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Labetolol and milk supply and Domperidone

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  • Labetolol and milk supply and Domperidone

    Hello colleagues,
    I have a client with high BP. She was on Labetolol and Hydrolozine (sp). She has a critically low milk supply and is pumping for twins. Her doctor took her off of the hydrolozine. How soon after going off the medication should her supply improve? What is the mechanism for the medication suppressing milk supply? She's been pumping rigorously around the clock for 3 weeks with varying results. She went off the meds yesterday and last night felt some engorgement for the first time in one breast only. The other breast doesn't feel milky at all.

    Normally I'd suggest Domperidone in this situation, but am concerned because I have no idea how that would work with a mom with an Hx of hypertension and on this medication.

    would Goat's Rue be a reasonable alternative for this mom while she's mulling over domperidone? what about fenugreek? I'm getting more and more nervous about fenugreek...
    Thanks in advance.
    Betsy Hoffmeister, IBCLC, RLC, MPA
    Last edited by Betsy; 09-27-2013, 07:08 PM.

  • #2
    Betsy:

    I've never seen any evidence that antihypertensives suppress milk supply. I suppose it's possible, but I doubt it. There are two that are routinely used in postpartum breastfeeding mothers and these are metoprolol and nifedipine. They do not seem to affect the milk supply.

    I'd suggest you do a prolactin level and see if her levels are low (<50 ng/ml). Have her pump, wait two hours and draw a blood sample. If her prolactin levels are low, domperidone or metoclopramide(short term) are indicated.

    I think fenugreek is not effective. Don't know about Goat's Rue, there's no evidence it works that I know of.


    Tom Hale Ph.D.

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    • #3
      labetalol and low milk supply

      I also have seen a few women taking labetalol and low milk supply. I have been trying to find some research as to why this is happening. Any ideas? Thanks!

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      • #4
        Dear Jenn,

        I could not find any evidence that Labetalol can suppress milk supply. Like Dr. Hale suggested above, you might want to look for other reasons that can decrease milk supply, like low prolactin level.

        Tassneem Abdel Karim MD
        InfantRisk Center

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