worked well for me, in addition to herbs. PM if you want it or need pictures.

[Happily Blessed]

Wow, I love you ladies here! that was so awesome to offer the dom!

I hope you have received your dom by now and that it is working for you.

I got mine about a week ago and have seen such an improvement. I take less than 6 a day because I really only use it for when I pump. My supply has increased from 4-5 oz. a day to 7-9. so much better!

I am going to give a box to my girlfriend because here LO is in the 10% percentile for weight and has been for a while. He does not tolerate formula well and that is what the pedi is pushing. He will be 1 in March so maybe she will be able to start whole milk soon.

laural

[MaryJaneLouise]

:bump:

[MaryJaneLouise]

:wave :bump:

[MaryJaneLouise]

Random :bump:

[lena1984]

i have some that i'd be happy to give away to any mamas needing some, i can only ship within the U.S. though pm me if intrested :thumb

[dcgrl]

Has anyone not had success with domperidone? what do you do then?

[SleepyMamaBear]

are you not seeing results? how much are you taking?
still drinking lots of water?
i have to take 14 to 16 10mg pills a day to see results.

[dcgrl]

well, I'm waiting on my second shipment. My first order of 100 (from a local compounding pharmacy--$$$) went fast. I took 9 10mg pills a day and didn't see much of a difference. of course 100 pills don't last long when you're taking 9/day, so maybe I just need to continue with it. And drink more water. and pump more. and and and...

(and thanks for letting me know that someone out there takes that much--maybe I'll boost my intake when it comes in...)

[Jezzy]

Just joining this thread I am trying to learn more about doperidone. There isn't a lot of info here in Germany.

[MaryJaneLouise]

Jezzy, that's interesting. Is it available as a gastric (stomach) agent there? Or are you saying most doctors don't know about its milk producing effect?

[Jezzy]

Nak

It is available, my ob didn't know of its milk producing effect, he gave me some to be his guinea pig when i told him about it. i dont have to take very much and have noticed a difference. i only took 10mg 3 times a day

[MaryJaneLouise]

Jezzy, you don't have to be a guinea pig :lol Here's a review article from the Canadian Medical Association Journal summarizing domperidone for lactation:

http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3494&itool=Abstract-nondef&uid=15451832&db=pubmed&url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15451832

Print it out & give it to your doctor. Let me know if it doesn't work for you. If you need it partially translated you can used something like Google translate, it does a terrible job but is better than nothing:

http://www.google.com/translate_t

[Jezzy]

Jezzy, you don't have to be a guinea pig :lol Here's a review article from the Canadian Medical Association Journal summarizing domperidone for lactation:

http://www.ncbi.nlm.nih.gov/entrez/utils/fref.fcgi?PrId=3494&itool=Abstract-nondef&uid=15451832&db=pubmed&url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15451832

Print it out & give it to your doctor. Let me know if it doesn't work for you. If you need it partially translated you can used something like Google translate, it does a terrible job but is better than nothing:

http://www.google.com/translate_t

Thank you! I did find a very good article and translated it for him along with the original, I am pretty sure that he speaks english. He wanted to test it out someone to have first hand info. kwim??

[salt_phoenix]

just an FYI about Dom:

It took TWO full weeks for me to see ANY changes in production, and now here at ONE MONTH later, I am finally producing "enough".

Sometimes you have to be patient when you start it! I was about to give up because I couldn't justify the cost of it with the amount of production but everything I read said to keep taking it for at least 6 weeks. It's true.

[Mommy2Haley]

subscribing. will edit with actual post when not NAK

[MCKH]

Ladies,

A girlfriend gave me the remainder of her domperidone from when she was struggling through nursing. I had to start taking it for a multitude of problems - 4th degree tongue tie, respiratory problems with my son, poor suck, etc. It worked like a miracle for us. I ordered my dom from www.inhousepharmacy.com that same day, two weeks ago (today is day 15.) I contacted them because I haven't received it and they said that if it has taken this long it was likely held up in customs...

WHAT??!! I only have 5 days supply left. I am flipping out because my son will not take a bottle (we've tried a bottle, Haberman feeder, finger feeder, syringe, cup, etc.) If my supply dies, I have no clue how I will feed him.

Has this been your experience with this company? Should it arrive soon? Is there any place that does rush shipments? Should I just place another order? I am so new to this and I am having a panic attack!

Thanks for any input.

