Prescription Galactagogues
Prescription Medications May Increase a Mother's Milk Supply
Domperidone (motillium) and Reglan (metoclopramide) have the side effect of boosting milk supplies of lactating mothers.
While most breastfeeding mothers are able to produce enough milk to nourish their growing babies, there is a small percentage that will struggle with a low milk supply. If the obvious culprits have been addressed, such as latch problems, strictly scheduled feedings, formula supplements, artificial nipples and tongue tie, and the mother is still experiencing a low milk supply, galactagogues may be recommended.
What is a Galactagogue?
A galactagogue is an agent that increases milk production. Many herbal galactagogues are available, but when these are not enough to bring a woman up to a full supply, a physician can prescribe something stronger. There are no medications specifically designed to increase milk supply, but Domperidone (motillium) and Reglan (metacloprimide) are known to produce this very side effect.
Domperidone (Motillium) and Its Effect on Milk Supply
Domperidone (motillium) is used for gastrointestinal disorders, is generally considered safe for nursing mothers, and is even prescribed to infants for reflux. It probably works by increasing levels of the hormone prolactin, which stimulates milk production in the early weeks of breastfeeding. While the normal dosage is 30 mg per day, a much larger dose must be taken in order to create the desired effect of boosting milk production—between 90-120 mg per day. Some professionals will even prescribe a maximum dose of 160 mg per day.
Many women find the resulting boost in milk production to be extraordinary, although it can take up to six weeks to receive the full effect. The side effects of domperidone can include headaches, abdominal cramps, dry mouth, and cessation of menstruation. Anecdotally, women also report experiencing mild joint stiffness. Domperidone is not FDA-approved and therefore not available in the United States, but it can be obtained in many other countries, such as Canada, or through an overseas pharmacy.
Reglan (Metocloprimide) As An Option to Increase Milk Production
Reglan (metocloprimide), like Domperidone, is designed to treat the digestive tract and works in a similar way. However, this medication is known to cross the blood-brain barrier, resulting in disturbing side effects such as depression and involuntary body movements. Post partum women taking the drug long term may be more susceptible than other patients. Reglan is available in the United States, but its mental side effects make it a less palatable choice for increasing milk production.
Of course, you should always do your own research before taking any prescription medication, especially while nursing. When speaking with your doctor, it may be helpful to bring your research with you. Many medical professionals do not know about the use of medications for increasing milk production. Dr. Jack Newman, a noted breastfeeding expert in Canada, makes two handouts on Domperidone available on his website.
Keep in mind that your low milk supply may only be temporary, and you may only have to take the medication for a short while. If you are nursing under different circumstances, such as after breast reduction surgery or if you are nursing an adopted baby, you may need to continue taking the medication long term to maintain your higher volume.
Please note: neither the author nor Suite 101 authorizes the use of any prescription drug. A doctor's advice should be sought and followed in all cases.
