not pumping enough milk after HG? try motilium

[jennyk]

During my pregnany I missed so much work that I could only take a 3-week maternity leave. Since I felt like I starved poor Annie while she was in utero I was absolutely determined to give her the best food possible after she was out. Trouble is I wasn't able to pump enough milk, in part because I was depleted from HG and in part because pumps can't extract as much milk as babies can.

My lactation consultant got me started on a drug called Motilium. It works great--lots of milk with no bad side effects and no risk to the baby. Here is a link to info about it: http://www.breastfeedingonline.com/domperidone.shtml

The other thing the lactation consultant got me to do was EAT EAT EAT. It takes a lot of calories to make breastmilk, and after HG my body didn't have many reserves to share.

Now my little HG baby is over 4 months old and even though I have been back to work for most of that time she hasn't had anything but breastmilk. If anyone out there is interested in trying Motilium I'd be glad to share the details of my experience with it.

Jenny

[***]

I was relieved to read that it wasn't just me that had trouble BFing after HG. So many people told me that I must not really want to BF because if I did I'd make enough milk. Finally when my daughter was 6 weeks old I got in touch with the lactation consultant at our hospital and she got me started on relactating ( I had stopped BFing because Cecilya wasn't gaining weight and her pedi told me to give her a bottle)That was tough but after another six weeks she was on breastmilk only and thriving.
Did you have to go to a special pharmacy or can any pharmacy get Motilium? How long did it take to work? How long did you have to keep taking it?
Sorry about the 20 question routine. My dh and I are going to ttc in August (that will be 3 1/2 months of HG preperations) and I really don't want to have to stop BFing again)
Thanks
Erika

[JennyK]

Hi Erika.

Motilium is not available in the US for reasons explained on that web site. The only place to get it in the US is from a compounding pharmacy. I ordered mine from a pharmacy in New Zealand listed on the web site, no Rx needed. It arrived in less than two weeks and the pills are bubble sealed. I have two friends who did the same thing with similar success.

I followed the instructions on the web site, which meant I started out taking 20 mg 4x a day. It started working within a few days. I have gradually weaned myself down to just 10 mg 1x a day with no decrease in supply. Hopefully soon I will be able to quit taking it all together.

What did you use for relactation? The lactation consultant had me take leftover Reglan before we tried Motilium. Reglan didn't cause too many side effects for me during pregnancy (didn't help much either), but it wigged me out when I was using it to get more milk! I did get more milk but quit after a couple of days because of the side effects. Motilium is much better because the possible side effects are not that bad and they are rare anyway. I have none and my two friends don't have any either. Plus, you can take Motilium long-term.

Neither my OB nor the pediatrician had even heard of Motilium. The ped checked into it, though, and has no worries about its safety.

Good luck ttc! Maybe you will luck out and not get HG this time. Last night I had a dream that I made it to 14 weeks without throwing up. I guess HG is still on my mind!!

Jenny

[***]

That must have been a great dream. Maybe I'll have a similar dream and it will come true!!!!
I've written down the website so if I need to I can check it out.
I used a Medela pump-in-style pump and started reglan (stopped for the same reason as you) I pumped every hour for 20 mins (10 each side) and was fortunate that was all it took. I used an SNS while nursing Cecilya. I'm lucky that I can be a stay at home mom and believe me we STAYED at home alot those first few months. Ceci was a premee and it was the middle of winter (she was born on Valentine's Day 2003) and I had some recovering to do.
She weaned herself at 11 1/2 months but I swear sometimes she still tries to nurse, especially if we've had a hectic day. Who was it that said BF babies forget what nursing is once they've been weaned? Mine didn't.
Good luck with everything and thanks for the help
Erika

[PamelaRose]

JENNY!!!!!!!

Hi, how is my pretty Annie doing? I have been meaning to get ahold of you one of these nights--give that little sweetie a hug from Auntie Pamela.