[Jezzy]

MCKH where are you from? i got mine from holland it is possible that customs will not allow the dom to be shipped. Here is where I got mine frim and because of the EU it didn'T go through customs http://www.inphar.de/pages/index.asp if you are ordering from the eu

[MCKH]

I'm not seeing Motilium or Domperidone on that website...
And it says you need to fax them a prescription, which I don't have...

I am literally sick over this. I have already started taking fewer pills to make what I have last longer but I've noticed a drastic dip in supply. What can I do?

[Jezzy]

I'm not seeing Motilium or Domperidone on that website...
And it says you need to fax them a prescription, which I don't have...

I am literally sick over this. I have already started taking fewer pills to make what I have last longer but I've noticed a drastic dip in supply. What can I do?

I didn't have a perscription and just got my order last week. They spell it withoug an E Domperidon here it is. http://www.inphar.de/pages/search.asp?QR=domperidon

Are you here in Europe? Maybe I can help you out

[MaryJaneLouise]

Unfortunately, sometimes things do get stuck in customs, then returned to inhouse. When I ordered through globaldrug (now merged with inhouse), they told me to reorder ASAP. You should be getting a letter from customs that they held up your order. Globaldrug told me to send that to them, and that they would refund the $ to me for that order, since it was returned to them.

Did inhouse mention that to you?

[loraxc]

My DS is gaining slowly (he's 2 months and gained about 10-12 oz last month) and nursing for very long periods (45 minutes-hour, every 1.5 to 2 hours except at night) very likely due to the fact that I have some kind of undiagnosed nipple pain issue and don't let down well for him. I don't think my supply is really all THAT low--borderline--but that I find it hard to relax and get anything beyond the first letdown. My LC, my midwife, and I are still aggressively pursuing the nipple pain issues, but I had the same problem with my first for all 15 months. (First was a slow gainer too, but not as slow as DS.) So I am not that hopeful.

I EPed for DD after 6 months, but that won't be possible this time with 2 kids. I cannot continue indefinitely with this pain. Either we find a solution or I wean early. (Like 6 months. Trust me, this KILLS me.) I know he is young, but I think he will continue the marathon nursing. DD did when I had the same issues.

Would domperidone make my supply abundant enough that I could nurse for shorter periods? This would be much much easier if he nursed for 15 minutes instead of an hour. Or is it unlikely to cause that kind of change?

I have a sympathetic medical team who would probably RX if for me.

[MaryJaneLouise]

:shrug: I don't know if it would, but I would be tempted to give it a try. If you don't have low supply, you might end up with too much milk, plugged ducts, and mastitis, so you should keep vigilant for that.

Have you also tried breast compressions to maximize milk transfer?
http://www.kellymom.com/newman/15breast_compression.html

Also check out the stickie at the top of the BF challenges forum for other ways to maximize milk production and/or transfer.

Good luck on the nipple pain diagnosis, I had a brief experience with Raynaud's / white nipple blanching and that was really horrible :hug.

[SleepyMamaBear]

so, whats going on with the nipple pain? hows his latch? does he have tongue tie? even slightly? are you blanching? what kind of pain is it?
are you seeing an IBCLC?
sorry to barrage you qith questions, but to get to the source, and get the solution to your probs we need to ask all sorts of questions.
how old is your son? how often are you nursing? for how long?
breast compressions is a great idea to help maximize milk transfer.
if you want to increase your supply, try other routes first, oats, herbs, etc, before heading to domperidone, cause DPD is a heavy hitter, and like a pp said you dont want to end up with over supply/clogged ducts, mastitis if your milk transfer is weak.

[newmamma_aug07]

I have been taking 150-160mg of domperidone for about 7 weeks and I have a great upswing shortly after starting and now I am back to struggling with my supply. I am doing just about everything possible. DS is almost 8 months. Is this just a normal drop b/c DS is eating solids or should I be concerned?

[SleepyMamaBear]

some women find that if they drop their DPD intake for a week, then up it again, that it helps to boost production, is he nursing less? for less time?
how are you feeding solids?
are you getting enough water? you need to be drinking to thirst, so be aware of your thirst cues and drink til you feel sated.
also, adding some herbs could help too.

[Kontessa]

I have a 5 month old who is failing to thrive. At 12 weeks she was 13lbs and then at 18 weeks she was little more then 10 lbs. All on my milk. I have never nursed a baby full time past 4 months because of supply/latch issues. This baby has a great latch though.

