Taking drugs to keep breastfeeding

Most breastfeeding mothers can afford to be vague about when they’re going to stop breastfeeding.

Their decision may depend on cultural expectations (“She’s walking and talking and you are still nursing her?!”) or personal comfort (“I just can’t deal with the biting anymore!”) or parenting philosophy (“He’ll wean when he’s ready.”)

But there are others, like me, who need to take a more pragmatic approach. The question of how long we’ll breastfeed goes hand in hand with another question: how long can we afford to take domperidone?

Domperidone is a drug normally prescribed for nausea but has the side-effect of increasing prolactin levels. In a breastfeeding mother this can noticeably increase her milk supply.

I first read about it in a kellymom.com article on low milk supply but when the lactation consultant who was helping us mentioned it, I asked the GP who was doing Talitha’s 6-week check to prescribe it.

I started taking it because although the tongue-tie cut greatly improved her latch and suck, she was hardly swallowing and still wasn’t gaining weight.

I was pumping after feeds, doing breast compressions while she fed and making sure the latch was correct every time. Yet there was hardly any milk and my tiny baby was never happy and hardly sleeping day or night.

Within 24 hours of starting domperidone (and it was a LOW dose of 30mg a day) my breasts suddenly had the feeling of fullness they had never had. Like Liska yesterday described happened to her, my baby was staying on the breast longer and was happier.

I ended up taking 90mg a day because the initial effect couldn’t be maintained on such a low dose. This is the starting dosage that breastfeeding expert Dr Jack Newman recommends for this purpose. However, my GP refused to prescribe it in that amount as she was unfamiliar with domperidone being used this way. I ended up getting the extra pills by other means.

In fact, she eventually stopped prescribing it for me altogether and instead prescribed a drug called metoclopramide (known as Reglan in the US) which is known for causing depression in postnatal mothers.

With a history of depression, I wasn’t taking any chances so refused to take it, did some research and took it to the GP, pleading with her to seek further advice on prescribing domperidone.

In the meantime I had three weeks without taking domperidone and had very little milk. I had my Supplemental Nursing System ready for every feed which was disheartening after getting to a point where I’d only needed to supplement with a couple of ounces of formula a day.

After speaking to the infant feeding midwife at the hospital, my GP agreed to prescribe the domperidone but only at 30mg a day. This hardly did anything to help.

When I finally started taking domperidone at 90mg it didn’t make much of a difference because of the time I’d spent off it. Then, without me even noticing, it suddenly kicked in. And Talitha began feeding better (I attribute this partly to the work done to her jaw in cranial osteopathy).

In fact, the scales showed she was gaining weight too quickly. So I began cutting out the formula supplements until it became apparent that she didn’t need them at all.

She could be exclusively breastfed. She turns six months this Saturday and we’ve finally got here.

Now this presents the conundrum. I’d initially said I’d stop taking domperidone when Talitha reached six months, feeling that was a more than reasonable stretch.

If the drugs weren’t working or had a minimal effect that would be one thing but I’m convinced that I need them in order to breastfeed my daughter and I’m just not ready to stop doing so.

On one hand I wonder whether I should be taking medication to produce breast milk. It’s somewhat artificial. On the other, formula is artificial. Breast milk is a live substance. Formula is not.

And it’s not just about the nutrition. Breastfeeding is so comforting to Talitha and so much a part of our relationship that I feel stopping suddenly would force me to rethink a lot of how I mother her.

On the health side of things, the amount of domperidone that enters breast milk is considered negligible and mothers have taken it up to eighteen months without adverse side effects.

I don’t think this is one of those questions whether there is a right or a wrong answer. Whichever decision I make will be the right one for us. Either way, I have already breastfed her for much longer than I imagined I’d be able to.

So tell me, when and how did you decide to stop breastfeeding? If you stopped around the six-month mark, was that enough?

Image: m-generic.net

This week is Baby Feeding Week on Circus Queen. I’m celebrating having made it to six months of breast and bottle feeding my daughter through LOTS of difficulty. Look out for tomorrow’s Baby Feeding Week post: “The best bottle for a breastfed baby.”

