Good time of day to take meds to increase supply?

Breastfeeding does not always work out, this is a place to discuss your situation and feelings

Good time of day to take meds to increase supply?

Postby katrinajazz » Thu Feb 21, 2013 5:35 pm

Hi there,
This is my first post, my bfeeding story is quite long and complicated so I will try to be extremely brief. I have insufficient glandular tissue (IGT) and had great difficulty feeding my first child. I kept going until he turned 1 but doing so took over a great deal of my life! I've continued to have low milk supply with my 2nd bub (and can't EBF) but feeding is much better this time around javascript:emoticon(':)'). I'm not sure if this is more because he's my second or because my gp is letting me take double the dose of meds I took last time....I've always felt I've had very different levels of supply at different times of the day, struggling to keep up early in the morning, going ok during the day and doing well in the evening and late at night. I'm wondering if this caused by my body / when bub feeds most / when we give comp feeds or by me taking the medication in the day only. I'm wondering if anyone has any information please about whether there are better times to take the tablets to increase supply? Many thanks, Katrina. :)
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Postby mooki » Thu Feb 21, 2013 6:28 pm

Hi and welcome.

There are a couple of other IGT mums here too, you've come to the right place for support. :D
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Postby Lilypad » Thu Feb 21, 2013 8:58 pm

Oh my, you sound like you could be me! Except my 2nd bubs is only 3 weeks old!

Sorry I don't know about the time of day to take meds, I'm on three times a day, with a meal. But I do notice that my supply is hugely variable. Usually the afternoons are lowest, but then yesterday I was able to pump my largest (tiny, but bigger than the others!) quantity in the mid afternoon. I don't understand it at all.
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Postby Gwen's Mum » Thu Feb 21, 2013 10:10 pm

On my phone and on holidays, so a quick response for now. :)

I have IGT and took meds (as well as supplements) for about 12 months. I was taking a fairly hefty dose, over the course of 3 times per day - so every 8 hours (when I woke, mud-afternoon, and just before bed). In that sense I was following the protocol suggested by Dr Jack Newman (google his bfing page for more info).

You're spot on in identifying that supply is variable across the day - both the amount and composition of feeds changes over the course of 24 hours, and often feeds later in the day can be smaller, more frequent, but also consist of fattier hindmilk than at other times. I found DD always cluster-fed then, but also settled and slept for a longerstretch afterwards.

There's an IGT thread off one of the main sections here, too - will pop back and link. It would be great if you could share your story! :)

Edited for appalling phone typos... :oops:
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Postby marie7 » Fri Feb 22, 2013 6:58 pm

Just curious how do you know when you have insufficient glandular tissue? Do you get tested for it? Ta
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Thanks for input re meds for supply :)

Postby katrinajazz » Sat Feb 23, 2013 7:17 pm

Thank you so much for your responses. I've been waiting for ages to be able to join the forum and am so excited to have you input. Please let me apologise first if this msg sounds at all abrupt I am simply short on time and trying to summarise.

Thank you Gwen's Mum for letting me know you took the meds every 8 hours. I take 3 x 2 tablets but tend just to take them in the day time, generally after a feed. I've always wondered why I feel so low in the morning when everyone else with low supply seems to report nights as tricky. I'll give eight hourly a try and see if there is any difference.

Lily pad I think maintaining breast feeding at all with low supply is a huge effort, I'm sure you're doing an incredible job :)

Marie7 I believe I have IGT because I:

- Am unable to sustain a bub with EBF, my first bub fell off the bottom of the growth chart as a 4 mo. I'd tried compressions, expressing, supplements meds and frequent feeds.

- IGT Mums' stories sounded spot on for my situation.

-Most health professionals thought I wasn't trying hard enough or were baffled as to what advice to give.

- My breasts changed little during adolescence or preg and are kind of missing the section in the middle although there are different kinds of breast differences with IGT.

- A LC told me I have IGT after a breast exam.
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Thanks for input re meds for supply :)

Postby katrinajazz » Sat Feb 23, 2013 7:17 pm

Thank you so much for your responses. I've been waiting for ages to be able to join the forum and am so excited to have you input. Please let me apologise first if this msg sounds at all abrupt I am simply short on time and trying to summarise.

Thank you Gwen's Mum for letting me know you took the meds every 8 hours. I take 3 x 2 tablets but tend just to take them in the day time, generally after a feed. I've always wondered why I feel so low in the morning when everyone else with low supply seems to report nights as tricky. I'll give eight hourly a try and see if there is any difference.