She is now up to 12 lbs, has had one bottle of formula but that might soon be a must. We have been blessed with breastmilk from a DDC mama but that is fast running out. She will nurse and then still drink 4 oz of the other BM.

I have been doing everything I can and I am just at wits end here. Finanaces are super tight as well thanks to some military pay problems.

I want to try this, I can not get a prescription for it. I have begged, believe me. I do not have the heart I think to spend what little money we have on pills to only have them not get here.

Is it really really worth it? I feel like this would be my last thing to try.

[loraxc]

so, whats going on with the nipple pain? hows his latch? does he have tongue tie? even slightly? are you blanching? what kind of pain is it?
are you seeing an IBCLC?
sorry to barrage you qith questions, but to get to the source, and get the solution to your probs we need to ask all sorts of questions.
how old is your son? how often are you nursing? for how long?

The nipple pain is by far the worst during nursing, and lasts the entire feeding at a constant level. Nipples are pink and hypersensitive at all times. I would describe it as feeling kind of like he is nursing with a mouthful of blunt thumbtacks. No cracks or sores. Nipples are sometimes slightly blanched after nursing and at random other times, also sometimes purplish. Color does not seem to connect to the pain level.

I saw an IBCLC at 2 weeks and she said his latch was great. I am not sure I think this is still so. I need to see her again. He looks okay from the outside, at least, but I wonder if something funky is going on with his tongue or palate. She did check him for tongue-tie, but I don't know how thoroughly.

I have been treated aggressively for thrush twice and had my milk cultured for bacteria (nothig).

He is 2 months old. He nurses at least 8 times a day, and more often 10. Feeds are almost always 30-45 minutes long at least and he rarely seems really 100% satisfied...although he does sleep a 5-6 hour stretch at night (can't figure that one out). He is a very mellow baby...perhaps too mellow, in this case. He may just be used to not really getting enough. I am doing breast compressions now that I know his weight is low.

I have started taking fenugreek (started Sunday) and am pumping during his long sleep stretch. I think my supply may be increasing a little.

The weird and baffling thing is that I had exactly the same issues with DD. We were told the issue was a high "bubble" palate. I can tell this baby's palate is not as high, but nursing feels sooo similar.

[SleepyMamaBear]

Loraxc: the blanching and thumbtack pain sounds a bit like raynauds, Jack Newman has some good info, as does Kelly mom.
COULD be a palate/latch problem, could be a combo of both. i say, find a great chiro that does infant CST, and get back to the IBCLC to get it checked out. does your babes tongue when he sticks it out look like the top of a heart?
definitely check out Dr Jack newmans and Kelly moms websites for info in help with milk transfer. sounds like he is eating often enough and for long enough, but milk might not be transfering all that well.

Kontessa, if you dont want to worry about customs, order a smaller ammount. small ammounts rarely get stopped. its the big packs of 19+ that usually get stopped. OR you could look into Shatavari, it does the same thing as DPD, but its plant based, originated in india, and i have a friend who takes it due to her having a heart condition and being unable to take DPD, and it works GREAT! you can order it online. there is a link through www.lowmilksupply.com OR you can just google search it. and get to an IBCLC. seriously i cant stress enough how important it is for us moms with low supply issues to go talk to an IBCLC. lots of them do sliding scale for low income moms. just call around.

[Violet2]

I was just wondering if you have heart palpations does that mean you should stop the Dom?

I went up to 2 pills 4x a day and had some issues. I went back down to 1 pill 4x a day and that's better, but I thought I would double check here that I'm doing the right thing.

Thanks
V

[newmamma_aug07]

some women find that if they drop their DPD intake for a week, then up it again, that it helps to boost production, is he nursing less? for less time?
how are you feeding solids?
are you getting enough water? you need to be drinking to thirst, so be aware of your thirst cues and drink til you feel sated.
also, adding some herbs could help too.

I drink TONS of water, about 90oz a day. I am making my own solid foods and feeding him when he's starting to get hungry or I will feed him solids after he nurses. His nursing hasn't changed at all. I used to take Mother's Milk but didn't notice a difference. But perhaps I could try just fenugreek? What would you recommend and how much?

