A number of people asked me to post about my experiences with Domperidone for milk production once I’d been on it for a bit.
I have now been on Domperidone 80mg/day for 9 days. I got a script from my OB/Gyn, and had it filled at a compounding pharmacy. They gave me a “super bill” to submit to my insurance. I was told a lot of insurance companies will cover it if prescribed and written up properly. It is NOT illegal, it is simply not commercially available, and that’s a huge difference. My insurance hasn’t responded yet, so I can’t tell you how that worked out in terms of coverage.
Meanwhile, here are my experiences and observations.
Effects:
began to work by the end of the first day (which was only 3 doses)
the first morning after I started I woke up because my breats were FULL- I got 6 oz out of them. That is now a standard amount every morning.
Full effect didn’t really happen until I’d been on it about a week.
Today I’ve kept track, and in the past 12 hours I’ve produced 17.25 oz of milk, which is more than I used to produce in 24 hours. I will post with a 24 hr grand total tomorrow. And probably one other day also, as today I have been under a LOT of stress and I know I’m making less than on other days.
Our formula usage has dropped dramatically. We are down from 30+ oz a day to under 6oz
Side Effects:
Made my intestines feel like they were full of wiggly snakes the first day. Day 2 I got a nasty headache. Nothing since then.
-If you let the capsule disolve in your mouth, it will taste like ass.
Pros:
Boosts milk like you would not believe
Easy to tolerate, even for people like me who are sensitive to meds
Works within 24 hours
Easy to take
Few side effects (YMMV), none after 48 hrs
Allows me to go out with only boobs as a food source
Cons:
You still have to pump/nurse 8 times in 24/hours to build and maintain supply (though maybe YMMV)
Must be swallowed with water. Swallow quick, it tastes like ass!
Must be taken 4 times a day
Can be expensive if bought in the US, insurance may or may not cover it
Can be sketchy if imported from elsewhere, though cheaper
That’s my report for right now. Feel free to ask any questions you may have.
Oh, I’m so happy it’s working for you! Has it decreased your grr while increasing your milk?
My dad’s looking into the research to make sure it’s OK for micropremies before I seek it for myself. He’s strongly hinting he’d prefer I simply take Reglan, but I’ve been depressed more of my life than I haven’t, so I think that’s A Very Bad Idea.
Hello, inkleberry, and good to meet you. I’m glad you’ve found a remedy and are willing to tell others about it. I have to say, when I opened this thread I thought that you’d merely misspelled Dom Perignon, and I still suspect the manufacturer of playing off the name. I have no axe to grind, but here is a site which talks a little about the pros and cons of Domperidone:
I’m curious, do you know for a fact that compounded domperidone is legal? Or are you assuming it is because it is being sold?
They aren’t one and the same.
Generally, it is not legal for US compounding pharmacies to compound drugs that have been taken off the market in the US. There are exceptions which I didn’t have the patience to dig through to see if domperadone falls into. The FDA goes by a “don’t look, don’t tell” philosophy and doesn’t go after many compounding practices, although they know they are technically illegal.
One thing that would worry me (if I were taking it to increase breast milk) would be the manufacturer’s warnings against its use in lactating women. It is passed in the milk, and nobody knows what its affects in the developing pituitary and hypothalamus of a newborn might be. It makes me remember my friend from high school who died at the age of 14 from a uterine cancer. If there had been a straight dope board 14 years earlier - in 1956 - her mother might have posted a thread on the wonders of DES.
So I don’t mean to be a wet blanket, BUT… any drug should be used carefully and for the minimal amount of time needed. Doubly so in a breastfeeding woman. The fact a MD will write a presciption for it and that it can be obtained in this country is no insurance that it’s always all good.
It is probably legal for compounding pharmacies to compound medications containing domperidone. I say probably because the FDA is suddenly saying it isn’t, but that flies in the face of State law and the way the laws have been enforced for years.
