Switching back and forth between Domperidone and Reglan - Urgent!! Docs recos - Mothering Forums
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#1 of 11 Old 12-19-2012, 11:19 AM - Thread Starter
 
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My LO is 4 months old. He doesn't take supplementation of ANY kind and I cannot pump.

 

First 2 months I had oversupply which due to his un-diagnosed tongue tie, reflux and ineffective transfer he brought down to low supply.

 

I started on 30mg/day of Dom when he was 2 months old and somehow kept plateauing and everytime that happened I added 10mg....

 

Now am on 160mg/day of Dom.

 

Have plateaued and I seem to have gotten drug-tolerant to it.

 

Am thinking of taking Reglan for 1.5 to 2 weeks to jumpstart my supply. I am aware of the risks.

 

I have heard that taking Reglan for even two weeks has long term supply benefits...versus Dom which needs to be taken continually. Is this true?

 

If I do take Reglan.. how do I switch? Stop Dom cold turkey and take Reglan for two weeks.. and then go back to Dom?

 

If I do go back to Dom because my Reglan supply isn't holding up should I take 160mg/day again or start over with 30mg/day?

 

Remember - my LO doesn't take any supplementation so I cannot experiment with low supply. It can get dangerous and go south very fast.

 

If I need a doc or LC or midwife to help me...who do I contact? My obgyn doesnt seem to have had experience with Dom. How can I find one who has experience with both and knows how they individually function and how they will interact with each other (atleast during the overlap time)?

 

Does anyone know one such person around the Seattle area? Does anyone know an answer to my Question? Apart from the side effects does anyone see an inherent detriment in my plan? 

 

I am thinking if Reglan doesn't work I will go back to Dom and at least I should be no worse than I am today and if Reglan works ..then great.. I should have a good supply again and if it is true that you need to take Reglan only for 2 weeks for even 2 months or more of benefit then I will be drug free..

 

...even if I get 2 months benefit out of this I will be in a better place because I will start my LO on solids when he is 6 months old.

 

Please help.

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#2 of 11 Old 12-19-2012, 07:03 PM
 
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I don't know much about dom, would avoid metoclopramide if you can.  have you thought of trying fenugreek?  taking high doses as indicated on kellymom.com and other breastfeeding sites seems to be very effective.  good luck!


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#3 of 11 Old 12-19-2012, 07:22 PM - Thread Starter
 
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There's isn't a galact I haven't tried :) and yes I have tried fenugreek.

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#4 of 11 Old 12-20-2012, 10:55 AM
 
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bummer :(  i'm in or but can't imagine you wouldn't be able to find a really good lactation resource in seattle. 
 


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#5 of 11 Old 12-20-2012, 11:51 AM - Thread Starter
 
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I am in touch with a good LC but she also says she doesn't know the protocol to switch back and forth and how reglan may work and how my body may work while cutting down Dom cold turkey.

 

Am trying to work out a protocol. If you know someone somewhere who would consult with me via phone...I would be willing to try that too...

 

Basically here's what I am thinking...roughly

 

Reglan is supposed to work for a longer period of time when taken for a short period ...versus Dom which needs to be taken continually.

 

I stop 160mg/day of Dom cold turkey and take 20 mg of reglan the first day (is this safe or will this tank my milk supply completely and suddenly?)

Next day I take 40 mg of Reglan ..and for 3 days

Then I take 60 mg of Reglan (my highest dose) for 3 more days. Am I right that 60 mg is considered a pretty high dose? What is the highest acceptable dose of Reglan? I know Dom is 160mg/day

That will be 7 days or one week already

 

Meanwhile if I hallucinate or have shivers or really bad symptoms I stop Reglan cold turkey any time.

 

Now I take 50 mg/day for 2 days...then 40 for 2 days...then 30 for 2 days and 20 for 2 days ... that is 8 days...

Approx 2 weeks....

 

Now the way I read about Reglan is... it needs to be taken for these 2 weeks and it boosts milk supply for the length of the breastfeeding relationship or at least till 2 months. If that happens.. then I don't take any drug for at least 2 months or more...

 

When I see a decrease I restart Dom.

 

Question is do I start at 30 mg/day and add 10mg extra everytime I see a plateau or should I add back the 160mg/day at that point?

 

And will these experiments take away the 80% supply I have going on for me right now completely and are more hazardous than helpful?

 

Remember 80% supply is not enough for me ..because my LO does NOT take any supplementation of ANY kind. Even expressed breastmilk. He spits it out even if we pour drops!

 

Can anybody chime in about the protocol? Or my assumptions on how Reglan works?

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#6 of 11 Old 12-26-2012, 10:22 AM
 
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I'm sorry you're going through this. Supply issues are scary and hard.