[SleepyMamaBear]

for herbs, i take a blend from Vitanica called the lactation blend. its awesome, or you could start fennugreek, 3pills, 3x a day, plus blessed thistle, goats rue, alfalfa. there are tinctures you can take, i think they taste terrible, but if you can choke them down they rock. like more milk plus. and mothers milk tea is good too, make it STRONG and drink lots.
always feed your baby after you nurse. right now food isnt about sutanance, its about exploring texture and taste, so you dont want to be feeding them enough to fill them up. have you heard of baby led weaning? (british weaning, not american, just means intro ing new foods) its what we are doing and its going fabulously. at their age they dont need meals of food, but they do need the opportunity to explore foods, so chunks of bananas, avocado, sweet potato, regular potato, fresh or frozen corn kernals, steamed veg cut into little pieces, all baby friendly, all healthy, all fun to explore. its gives them "meal time" while still leaving you as their prime source of nutrition, as it should be.

Violet, talk to your dr about the palpatations, could be a sign of underlaying problems with your heart, not the dom.
if it would make you feel better you can also switch to shatavari.

[loraxc]

does your babes tongue when he sticks it out look like the top of a heart?

As a matter of fact, it DOES. However, when I look under his tongue, it doesn't look tied like in pictures of tongue-tie. I read the heart-shape can be normal, but I wonder.

[SleepyMamaBear]

at a class i am taking regarding lactation it was mentioned that a hear shaped tongue is a tried and true sign of tongue tie.

[quetinha]

Just got mine today... I'm excited but scared too.

I've read through all these posts over the last few weeks... But I am still hesitant.

I'm not sure how "low" my supply is. I feel like it's quite often a struggle - especially around AF when it will drop from pumping about 9 oz a day (while at work) to less than 7. I went through my stash in those times so I really want to build back up. 7 is way too low for him for his 8 hours in daycare.

I've seen the questions about if you take it then quit does the supply go back down... So I'm wondering if I can somehow end up Worse by starting it then stopping??

[Jezzy]

Does it take a while for the dom to start working?

[dcgrl]

Does it take a while for the dom to start working?

I think it depends on the individual.

I started my new shipment last wednesday and haven't had to supplement my baby since Monday. The first time I took it, I didn't notice a huge improvement, but it might be because I wasn't taking enough. I'm now taking 12-16 pills/day. I'm not sure if I need more because I'm heavy, but it would stand to reason. Give it time before giving up on it. some people don't notice a difference for a couple of weeks.

[Jezzy]

I luckily have never had to supplement I am just looking for a little more so I could pump some and store it for a rainy day :wink

[PingPong'sMom]

InhousePharmacy shipped my 4-month supply on April 7.

How long should I wait?

Was this too large of an order? If so and I re-order, what size should I order next time to make it through?

If my shipment was stopped in Customs, how long til I get a letter in the mail? Will I have to sign for it, etc.?

help?

Edited: I just got my shipment! Now onto trying the meds and see if they work...

[mommabird]

Hi, everyone!

I'm Nora and I'm battling low supply and a "lazy nurser."

My son, Aran, is just about 5wks. and we've had problems from the start. Every health worker we've gone to for advice has been crappy at best. In the hospital I knew his latch was bad, but no one - not even the LC - took me seriously and I left cracked and bleeding. We were told to supplement with formula on his 4th day of life because he'd lost 6% of his weight, my milk was not yet in, and he had slightly elevated bili levels. We blindly let him nurse and then gave him a 2oz. bottle of formula. I didn't have a pump. Nursing was incredibly painful for me because of his latch. He just didn't open his mouth widely like in all the pictures and videos. He just had this teeny little bird mouth. Then we saw another LC and she said to keep plugging along and make sure he didn't feed for more than 30 minutes. He was so sleepy all the time that 30 minutes was an insane request. No matter what I did - compression, manual expression, everything - he would not seem satisfied after feeding. It was hard to get him to really eat. Actually no one ever explained to me what it should look like when he's actually drinking. I just let him sit at the breast and suck however he felt like without knowing at all if he was really eating. We thought he was doing well so we cut back on supplementing but then he started to lose weight so we were ordered back on to it. I finally got a Medela PISA and saw a 3rd LC. She said to feed twice per side, bottle feed, then pump every time he ate and to do it at least every 2 hours during the day. Well that routine was taking more than an hour so I was basically feeding all day still. I started fenugreek and another mixed supplement called Lactation Support. I never pumped more than 1/2oz. total at a time and he was still starving until he got the bottle. I finally saw a 4th LC and she set us up with an SNS. She also sort of helped us with latch. We are supposed to have him feed at the breast with 2oz. of formula and breast milk (what little I'm able to get) in the SNS. I'm supposed to only let him latch if he opens his mouth really wide (which takes forever because it literally never happens) and then as soon as he stops actively sucking for more than a second or two to take him off completely and give him a minute then relatch so that he learns that boobs are for food, not comfort. I'm also supposed to keep his nursing at less than 1hr. at a time so he doesn't expend more than he takes in. However, he's still never satisfied after nursing. Sometimes he'll nurse for 3 hours straight and only take in 1oz. from the SNS. The LC said he gets about 1oz. to 1.5 from me which means I make some where between 1/3 and 1/2 of what he needs. But now I think he's in a growth spurt and he's eating constantly. From about 5pm - 1am he's constantly eating. Boob is not enough. SNS (if he manages to stay awake and eat) is not enough. Even bottle is not enough. He'll eat what's there and be hungry 20 minutes later. There is no way I can limit his feeding time to 45min. (I can't stand to hear him cry about it for more that 5 minutes or so) and everything takes so long that his feedings blend together so I don't have time to pump. The only time he feeds well is in the early morning when I'm SUPER engorged (well for me - my boobs are barely bigger than pre-preg. and I still wear the same bras as before and I rarely feel engorged.

