I have a little hand-out I've created called the Breast-Brain connection.  Milk supply issues occur when either the breast or brain are not functioning properly OR there is a breakdown in the plumbing or wiring connections between breast and brain.  For wiring to work - there must be good connections between source and receiver.  For plumbing to work, the same thing.  In addition, the receiver has to be open to receive the signals.  If there are drugs that prevent nerve transmission, or drugs that enhance nerve transmission - if the receptacle is full or empty - these things affect the delivery of signals, milk components, hormones, etc.  When I am working with a mom I say - we are going to play detective here and look at every problem.  It seems to help moms to stop taking it personally against themselves or their babies and look objectively at the issues. Eliminate them one by one. And realize that the longer an issue the longer it takes to "fix". 

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of laurie wheeler
Sent: Wednesday, July 31, 2013 10:50 PM
Subject: low supply on domperidone?

Hi Kristi,
In my opinion her breasts need more baby time. Sounds like she might have spent the first 3 wks with quite suboptimal breast drainage, with a lack of baby bf and a lack of sufficient pumping. If baby can transfer well now, and mother wants to just bf, then have her go ahead and AD LIB ON EVERY CUE bf the baby (emphasis for mom to understand how important this is). Of course, do a wt check in a couple days. If she is pumping and still intends to do a good bit of that, then she must have an effective pump and, as you said, use it frequently, and for a sufficient amt of time like 20 or 25 minutes. And "hands on" pumping will get her more milk.
I am afraid that many people think galactagogues are the "magic bullet" and a "quick fix" (not saying you think that), but our latest knowledge on this shows that adequate and frequent breast drainage are key. These galactagogues must be used in conjunction with frequent emptying.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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