It is certainly legal to get a US doctor’s prescription and import the drug for personal use, limited to a 3 month supply per purchase. Many women order it through Canadian pharmacies, and it is absolutely legal. I provided citation for that in another thread, which I’m sure you can find by searching for “domperidone.”
Domperidone is recommended by the American Academy of Pediatrics and listed on it’s table of “Maternal Medication Usually Compatible With Breastfeeding.” It’s considered safe and effective by them for increasing the breast milk in nursing mothers of full term infants.
The only studies which have shown hazards are with domperidone intraveneously administered to babies, not to babies who have consumed it through breastmilk. The amount present in breastmilk is .042% of the mother’s dose.
So why haven’t I started it yet? 'Cause I have a micropremie who’s still developing all those things that four month old baby Tinkleberry already has (like a brain and a heart). And because I don’t have access to all the information on how it works and any theoretical risks for micropremies. My father (Doctor of Pharmacy who works in a neonatal intensive care unit) is checking that out for me, and I’ll be happy to share what he says.
How long do you have to use the domperidone for? Is this something that you would need to take for as long as you’re nursing tinkleberry? Or just for a week or two while the boobies get up to speed?
I never had a supply problem with either kid, but Moon Unit was a 34 week preemie and did not know how to breastfeed when she came home from the hospital. Those first 2 weeks are a blur of pumping, attempting to nurse, feeding via SNS or finger tube or bottle, pumping, lather, rinse, repeat. I didn’t leave the house once. So I know what a treat it is to be able to go out with just the boobs for feeding purposes
Is tinkleberry nursing pretty well most of the time? or are you mostly having to bottle-feed?
No cite needed. In adults and term babies, you’re absolutely correct. Premies sometimes metabolize differently. Jury may be out, or jury be be in and I just don’t know about it yet.
Actually, the main concern dad’s looking into is the heart. There was another reflux drug (don’t remember the name, starts with a “c”) that used to be used, much like Reglan and domperidone (huh, wonder why all these reflux drugs increase milk?) that is no longer used because there was some decent evidence that it caused Long QT syndrome in premies. What’s Long QT syndrome? Uh…it’s something to do with the heart not beating right in a certain part of it’s rhythm. Probably not a concern for older babies where the heartrate is already well established, but a real no-no for premies who’s hearts are still developing. Dad’s looking into whether domperidone works in a similar chemical manner to this other “c” drug. If it does, I probably won’t use it.
Again, for you, inkleberry, I wouldn’t worry. Tinkleberry’s much older than WhyBaby, and the evidence seems in favor of domperidone being safe for you guys. I know you’ve researched it well. I’m just trying to do the same for our rather different circumstances.
Oh, man (woman) I’ve been on every puming schedule under the sun, and it seems to make about thismuch difference in production. Right now I’m doing an “every 4 hour 'cept while I’m sleeping, pump for 20 minutes or 2 minutes past the last milk drop” schedule. So 7AM, 11Am, 3 PM, 7 PM, 11 PM. And on the weekends when I’m home more, I switch it to an every three hour: 7AM, 10AM, 1PM, 4PM, 7PM, 10 PM, 1AM.
My Lactation Lackey (board-certified, blah, blah, blah) tells me that it’s better to pump more frequently and less long, so 3 hour pumps for 10 minutes will increase milk more than 5 hours for 30 minutes. And it’s easier on the nipples. She also said something about the prolactin levels being more impacted on feeds between 11PM and 6 AM, so pumping or nursing then does even more to increase supply than pumping other times. If I could only drag my butt out of bed at 6 am…
Have you tried Lanisoh ointment yet? 'Tis the stuff of the Gods for sore nipples. I tend not to believe product hype, but this one totally, completely and udderly (hah! nursing pun there for ya!) deserves all the accolades bestowed on it. And it works immediately - no applying for 6 applications before you see results. Smear it on and they feel better. And you don’t even have to wash it off before nursing or pumping. You also need very little of it - that 2 ounce tube will last for a year.