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  • And for others the question of how long we can breastfeed depends on how long we can take off work. I know that in theory a work-place has to provide you with facilities to express/store milk if you choose to continue with breast-feeding when you return to work, but if you only get one 30 min break in a 12 (usually actually 13 or more) hour shift, and during that time you also need to eat, drink and use the loo, then the likelihood is you won’t get much expressing done! I found that my return to work did prevent me from continuing breast feeding with Ben, and he was 10 months at the time (although he was down to only 3 feeds a day by then). I’d really like to try and maintain at least 1 feed a day when I return to work in March, but we’ll just have to wait and see how it goes!

    Hope you’re having a lovely time, sorry to hear that T is not feeling great. x

    • That’s a very good point. The law needs to be more realistic about protecting breastfeeding. I hope you manage to continuing feeding as long as you’d like to. Ten months is brilliant though! Well done.

    • I went back to work when my little one was 8 months old. I was still giving her breastmilk morning and evening and on demand at the weekends. I am still feeding her now nearly a year on. You can be a working mummy and breastfeed – it can be done!

  • I also struggled with breastfeeding. My son was premature and so couldn’t breastfeed for ages and I needed to take domperidone to get my supply going and then to maintain it as I ended up mainly expressing and feeding via the bottle due to latching problems and recurrent bouts of mastitis. I supplemented with formula from about four months too. I agonised about giving up breastfeeding for days, weeks, months probably. I think I actually stopped when my son was 9 months old. He is now 5 and a half and it speaks volumes now that I can’t remember when I did actually stop. Now I look back and think I did really well and can’t believe I gave myself such a hard time. I think I would be proud whether I’d breastfed for 1 day, 1 week or 1 month given the difficulties I encountered. A few years down the line breastfeeding seems (to me) like such a small part of the whole parenting experience. Whatever you decide will be fine xx

    • That’s so encouraging, Alice. I think I do often forget that I will look back and this won’t be the big deal it is now. You did really well to carry on for so long and could not have been faulted had you decided to stop sooner. I have to sit down and make a decision about this and stop giving myself so much grief.

  • Hi Adele, I find your story really fascinating, everything you’ve gone thorugh to continue breastfeeding is just amazing. I’m afraid my story is nothing like yours! Before my first one was born I was quite naive, I thought everyone breastfed. I thought i’d feed til baby was 1 cos in my mind it seemed pointless to stop in order to start paying for inferior milk and I was also just lazy!  12 months came and went and I breastfed til she was 2 1/2! (though not in public from about 15 months).  I;m currenty feeding my 7 month old and although i’m not sure if i’ll feed him for as long, i def can’t imagine stopping anytime soon. He’s has quite a few health problems, nothing too serious but everytime I feed I feel like he’s getting medicine. that’s what i loved about feeding my toddler, I knew she was getting the best food whenever she was ill, no matter what it was that she was ill with.
    You seem very well researched so you’ve probably read ‘making more milk’? It’s a fascinating book. I don’t know much about domperidone (i’d love to know how to pronounce it!) but if you have a background of depression, I know it’s best to come off it slowly, if you choose to. Did people discuss with you the possible reasons for your low milk supply?
    I think that you should choose to do what makes you and your family most happy. What decision do you think will most likely leave you with the least regret?

    • It’s been suggested that because of Talitha’s tongue-tie she was not stimulating my milk supply for the first eight weeks. After her tie was cut it still took a long time for her to feed properly. Despite having a lactation consultant look at my latch and help with positioning, pumping and using a supplemental nursing system instead of bottles my supply just never recovered. I believe breastmilk with domperidone is superior to formula so that definitely features highly in my decision-making.

      You should be really proud of how long you’ve fed both of your babies. I’m so pleased whenever I hear about breastfeeding working as it should. I know what you mean about it being like medicine. There’s a sweet purity about it. I haven’t read “Making More Milk” but I’ll take a look.

      • Hi Adele, i’m pleased it’s encouraging hearing a successful story and not annoying! I mentioned the book just for interest’s sake rather than ‘this will help you’. I’m not sure you’ll learn anything new but it’s full of other people’s stories too which is always nice to read.

  • How fascinating. It had never crossed my mind that you could medicate to help breastfeeding. For us personally, we stopped breastfeeding just after F turned one. It was such a gradual thing, once she was relying on solid food, that I hardly noticed it. Until we got to one feed a day and suddenly she just stopped. I still miss it now!