I desperately want to breast feed him. I have tried pumping, power pumping, herbal supplements, constantly having him at the breast (despite advice to the contrary), and just about everything short of drugs. I'm so afraid that I'll never be able to catch up with any of these methods because he'll just grow again and need mroe than I can make again.

I cannot take Reglan because of a history of depression. Dpd seems like my only remaining hope to salvage this relationship.

It's going to take forever to get the pills and then longer for them to start working. Is this worth it? I don't know if I can wait 2wks. then maybe as much as another month.

Any suggestions?

[lactationlady]

What jumped out at me from your post is that this all seems to stem from a latch issue. It would seem logical to try to pinpoint the cause of the poor latch. Two places I would start are CST (cranio-sacral therapy) and evaluation for tight frenulum (tongue-tie).

Here is a link with more info on CST: http://www.kellymom.com/bf/concerns/baby/cst.html

Here is a link with more info on tongue-tie: http://www.kellymom.com/babyconcerns/bfhelp-tonguetie.html

One other resource might be consulting with a breastfeeding-friendly Occupational Therapist or Speech Therapist to see if he needs oral motor therapy to improve his suck. Here is a link to a page where you can read about normal and abnormal lip & tongue movements to see if any of this sounds like your little one: http://www.beckmanoralmotor.com/patterns.htm

Best wishes to you!

[Jezzy]

Ohhhh Mamabird. Hugs to you

[dcgrl]

Mommabird--yes--please check for tongue tie.

also, one thing that stands out to me is the relative lack of change in your breasts during pregnancy. This can be a sign of insufficient glandular tissue (IGT). If you have PCOS, that's a clue, too. google breast hypoplasia to see if you might fit this diagnosis.

but as for domperidone, it does work for many, many women. and the nursing relationship is so worth it--fight for it. And remember that it doesn't have to be all or nothing to be a success. YOU define what success is, and any bm you give your little one is a gift.

good luck--keep us posted!

[mommabird]

Thanks for the support, ladies.

Aran is up to 9lbs., 7oz. at 5wks. from his birth weight of 8lbs., 11oz.

I had the ped. NP asses him for tongue tie and he definitely is not.

I am getting over a bout of mastitis. It's left me virtually dried up.

I'm feeling lower than I ever have.

Aran will latch on, SNS is full and flowing, and he will either suck for a few minutes and stop and just sit there, or he'll suck for a bit and fall asleep.

I have been trying my hardest to do what the LC said - as soon as he stops actively sucking to take him off the breast and get him awake and alert and then relatch him. I'm supposed to do that every single time he stops actively sucking to "train" him that my breasts are for food only.

I understand the logic, but that makes a feeding take 3+ hours and in that time he still doesn't get enough milk to be satisfied and it just bleeds right into his next feeding. I never get a break unless he falls asleep and he's never full.

I also never really have time to pump after each feeding to build my supply, since I generally have no idea when one feeding stops and the next starts.

When I take him off the breast he just screams and screams. He rarely takes a pacifier, and occasionally will suck on one of my fingers.

His latch isn't terrible, but I just don't feel like he takes in enough of my breast. I'm usually not in any pain when he latches, but I know he could have more of my breast in his mouth.

I've been trying to manipulate his mouth when he's not on the breast to try and get him to learn to open wider, but it's not working.

