I have a feeling that this poor mom has tried everything under the sun with
previous babies, considering this is her third baby and already has
Domperidone on hand. You mentioned that she breastfed her other two
children (with struggle and supplementation), I wonder what that history
truly looks like. I think your gut is right, Domperidone shouldn't be used
as a first approach and it is not a cure all (although it can work
wonders). I think that all of the other factors that could affect milk
supply should be addressed first (position and latch, skin to skin, breast
compression, and possibly milk expression after feedings). I have noticed
that moms who have breastfed before forget what it is like to breastfeed a
newborn and try to use a cradle position, when they should really use a
cross cradle position (and can switch into a cradle once latched
properly).
I can't find any information about your specific questions. I can't imagine
that it would be problem to start using it, since people take it to induce
lactation. But to protect her and yourself, she would need to ask her MD.
If she has primary lactation failure, due to insufficient glandular tissue,
would it even work? And how would that effect hypoplasia? Sadly, I don't
know if there are answers to these questions because of the FDA ban, I
doubt there have been studies done :(
If she were my patient/client, I would give her a big hug and explain what
you see happening in her history and present situation. There are so many
benefits of breastfeeding, even if she has to supplement, she can use an
SNS. That may relieve some anxiety on her part, create the bond she wants
with her baby, and feed her baby the milk she does have while supplementing
at the same time. I doubt this mom will have the time or strength to pump
with three kids at home, so an SNS may be her best bet while waiting to see
if she does actually produce enough milk:)
You may want to reach out to Dr. Jack Newman. I know he takes questions
through email, possibly phone calls also to ask more questions about Dom.
Best of Luck!
Shaland Verdi, IBCLC
On Wed, May 30, 2018 at 10:52 AM, Adria Bell, BS, IBCLC <[log in to unmask]>
wrote:
> I don't think I would feel comfortable recommending the use of domperidone
> considering it's banned by the FDA in the U.S. Maybe she can try some
> herbal galactogogues and supplement in the meantime if her supply is not
> adequate.
>
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