Breast milk remains the optimal form of enteral nutrition for the term and preterm infants until up to six months postnatal age. The World Health Organization recommends exclusive breastfeeding for the first 6 months of your baby’s life and for breastfeeding to continue, with the addition of other foods, until 2 years or older. You can keep on breastfeeding for as long as you and your child wish. One of the most common reasons mothers give for weaning is that they feel they don’t have enough milk for their baby. Here are some drugs to help you work out if your supply really is low.
Poor milk supply can result from:
- Less than perfect positioning and attachment of the baby at the breast resulting in incomplete breast drainage
- Infrequent, restricted, limited feeds
- Reduction in milk supply is frequently noted after premature delivery with milk supply maintained only by expression over a period of weeks
Galactagogues are foods, herbs or medications that may help to increase breast milk supply. The use of a galactagogue requires consultation with a lactation consultant and/or medical. Use of these medicines as galactagogues is outside of the license application and prescribers are required to take ultimate responsibility for their use. Prolactin is a woman’s main breast milk-producing hormone. Most medications that act as galactagogues work by increasing prolactin levels. This is usually concluded after numerous options have been exhausted, such as lip and tongue tie revisions, various breastfeeding positions, and other potentially beneficial methods that could aid in breastfeeding success. Other instances in which lactation medications may be used include cases of adoption and LGBTQ families. These individuals may seek out breastfeeding drugs to induce lactation without pregnancy.
5 Must Know Prescription Drugs to Increase Breast Milk Supply
Examples of Galactagogues:
This drug is used as an anti-nauseant. Clinical studies have shown that it increases prolactin levels and consequentially milk supply at a dose of 10milligrammes three times daily. However, it can produce side effects including tremor and slow, shuffling movements as well as precipitating depression. Additionally, Metoclopramide should not be taken by anyone with a history of seizures, bleeding ulcers, Parkinson’s, high blood pressure, asthma, and liver or kidney failure. Metoclopramide has been noted to cause adverse reactions to people with these specific health concerns.
Domperidone is a prescription drug used for decades for gastrointestinal disorders. There have been a couple of quality scientific studies done which show that domperidone appears to be an effective galactagogue too.These studies suggest that domperidone has few side effects. However, there have been recommendations that domperidone not is used in women with a history of cardiac problems. Domperidone (like metoclopramide, a D2 receptor antagonist) is not approved for enhanced lactation in the USA.
Oxytocin, sold under the brand name Pitocin among others, is a medication made from the peptide oxytocin. Oxytocin is sometimes prescribed for mothers to stimulate breast milk production to help with feeding their baby. However, women receiving intranasal oxytocin per day before breastfeeding produced only slightly more milk after two days.
It is commonly used in various countries including Zimbabwe, South Africa and Chile. The primary use for sulpiride is for schizophrenia (it is an antipsychotic and antidepressant), but it also increases serum prolactin levels and thus can enhance breast milk yield. Sulpiride should not be used during pregnancy, especially during the last trimester. Application during the last trimester can cause following symptoms in newborns:
- Muscle weakness and muscle cramps
- Difficulty breathing
- Feeding problems
It is excreted in breast milk and breastfeeding should be avoided while taking Sulpiride.
Risperidone, or brand name Risperdal, is an antipsychotic medication that is occasionally prescribed for lactation problems. The studies performed on infants whose mothers took Risperidone have shown no adverse developmental or physical reactions, despite small traces of the medication excreting into the breast milk. The side effects of Risperidone are quite vast, making it a lactation medication that should only be prescribed if necessary. Some of the side effects include tremors, uncontrolled movements, spasms, fatigue, insomnia, sun sensitivity, anxiety, agitation, and headache.
The use of other medications is still in the experimental stage. Prescribed galactogogues are available to help improve milk supply but need to be used with caution, and only on the recommendation of a health care provider who will monitor the reactions of both mother and baby. Before consideration is given to medication, all other efforts should be made to identify and resolve modifiable causes of low milk supply.
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