Lily pad I think maintaining breast feeding at all with low supply is a huge effort, I'm sure you're doing an incredible job :)

Marie7 I believe I have IGT because I:

- Am unable to sustain a bub with EBF, my first bub fell off the bottom of the growth chart as a 4 mo. I'd tried compressions, expressing, supplements meds and frequent feeds.

- IGT Mums' stories sounded spot on for my situation.

-Most health professionals thought I wasn't trying hard enough or were baffled as to what advice to give.

- My breasts changed little during adolescence or preg and are kind of missing the section in the middle although there are different kinds of breast differences with IGT.

- A LC told me I have IGT after a breast exam.
DS1 2.5yrs
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Postby Karleen » Sat Feb 23, 2013 8:29 pm

Sounds like you're doing really well Katrina. Good on you!
I don't know that there is much difference with what time of day you take domperidonnne (that's the one you're on I guess). I would suggest that it would be worth calling Rodney Whyte at Monash Medical Centre to ask about it. He'll be able to tell you if there has been any research on this (my guess is not).
If it is Domperidoone that you're taking it might be helpful to read the info sheet from the Royal Womens in http://www.thewomens.org.au/medication to increase supply ... milksupply
Some women take a higher dose than 60mg/day...

Lilypad with the variation you found in pumping it may be that that's not so much about how much milk you have in your breasts but related to your let down. Maybe next time you need to pump have a big cuddle with your bub just before or while you are doing it and see if that makes a difference. It's the hormone oxytocin that releases the milk from breasts and a loving cuddle can get it flowing!! If you try it, please let us know how you go.
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Postby Nedsmum » Sat Feb 23, 2013 8:57 pm

Quote:
- A LC told me I have IGT after a breast exam.

From what I understand, this is quite obvious - the shape of the breast is 'cone' shaped rather than 'bell' shaped...

I think the technical term is 'breast hypoplasia'.

If found one LLL link with lots of information here:
http://www.llli.org/llleaderweb/lv/lviss2-3-2009p4.html

I found a good quote on that link:
"What are the visual markers of hypoplastic breasts? In a study of 34 mothers by Kathleen Huggins, et al. (2000), the researchers found a correlation between the following physical characteristics and lower milk output:

widely spaced breasts (breasts are more than 1.5 inches apart)
breast asymmetry (one breast is significantly larger than the other)
presence of stretch marks on the breasts, in absence of breast growth, either during puberty or in pregnancy
tubular breast shape ("empty sac" appearance)

Additional characteristics that may indicate hypoplasia are:

disproportionately large or bulbous areolae
absence of breast changes in pregnancy, postpartum, or both

Hypoplastic breasts may be small or large. It is breast shape, placement, and asymmetry that indicate hypoplasia -- not necessarily size. Normal-sized breasts that are lacking glandular tissue may be made up of fatty tissue that will sufficiently fill a bra cup.

Most of the existing medically documented literature on hypoplasia can be gleaned from the plastic surgery field, since women with hypoplasia, concerned with the appearance of their breasts, may seek surgical augmentation (implants) of their breasts. If these women go on to have babies and attempt to breastfeed them, we may mistakenly assume that the presence of breast implants has caused milk production issues, when in reality the cause is the absence of glandular tissue that preceded the augmentation surgery. If a mother presents with milk production issues and has had breast augmentation surgery, it may be helpful to inquire about the shape of her breasts before she received her implants. She may offer to share "before" photos, which can also provide some insight. An excellent resource for mothers who have breast implants can be found here: http://www.bfar.org/possible-augmentation.php.
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Postby Feather » Sat Feb 23, 2013 10:06 pm

Sorry I'm late to see this post! Welcome to the forum :D

I have IGT as well, diagnosed with my first. I never ended up being able to get enough domperidonnne prescribed so didn't stick with it. I used a few different herbal supplements instead.

It's great that breastfeeding is going better this time around for you. Please hang out here and keep us updated with how you're going if you wish to.
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Postby katrinajazz » Wed Feb 27, 2013 6:48 pm

Hi again,
Nedsmum, if you're facing feeding issues I hope you're able to find answers to your questions :) Thank you for the welcome Feather, congratulations on all your hard work feeding with a supply line. I have tried and given up on that several times, it requires fast fingers and a patient Mum and Bub! I will hang out and hope to talk with you further in future :) Katrina.
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Postby Esther » Wed Feb 27, 2013 8:18 pm

www.lowmilk.supply.org is a great site and I know talks about IGT as well. The book is fabulous and very readable - important if your brain is in baby mode!

Good luck :)
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