Labitolol and supply issues

[Macha8]

I’m wondering if anyone can help me out here. In december i gave birth to my third baby. With my other two children, I had chronic low supply problems (both lost weight and advised to give formula) probably due to IGT (mammogram showed little breast tissue after baby 2).

However, after having baby 3, my milk came in and baby was gaining very well and very satisfied. Breasts filled in between feeds for the first time. After a couple of weeks, I was diagnosed with postpartum hypertension and put on Labitolol. My supply tanked, then recovered after a few days. Every time they put my dose up, the same thing happened. Then after the last increase, my supply never recovered and went back to its old tricks. I have consulted lactation experts, but no one has an explaination for why this happened.

I had a period where I didn’t take it, then a period on nifidopene, but still my supply didn’t recover.

Any ideas?

[admin]

Macha8:

I don't have any idea why this antihypertensive would suppress your milk supply. It might be interesting to check your prolactin levels (1 hr after feeding), to see if they are low (<50 ng/mL). A short treatment of metoclopramide (10 mg TID) or Domperidone (20 mg TID) would increase these and bring your milk back IF your prolactin levels are reduced by Labetalol.

Tom Hale Ph.d.

[Macha8]

Thank you for your reply. It means a lot to me. I have been taking domperidone 8x10mg/day as well as methyldopa 3x250mg/day so hard to test prolactin levels. But I do know that if I skip doses, my supply decreases a lot. Considering increasing domperidone dose as per Jack Newman guidelines.

[admin]

Macha8:

I would strongly urge you NOT to exceed 60 mg/day. Doing so may increase your risk of arrhythmias, and there are no data that it increases prolactin above the 60 mg/day dose.

Tom Hale Ph.d.