[Kimber]

I over-produced my first time and under-produced my second. I was amazed at how much homeopathics helped. I added a link on the Preg & Parenting pages with info on b'feeding and homeopathics. I was horribly engorged (I had 2 huge rock piles) and it dissapated less than 24 hours after taking homeopathics. I also used a product called Lactation Flow which is available via health professionals (your lactation consultant or a nurse, etc.) which is a combination homepathic liquid compounded by Professional & Complementary Formulas http://www.professionalformulas.com here in Portland OR (they ship nationwide). I used the flow increase and found it increased my supply within 12-24 hours. I used it when I knew I had to pump or was getting behind. No side-effects or adverse effects on baby. A few friends have used it successfully as well. I wish more lactation consultants would give it a try. I am so thankful for it - saved me a lot of pain!

Kimber

[cthmschler]

Who was it that said BF babies forget what nursing is once they've been weaned? Mine didn't.
I'm just praying my youngest "forgets" before the new one comes (I'm due 8-5-04) Quentin turned three a few weeks ago, and he's been weaned for at least 8 months, but listen to this: He found the Boppy in the laundry room closet a month or so ago, and started using it constantly in the living room (sitting in, lying on, ect) and calling it "MY lillow!" A week or so after this, he dragged it up on the couch when I was about to read to him and put it around my waist before climbing on my lap His dad was laughing at him and I jokingly asked "What, do you think you're going to nurse?" (Not thinking that he'd even equate the term "nurse" with BFing, as he would usually ask for milk when he wanted to BF, before he was weaned) and he yelled "YES! YES! I want milk!" So I said "Okay, I'll have Dad get you a cup of milk and you can drink it while I read to you." and he poked my breast and said "NO! I want this kind milk!" Needless to say, helpful Dad was just about ROFLOL by this point, and we did manage to distract Quentin who, thank the Lord, hasn't asked again
Also needless to say, we're now planning on buying a new Boppy for the new baby but I certainly hope that Q "forgets" a whole lot more in the next 9 weeks!

[***]

I hope Cecilya forgets or isn't reminded what Bfing is when/if we have another one. That's part of my fear is that I'll be BFing a baby and have a toddler who wants to nurse too. It's bittersweet that she weaned herself. I was prepared to nurse her into toddlerhood. Now that she is weaned but wants to nurse again it kind of makes me sad. My friends oldest had been weaned for 16 months when his little sister arrived and he asked to nurse, she let him...thinking he would think it was too watery and too much work. Nope she ended up nursing a new born and a 3 3/4 year old.
Good luck
HUGS
Erika

[Laurie]

I was still bf #1 when I found out I was pg again. I was scared about being so sick again and the possibility of a forced fast weaning but I found that when I was actively nursing, I actually felt relief from the nausea. I was able to control the vomiting with B6 & Unisom but the nausea was almost unbearable. Nursing was the only relief I had from it.

[JennyK]

I should add that the FDA just issued a warning not to use Motilium (domperidone) for breastfeeding. Dr. Tom Hale, who is a leading expert on breastfeeding, says the FDA's warning is full of BS and he is ignoring it. Here are links to both:

FDA warning: http://www.fda.gov/bbs/topics/ANSWERS/2 ... 01292.html

Dr. Hale's response: http://neonatal.ama.ttuhsc.edu/lact/htm ... idone.html

[carriedodson]

Hey gals,

I wanted to recommend FenuGreek for new breastfeeding moms who are trying to establish their milk supply. These are available in the US through lactation consultants/ health food stores. I took them for the first four weeks and it was a huge help. I also pumped after every feeding the first week or two on both sides to encourage good milk supply. My advice to new BF moms-- don't give up. See a lactation specialist-in the first days of newborns life. They can get your baby to latch on when everyone is telling you to give your "hungry" baby a bottle. Good luck!
Carrie

[jjbeck]

Hi Jenni. Thanks for the article from the FDA. I had thought of getting domperidone, but now I am glad I didnt. I guess I was never comfortable with ordering a script from another country...to many risks IMO. But the thing about the arythmias...I dont think is something to dismiss, I have had issues w/ cardiac problems, so maybe ladies might want to be sure they do not have any cardiac problems before getting this med.

Some of the things that have helped me are fenugreek, Homeopathic rem that Kimber mentioned and COFFEE.

[JennyK]

Hey, Jen.

Actually, I still take motilium and have no problem with it. I have researched it extensively, as have my lactation consultant, OB, and pediatrician. Based on everything I have learned, I have concluded that the FDA's warning is completely unfounded and they are looking out for pharmaceutical companies rather than my health or my daughter's health. My OB, ped, and LC all support my continuing to take motilium and have no worries about its safety. I just wanted to put all the information out there so each woman can make an informed decision for herself.

