Domperidone dosage

[Natasa85]

I am the mother of a 6 month old baby boy and I have had a very rough time with breastfeeding him.
We had a difficult start due to poor latch issues that led to extended supplementation with formula. However, since he was 3 weeks old I have done everything possible to increase my supply and through a few nursing vacations we have managed to decrease his formula intake by 50% - he is drinking approx. 500 ml of formula for the last 4 months and the rest he is receiving it through nursing. He is very healthy and thriving (17 lbs at his 4 month old doctor's appointment). Unfortunately though, as he started sleeping through the night, I noticed that my milk supply started decreasing so I started using domperidone (10 mg, every 8 hours) along with pumping in the evenings. In addition we had a tongue tie release a month ago that has significantly improved his ability to remove milk.
I have been on domperidone for a week now and I have not seen a difference so far. How long could it take for me to see a significant result - if any? And would an increase in dosage result in higher milk production/output? I would very much like to breastfeed him until at least his 1st birthday, or ideally until he decides to wean.

Please excuse the long message, I wanted to provide you with as many details as possible.

Thank you for your time!

[kaytlin]

Hi Natasa,

You can usually tell after the first week. There are many factors that influence low milk supply. Unfortunately, domperidone only works if you have an issue with low prolactin. Many women have plenty of prolactin, but still have trouble producing enough milk--domperidone just doesn't work in these cases. There isn't good evidence that increasing your domperidone dose will increase milk supply either, but it WILL increase the risk of maternal adverse effects. I don't recommend it. If you haven't already, your best bet is to do a middle-of-the-night pumping session or two as he sleeps (if you can stay awake!). Consistently removing milk from the breast is the surest way to increase supply.

Best of luck,
Kaytlin Krutsch, PharmD

[Natasa85]

Hi Kaytlin,

Thanks so much for your response!
I do one milk removal during the night, either by pumping or nursing. I almost never go longer than 5 hours without removing milk and this has helped but not as much as I would hope.

Best,
Natasa