 

What is the reason you cannot pump? Even though baby will not take a supplement, have you considered pumping only to increase your supply? You don't have to give the milk to baby, use the pump as a tool in addition to the medications you're taking to increase your supply. 

 

When you pump after nursing, you don't get a lot of milk, it's more to stimulate you and cause your body to produce more. If you can find a way to pump, I would consider renting or borrowing a pump for a month and pumping for 5-10 minutes after every feeding, whether you plan to use the milk or not. Also, you can always store this milk and freeze it to save for when baby starts solids (mix it with cereal, or add to veggies) if you don't want to waste it. :)

 

If you can't pump after every feeding, we tend to cycle how much we produce during the day and you might consider pumping after the feedings where you produce more. For me that was always the first two morning feedings. This will help and won't get in the way of your life as much as pumping at night and such. And might be a long term solution for you to help with stimulating your supply.

 

As far as switching from dom to reglan, I just switched from one to the other without a second thought. My doctor took me off of one due to what it did to me. I was switching off of reglan due to the side effects causing severe PPD like symptoms and dom didn't cause me to cry for 24 hours a day.


Married to DH in 1999, Mother to Big N (2004), Mother to Little N (2005), Expecting our third in March (2013).

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#7 of 11 Old 12-27-2012, 12:14 PM - Thread Starter
 
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Cannot pump because I have only one working breast and my son is a sporadic eater..so sometimes eats 10 mins after a feed or.20 mins..etc. Very impatient and will scream bloody murder if he finds my breast empty.

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#8 of 11 Old 12-28-2012, 11:13 PM
 
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Can you try to pump for just a minute or two after a feed?  Technically breasts are never "emtpy" since milk is produced mainly when it's needed anyway.  You should try to up the demand for milk to clue your body in.

 

My experience is old (with my daughter, who is almost 7!), but I did have good experiences with the LCs at the Breastfeeding Center at Evergreen Hospital in Kirkland. 


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#9 of 11 Old 12-29-2012, 05:28 PM - Thread Starter
 
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Quote:
Originally Posted by Melany View Post

I'm sorry you're going through this. Supply issues are scary and hard.

 

What is the reason you cannot pump? Even though baby will not take a supplement, have you considered pumping only to increase your supply? You don't have to give the milk to baby, use the pump as a tool in addition to the medications you're taking to increase your supply. 

 

When you pump after nursing, you don't get a lot of milk, it's more to stimulate you and cause your body to produce more. If you can find a way to pump, I would consider renting or borrowing a pump for a month and pumping for 5-10 minutes after every feeding, whether you plan to use the milk or not. Also, you can always store this milk and freeze it to save for when baby starts solids (mix it with cereal, or add to veggies) if you don't want to waste it. :)

 

If you can't pump after every feeding, we tend to cycle how much we produce during the day and you might consider pumping after the feedings where you produce more. For me that was always the first two morning feedings. This will help and won't get in the way of your life as much as pumping at night and such. And might be a long term solution for you to help with stimulating your supply.

 

As far as switching from dom to reglan, I just switched from one to the other without a second thought. My doctor took me off of one due to what it did to me. I was switching off of reglan due to the side effects causing severe PPD like symptoms and dom didn't cause me to cry for 24 hours a day.

 

 

What dose of reglan were you on? Was it helping your supply sufficiently? What dose of Dom did you start on switching and how high did you go? Was your supply consistent at the highest dose?

 

Thanks and I will try and pump for a few minutes after feeds,,,,,,,

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#10 of 11 Old 12-31-2012, 03:45 AM
 
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Quote:
Originally Posted by Blessed_Mom View Post

 

What dose of reglan were you on? Was it helping your supply sufficiently? What dose of Dom did you start on switching and how high did you go? Was your supply consistent at the highest dose?

 

Thanks and I will try and pump for a few minutes after feeds,,,,,,,

 

I actually do not remember. This was in 2004 for me. I never upped the reglan dose, I was on a pretty low one. I want to say 10mg. The dom was a little higher, but not much. I never upped that, either.


Married to DH in 1999, Mother to Big N (2004), Mother to Little N (2005), Expecting our third in March (2013).

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#11 of 11 Old 01-03-2013, 10:23 AM
 
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I'm really not sure about your protocol as I haven't used Reglan, but from what I've heard, the lowest effective dose of Dom is typically 90 mg. I took 120 mg a day for about 10 months and the couple times I missed days or even single doses, I noticed a marked decrease within 24 hours. Dr Jack Newman in Canada has a lot of information about Dom, and I've heard of other people calling/emailing him for consultation.
 

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