The only time I've ever seen a look of satisfaction on my son's face is after he's had a bottle. That hurts me emotionally. It makes me really sad to know that I can't satisfactorily feed him at my breast.

I can't even pump enough to feed him. After using hot compresses, breast massage, pumping 10min.(with a Medela PISA), and then manually expressing until virtually nothing comes out I still am lucky to get 1.5oz. - even if he hasn't nursed in 3 hours. Usually I'll pump about an ounce total in a 10 minute session.

He generally needs 3-4oz. per feeding and some days he eats every 2 hours. Though sometimes he just eats constantly - a paci won't help, my breasts won't help, and the bottle must consistently be added to or he goes ballistic.

DH and I are at our wits' end.

I want very much to breastfeed him. I would be ok with exclusively pumping, but I would really rather feed him at my breast.

To do either though, it really seems like Dpd is my only hope. I'm taking arseloads of fenugreek and drinking gallons of water and eating well and trying to rest as much as I can. I'm getting a little tired of smelling like pancakes and having little to show for it.

Aran is almost 6 weeks old and every LC I've seen has siad he should be "getting it" by now.

I feel doomed to giving up. I've seen FOUR LCs, and I still can't et my supply up or satisfy my son. I just don't know what to do any more.

I don't know if I can make it through another month while I wait for the Dpd to ship and then start working.


ETA: I don't think my breasts are hypoplastic. They're small and sort of cone shaped. I'm an A cup. I'm still an A cup, even when I'm "engorged."

I'm debating taking him in for craniosacral therapy, but it's another huge co-pay, and it may not work.

[SleepyMamaBear]

alot of babies dont "get it" ntil they are older than 6 weeks.
and 6 weeks is prime time for growth spurt, so he is going to be HUNGRY all the time. its normall and natural for him to want/need to nurse all the time. frustrating and exhausting, but normal and natural.
are you seeing hospital LCs or IBCLCs?
have you checked out jack newmans page for latching help?
really once your son gets a good deep latch your supply is going to jump.
if you dont want to wait for dpd you could order some shatavari.
http://www.vitacost.com/Ayurceutics-Shatavari

[svmaine]

I've been weaning myself off the Dom. and will have I think 3 "sheets" left. You're welcome to them if you'd like, I could send them priority.
:Hugs to you!! I do have IGT/hypoplasia and also went through hell and beyond trying to produce enough BM. With DS #3 I'm producing about an oz. total per feeding and having to supplement the rest, it sucks but at least he's getting some. BTW, I did take tons of goat's rue in my last month of pregnancy and for the first couple of months and for the first time I did get engorged though my breasts didn't get any bigger. I think the goat's rue just turned what tissue I had into glandular tissue so finally with DS #3 I'm actually producing some milk:D!!

Good luck and know that you are doing everything in your power to make it work and if you have to stop to keep your health and sanity it's ok:love!!

sarah

[mommabird]

Sarah -

That's soo generous of you! You can email me at nora.kate@gmail.com so we don't have to talk about it here. I've been reading about the goat's rue, but every thing makes it sound like you really need to be under a doctor's supervision. My midwife is crunchy, but she's not super herbal crunchy. Do you have any good links about where to get it/ how to take it? It sounds like you've been working through a lot yourself! I'm definitely a sympathetic ear if you ever need one. Thanks for being so reassuring and supportive!

Tiffany - Everyone keeps saying 6wks. is like this magical turning point with BFing (and life in general). I'm really hoping it's true. It did strike me as odd that every LC I've consulted (a hospital LC, a ped. NP that's also an LC, and 2 different IBCLC's) has made it seem like he should be having clearly delineated feedings. My gut tells me that nursing for 5 hours straight isn't abnormal at his age, but these LCs have planted the seed of doubt, so now I'm a clock watcher and it's driving me crazy. I obsess over how much time he spends eating. I am worried though that he's never satisfied after nursing. I know I'm not making enough to satisfy him. I have looked at the Newman page (actually his handouts were what that worthless LC at the hospital handed to me after she shoved my son onto my breast and said "that's how it's done" and left). Honestly, my son just does not open his mouth the way the baby in the drawings and in the videos does. He's got a little bird mouth. It only opens wide when he's screaming or yawning - and neither of those times will he let me get my breast in his mouth. He will latch with out pain now, but I know he could be taking in more of my breast. I've tried manipulating his mouth every chance I get (on advice from an IBCLC) to help him learn to open it wider, but it's a no-go. This makes me want to try the CST, but I'm so afraid they're going to say he needs 20+ treatments for it to be effective, and honestly we don't have the $ to pay $800 or more in co-pays. I'm looking into getting the Shatavari. It sounds promising. Thank you for your support. I also wanted to say I LOVE the name Niamh. It was on my short list for a girl - right behind Aoife.