    • I was surprised when I heard about domperidone too. It’s been such a lifeline – obviously not to be taken until you’ve tried everything else but we have literally done everything else.  It’s great to hear about babies self-weaning. By the way, missing breastfeeding is another indication that, ahem, you need to have another one!

  • Hi Adele really enjoyed your post again im asking the same question when is time to stop for me and Maisie-Jean who is now 2. Some days I think that time may be approaching and others i really dont want to stop. Also feeding is a massive part of my parenting we have cuddles and a feed for her nap or if she falls over. I have decided when its time i will know or she will stop i think this time is different for every one and what ever you decided wow you have done so well i really admire you perseverance and dedication. I hope your having a lovely time hope we can catch up when your back and i can hear all about your trip. 

    Sy 🙂 

    • Hi Sy, I’ve only just seen this comment. It makes a lot of sense in light of what we were talking about yesterday. It’s great seeing a real life person breastfeeding a 2-year-old. You’ve give Maisie an amazing start. Here’s hoping that you’ll have an easy time weaning whenever the time comes. x

  • Adele, I think you have to see how you go and do what’s best for you and Talitha like you say.  Perhaps you could try gradually lowering the dosage you take and see if with Talitha’s now established feeding routine your milk supply is more stimulated than before…also since you are probably just about starting weaning, as she starts on food her demand for breast milk will gradually decline so if your supply does as well, perhaps the two will coincide?  I suppose it’s a means of seeing how satisfied she remains after feeding.  LLC was always small and I don’t think I had a massive milk supply (no milk shooting out of breast for me!) but at the same time I could feel my breasts fill and drain and what I had was enough for her to feed and sleep without issue.  So I guess I’m saying to keep looking at Talitha’s response to gauge the impact if you do reduce your dosage.  Also, I’m not sure of the cost for domperidone but I know a natural supplment that had been suggested to me was fenugreek, perhaps less pricey as herbal but I don’t really know…..http://www.breastfeedingonline.com/fenugreek.shtml

  • B is 17 weeks and I am in a breastfeeding slump. It’s all been so easy up till now. Suddenly she is struggling to get my milk to flow. I am swapping her from side to side and back again. We are not using formula yet, but it’s sitting in the cupboard, taunting me. It’s saying “Look at me all thick and ready and accessible” – while I sit hunched on the sofa with a whingy, hungry baby and a sore back. I wanted to skip formula all together with B and keep breastfeeding right through to cows milk. I am having to accept that is not going to happen. Like you, now I am just taking it one feed at a time – one eye on the cupboard.

    • I can so identify with what you’re feeling. Obviously you know that you’ve got to do what gets you through but it seems it would be a shame to go to formula when your breastfeeding relationship has been so successful up until now. Perhaps it’s time to look for some more experienced support? La Leche League, NCT & NHS helplines all useful. There’s also bound to be a good IBCLC in your area. It depends on what you think works best for you and B. Just make a decision that you’ll look back on and be happy with. In the meantime, here’s to one feed at a time! I’ll be doing another one in a few minutes after bath time’s over!

  • I had 3 mastitis and the GP told me to stop after the 3rd one, G was about 5 months old. Bottles are easy and I never looked back. I was a bit gutted at first, but then I liked the idea of knowing how much she was drinking and of having my body back to myself. Formula helped her sleep through the night too, so it was happy days all around. The thought of another mastitis and more penicillin would have just killed me. I was in agony for a week by the 3rd one. you just know when you have given it a good go, but eventually it is time for YOU to stop. G was ready for it, she always took expressed milk in bottles and had no issue with bottles or formula, whatsoever. I missed the happy hormones at first, but enjoyed wearing normal bras instead of nursing ones…

    • Three bouts of mastitis sounds horrific. I’m sorry you had to endure such pain. I imagine it was quite an emotional time since having carried on for so long and through 2 bouts already you were obviously making a real go of it. It’s a pity the cause of your recurring mastitis wasn’t found and addressed. I’m glad your baby made an easy transition. She’s got a hardworking mama!

Further reading

Showing up as myself

[image description: Adele and her youngest child sit in the greenhouse, looking at the camera] You may have noticed that I’ve changed this website’s name and URL to my own: Adele Jarrett-Kerr. When I started this blog nine years ago, it...