Jenny

[jjbeck]

Well, I have not read too much about domperidone but do know that it is used to treat gastroparesis ( which I have ) as well it has been used to treat horses for years. While I am sure there is a good chance it is safe, I would not want to take the chance being that I have already had issues with rhythem disorders...not something a person wants to mess around with imo. I came close to needing a pace maker...at 29 it was very scary for me. I know the FDA sometimes is too careful as well, sometimes not careful enough, for me, I do not usually like to try a drug unless it has been FDA approved for several years. Although sometimes I try to weigh the benefits vs risks
I know a BF consultant would probably tell me too that it is safe, but they also told me that when the head pedi told me not to breast feed my baby until her sugar levels were stable...she needed to be on IV dextrose and when she went off IVs needed to be on a hi cal formula if I wanted to take her home. ANyway, the breast feeding consultant was fuming and told me he did not know what he was talking about and that I should just ignore his advise. In my opinion, this was very reckless and unprofessional of her as low blood sugar in infants can result in seizures and death. Of course I was not willing to take the chance and did not appreciate that woman making me feel guilty for trying to do what was in my baby girls best interest health wise. You know what I mean?

Anyway, the flow is is still not where I would like it to be. But I have certainly been trying sooooo hard. I would love for her to be just on breast milk and no formula, but it has not worked out that way so far. you would not believe how much feeding entails in this home for this baby. I breastfeed her....she wants more when my milk has stopped...I give her formula....when I pump and pump and pump. I have use fenugreek, homeopathic drops ( which works pretty good). I have done pushed and pushed fluids...I have been retaining and swelling not fun. I have had s many problems with BFing to. I have had yeast infection in both breasts...still do a bit( have used gentian viloet, acidophilus acoided sugar and a couple of doses of diflucan, possible mastitis, though was not treated, have had and still do cracked nipples bleeding nipples aweful shooting pains daily and vasospasms of nipples. I have done everything I can think of. Looked for info on the LLL site as well as Kelly mom...talked to my doc who breastfed and knows much about LLL, have even had OMT...nothing helps. Not latch on problems as it all occurs with pumping too. Often I have to take a break from nursing as it is so painful ( the toungue feel like very abrasive sandpaper on my already sensitive nipples...I still pump though.
UGH!!!
Any other thoughts you have on this? ANything I may not have tried?

Thanks
JEn

[JennyK]

Wow, Jen, it sounds like you've really struggled with this. I am assuming you use lanolin for the soreness. It sounds really painful. Lucky for me I haven't had those problems so I don't know what else you can try.

I do know that oatmeal helps some people with supply. So does Mother's Milk tea. Before I started domperidone I tried taking my leftover Reglan from pregnancy. I couldn't deal with the side effects, but I did get a huge increase in my supply. It's strange that the side effects were not so severe when I was pregnant.

By the way, domperidone is approved for use while BF by the American Academy of Pediatrics, but Reglan is not. Also, domperidone has the "safest" designation for use in BF, called L1, which is more or less the equivalent to a Category A drug during pregnancy. I think Reglan is L3 but I'd have to look it up. Given your history I don't blame you for being extra cautious about domperidone.

KellyMom is the best BF resource I've found, so if you've checked there you probably know the same "tricks" I do. How old is your baby?

[JennyK]

Jen, one more thing I forgot to say. Do you eat enough? I eat a TON of food. I gorge all day. In order to pump enough at work I need to maintain an oversupply. My LC told me I had a choice between formula or eating a lot, so I chose to make up for all the eating I didn't do when I was pregnant. The LC was right. I can pump way more if I ate a lot the previous day. My husband is 6'3 and has a metabolism so fast that he eats like a teenager. I easily out-eat him and I'm still not gaining any weight because all those extra calories are making milk!

Jenny

[jjbeck]

Yeah, for the first couple of months i really ate and ate and ate as well as drnk alot. It did not seem to help but I did retain a whole lot of fat and fluid .
Things are slowly improving. I have stopped trying to eat and drink so much. I think the homeopathic drops and fenugreek are helping. As well, I stopped taking all of those other supps and vits. I think they may have been making things worse.
Thanks for your input