[SleepyMamaBear]

i LOVE the name Aoife!!!!
we did CST with Niamh and it helped TONS!!!!! if your insurance covers your son, and you have an infant CST practitioner in the area, DO IT! seriously Niamh was a flaily screaming angry baby til she got CST then she calmed right down. it also helped her latch tons!
also she would be at the breast almost all day long, even with the Lact-Aid supplimenting at the breast. she was just a needy nurser. till about... hmm 11 weeks. then she would take 20-45 breaks between nursings. now she can go almost 2 hours at 9mo.
some babies just need the boobs :)

[mommabird]

SO do you think I'm crazy to be trying to "train" Aran that boobs are for food?

I feel bad not letting him comfort nurse, but the IBCLC I've been consulting with of late seems to think he doesn't need it and that letting him do it all the time has made him "content to under eat" to the point that he'd rater just suck and fall asleep than actually eat a meal.

I guess I need to stop obsessing about how long it takes him to eat.

It makes me feel a lot better that Niamh would feed for hours, even when your supplementer was full. It can take Aran 3 hours to finish it sometimes, and it's only got 2 or 3 oz. in it!

This is probably the only time I'll ever wish my kid better modeled the "average."

[SleepyMamaBear]

you cant train a newborn any better than you can train a snail. thats just my opinion on that.
if your son needs to nurse, nurse him! follow his cues.
Niamh cant sleep without a boob in her mouth, and know what... thats OK! she is getting her rest, getting milk, and we are getting special bonding time together. so, where is the negative?
sounds like your LC isnt very AP.

[mommabird]

I went to a New Moms Group meeting near me today. They had an LC on hand and a sensitive scale.

He's now just under 10lbs. So he's up give or take 6oz. in 4 days on nursing and formula, but mostly formula.

We did a before and after weigh in and he's taking about 2oz. from me now! I'm super excited that he's getting double what he was just 2 weeks ago, but also sad because he needs 4-5oz. per feeding, so I'm only making about 1/2 of what he needs still. Though it's better than only 1/3.

So I BFed him earlier for about an hour (at that point he wasn't staying latched for long on either breast so I did some compression and then got him a bottle) and then instead of giving him 3oz. I gave him only 2. He did OK. He was still acting hungry, but I gave him a Soothie and put him in the swing and he did alright for a while. I think next time I'll do 2.5oz. instead of only 2.

I've decided that I'm going to use part of the $100 gift cert. we got for amazon.com to order some shatavari and maybe some more fenugreek.

The LC recommended we take him to a SLP to assess his oral motor skills since his suck seems weak. I'm scheduling an appt. tomorrow. She said CST may be helpful, so I'm going to try and find an infant specialist for a consult.

As soon as my stimulus check gets deposited I'm ordering the dom.

Things are on the up for us it seems.

P.S. Tiffany, it's so awesome that you're able to BFAR!

[SleepyMamaBear]

it IS so awesome. i am determined to BFAR #2, since i had CRAP advice and failed miserably at BFARing #1.

if you would rather use human milk instead of formula folow the milk share link in my sig.

also, have you considered not counting ounces and just going by his hunger, nursing needs, and diaper output? that way, if you are a "need to count" type of person, you can count his diapers, and number of feedings instead of the oz you are putting into him. he should be having 4-7wet disposable or 8-10 wet cloth diapers, and at least 1 bowel movement a day. so, next time you feed him, you could nurse him both sides, with compressions, twice each, then if he still wants to suckle and is fussy give him his soothy in the swing see if that calms him, and if it does, he isnt hungry still, just wants to suckle (which is ok for him to do on you if both of you are happy with it) then when he starts to get fussy try to nurse him again. the more he is on the breast, the more you are going to make. so every feed, or even half feed, of formula you are giving him in a bottle, thats a feed or half feed that he isnt stimulating your breasts.
remember breasts are never ever fully empty, they are always producing. some of us produce more, faster than others, i am not one of the more/faster type of producers, and thats ok. we dont have to be, we feed our babies more often, for longer periods of time, and use at the breast supplimenters to stimulate our supply, and we just keep on producing. :)

dont take the shatavari and the dom together, but you can take either with the herbs. goats rue, blessed thistle, nettles, and alfalfa are all great galactogues. so are oats. so a bowl of oatmeal or cheerios for breakfast, and a nice oatmeal cookie after lunch should help tons too :)

