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Motilium = Increase Breastmilk??

  1. #1
    blingdiva is offline Registered User
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    Motilium = Increase Breastmilk??

    I've recently heard that motilium can increase the milk flow but you have to pop about 4 pills each time, has anyone use motilium before and what are your thoughts??

  2. #2
    LLL_Sarah is offline Registered User
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    Motilium is a trade name for the drug Domperidone and is widely used to increase the milk supply, especially outside of the USA.

    This is what Dr Thomas Hale writes about the drug in his book Medications and Mothers' Milk 2008.

    DOMPERIDONE

    Other Trades: Motilium, Motilidone
    Uses: Gastrokinetic agent, galactagogue
    AAP: Maternal Medication Usually Compatible with Breastfeeding

    Domperidone (Motilium) is a peripheral dopamine antagonist (similar to Reglan) generally used for controlling nausea and vomiting, dyspepsia, and gastric reflux. It blocks peripheral dopamine receptors in the GI wall and in the CRTZ (nausea center) in the brain stem and is currently used in Canada as an antiemetic. Unlike metoclopramide (Reglan), it does not enter the brain compartment and it has few CNS effects such as depression.

    It is also known to produce significant increases in prolactin levels and has proven useful as a galactagogue. Serum prolactin levels have been found to increase from 8.1 ng/lmL to 124.1 ng/mL in non-lactating women after one 20 mg dose. Concentrations of domperidone reported in milk vary according to dose. But following a dose of 10 mg three times daily, the average concentration in milk was only 2.6 ug/L.

    In a study by da Silva, 16mothers with premature infants and low milk production (mean= 112.8 mL/d in domperidone group; 48.2 mL/d in placebo group) were randomly chosen to receive placebo (n=9) or domperidone (l0mg TID) (n = 7) for 7 days. Milk volume increased from 112.8 to 162.2mL/d in the domperidone group and 48.2 to 56.1 mL/d in the placebo group. Prolactin levels increased from 12.9 to 119.3 ug/L in the domperidone group and 15.6 to 18.1 ug/Lin the placebo group. On day 5, the mean domperidone concentration was 6.6 ng/mL in plasma and 1.2 ug/Lin breast milk of the treated group (n=6). No adverse effects were reported in infants or mothers.

    The usual oral dose for controlling GI distress is 10-20mg three to four times daily although for nausea and vomiting the dose can be higher (up to 40 mg). The galactagogue dose is suggested to be 10-20 mg orally 3-4 times daily. The prior studies clearly suggest that doses of 10-20 mg three to four times daily elevate prolactin levels to levels more than adequate to produce milk. Doses higher than this should be avoided in breastfeeding mothers.

    Recently the US FDA issued a warning on this product stating that it could induce arrhythmias in patients. These claims were derived from data many years old where domperidone was used intravenously as an antiemetic during cancer chemotherapy (20 mg stat followed by 10 mg/kg/24 h) Many of these patients were undergoing extensive chemotherapy and were extremely ill, and hypokalemic to begin with. Further, intravenous domperidone produces plasma levels many times higher than oral use. Thus far, we do not have any recently published data suggesting that domperidone used orally in breastfeeding mothers is arrhythmogenic.

    Pregnancy Risk Category: C

    Lactation Risk Category: Ll = SAFEST

    Adult Concerns: Dry mouth, skin rash, itching, headache, thirst, abdominal cramps, diarrhea, drowsiness. Seizures have occurred rarely. Could induce arrhythmias in hypokalemic patients, or patients subject to arrhythmias.

    Pediatric Concerns: None reported. Considered the ideal galactagogue.

    Drug Interactions: Cimetidine, famotidine, nizatidine, ranitidine (H-2 blockers) reduce absorption of domperidone. Prior use of bicarbonate reduces absorption of domperidone.

    Theoretic Infant Dose: 0.18 ug/kg/day

    Relative Infant Dose: 0.04%

    Adult Dose: 10-20 mg 3-4 times daily

    Alternatives: Metoclopramide

    (Bold is mine!)

    Best wishes,
    SARAH
    Last edited by LLL_Sarah; 07-29-2009 at 05:33 PM.
    La Leche League Leader
    www.lllhk.org

  3. #3
    Kimmy2009 is offline Registered User
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    I am currently on motilium. It does increase my milk production. I have headache on the 2 day only but seems ok now. I wonder will my milk production continue to increase after I stop the pill? Doc given me pill for 5 days only.

  4. #4
    LLL_Sarah is offline Registered User
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    Dear Kimmy,

    It is difficult to tell exactly how your body will react to the drug. Some mothers find that one dose is all they need to increase their milk and the normal suckling of the baby will maintain their supply. Other mothers find they need more doses.

    Have you also tried Switch Nursing?

    Switch nursing is changing to the other side when the baby no longer seems interested. Usually when we start feeding the baby is very interested to suck, as the baby slows down we start the breast compression and when the baby slows down with the breast compression we change and get the baby to have the other side. On the other side after the baby starts to slow down we again use the breast compression and when he slows down again swap back to the first side again. We can continue swapping sides as much as we like and for as long as the baby is willing to continue to suck. It is fine to swap sides 8, 9 or 10 times in one feed.

    Best wishes,
    SARAH
    La Leche League Leader
    www.lllhk.org

  5. #5
    Workingmom1975 is offline Registered User
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    Could someone tell me where to go to get Motilium/Domperidone? Can I get it in a regular drugstore or do I have to go to a doctor? Thanks in advance!

  6. #6
    blingdiva is offline Registered User
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    I got mine at Mannings pharmacy in IFC. Around $300 for a box.

  7. #7
    Workingmom1975 is offline Registered User
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    Thanks a lot!

  8. #8
    Workingmom1975 is offline Registered User
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    One follow-up question - the instruction of Motilium specifically says that breast-feeding is not recommended for mothers who are taking Motilium. Just wonder if it's 100% ok for me to take it to increase my milk supply? Thanks in advance!

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