[dcgrl]

Mommabird,
I wonder how you figure he needs 4-5 oz/feeding. If it's based on what it takes to satisfy him in a bottle, you may be overestimating his needs. Babies suck down bottles so fast, they don't feel satisfied until they've overeaten. Along with the nutritive value of milk, babies have a need to suck, and bottle feeding doesn't permit that as easily as nursing. Average intake for a breastfed baby your son's age is 25oz/day. If you feed him 10 times a day (and I suspect you're closer to 11 or 12 feeding/day), he might be getting 20 ounces, or 22, or 24. Of course, your milk supply varies throughout the day, so you can't assume you always produce 2 oz/feeding--in the mornings, you might be making 3 oz, in the evenings, maybe only 1 oz.

Next time you give him a bottle after nursing, consider giving only 1oz, then nurse him again to allow him the chance to comfort suck and see if he's satisfied. I'd ignore the advice to limit the baby's time at the breast. That's the advice my ped gave me, too, and I think it's off the mark. Babies know what they need.

I've heard great things about CST. From what I understand, CST isn't like chiropractic, where you tend to have to go back multiple times in order to have good, lasting results. You might need a few sessions, but I wouldn't imagine you'd need ongoing therapy.

Your situation sounds like mine--my son wanted to be attached constantly, but he nursed maybe 1/2 the time he was latched on. (And the pumping--don't you love how LCs tell us to pump as if it's the easiest thing in the world?) He's slow growing, and I have lowish supply, but I stopped supplementing him with formula last month and he seems to be doing well.

Are you familiar with kellymom? really good resouces there...

[mommabird]

I got 4-5oz. because I now know he gets about 2oz. from me and then he was taking a 3oz. bottle after a feeding.

He used to only get a 2oz. bottle, but about 2 weeks ago he started acting hungry still after he finished the bottle (we stopped using the SNS because he'd nurse for 3 hours and still not finish what was in it, but then act hungry when I took him off the breast). He'd smack his lips, stick out his tongue, and root until he got more bottle.

We upped his supplement to 3oz., thinking it was related to a growth spurt, and he would eat and be content - or fall asleep.

I have never seen my son be contently full and really awake. He will nurse for over an hour (sometimes multiple hours if I feel up to it) and still be hungry. I'll give him a bottle afterwards and he will either fall asleep after eating or still act hungry.

Sometimes we are able to get him to take a paci or one of our clean fingers and he'll suck for a bit and drift off to sleep.

If this child is awake and not on my boob or with a bottle in his mouth then he is constantly acting hungry. He will smack his lips, root, stick out his tongue, mouth the air, do all the classic hungry cues (he shakes his right arm too, which is kind of cute, and breathes really rapidly) until he gets either boob or bottle.

There are times where he will not nurse any more, has just had a 3oz. bottle, and will not take a paci or finger. He will just cry and cry no matter how much we rock him, bicycle his legs, sing to him, change him, add layers, take them off, etc.

I'm a FTM and I guess I'm fairly clueless when it comes to feeding.

I tried exclusively nursing him today. This morning he got a good feed in and fell deeply asleep and stayed that way for almost 2 hours. After that he nursed for probably 3.5 hours off and on with maybe a few 5-10min. cat naps before I needed a break and gave him a 2.5oz. bottle (I'm trying to cut back on his supplementing). He didn't sleep long, but it was enough for me to eat a sandwich. After that I nursed him off and on again until just about 20 minutes ago. He's now asleep and I managed to get him in the bassinette.

It's just so frustrating because for at least a month now he'll nurse for hours on end if I let him, and still come away hungry.

It's rare that he isn't really hungry. I test him. I try to give him a paci or a finger, but he won't take them. By this time he's nursed so long that he either won't take my breast or if he does he gets really frustrated because he can't get anything out of it. It feels like there's nothing left.

I can tell he nurses well when I'm feeling full. As soon as I go soft and the flow slows he gets really "lazy" (I hate using that term). Sometimes even after I do compressions for 30min.+ he'll still be "hungry."

Not allowing comfort nursing sounded a little backward to me, but honestly I don't know if I can handle him