So whose advice do you take? The midwife who you have literally trusted with your life and the lives of your children, who is also a newly qualified lactation consultant, whose word has always been absolute gospel and who seems to see right into your heart and bring out the most vulnerable sides of yourself that you had really never known to exist before? Or perhaps the most internationally renowned lactation consultacy team on the planet, who knows very little of my story, who has never met my family or seen me breastfeeding, but who is the absolute go-to for lactation issues?
I spoke with Anja, my midwife, about my domperidone usage. She has always admitted to me that she has very little experience with it and is not the greatest source of knowledge when it comes to that area. She even guaranteed that I know infinitely more about it than she does, because I am a bit of a research junkie, and have read from such a wide variety of both reliable (ie scientific journals and government bodies) and unreliable (ie forums and blogs) sources. She says that she is excited at the prospect of me perhaps becoming a lactation consultant one day, and she can refer people to me for low-milk-supply issues and domperidone advice. That’s a cool idea…
Lacking photos for this post!
So here’s my sweetness, 14 weeks.
The thing, though, is that she spoke mainly about what an amazing start to life my little boy has had, and that I shouldn’t get so caught up in needing to continue indefinitely. He is three and a half months and could potentially start solids in two weeks (though I have always been a fan of waiting as long as necessary until they start to want to eat my food – for my big boy, that was five months and one week) and then he perhaps won’t need as much milk. She said that there is no need to continue taking this drug until he is one year old, and that he will probably always want to come to the breast for comfort, as we have that well established. She said that I need to let it go a little, and that we have already achieved so much more than any of us had ever expected, considering that I was at the point where I was not really even going to try to breastfeed again, after my last experience. She suggested that I wait one or two weeks until I feel ready, and then I slowly begin to lessen my domperidone usage.
This is the first time that I have spoken to her where I felt a little defensive. And that has really made me think. A lot. Usually, what Anja says goes. She is my guru and I trust her instincts implicitly. I do, however, feel as if I also know her very well now. I know that she is a big believer in anthroposophic medicine, and is perhaps as alternative as they come. I was originally surprised when she mentioned domperidone to me, as I would never have expected her to suggest a pharmaceutical medicine. She knows, though, that I have tried everything else.
She originally suggested that I take 60mg a day for eight days and then wean off. None of my research ever mentioned anything like this. Women take it for the duration of their breastfeeding time, for months on end. And they appear to take anywhere between 90 and 140mg. So for the past seven weeks I have been self-medicating, tentatively, taking the 60mg.
So yesterday I wrote an email to Dr Jack Newman, telling him a little about our situation, with the domperidone, the donor milk and the SNS. Did he think I should increase my dose? Or should I see how we go with solids?
His reply, though I am not permitted to copy and paste, is that of course I should increase my dosage, and that I should take it as long as I want to breastfeed. I can occasionally try to reduce one of the nine tablets and see if that affects my supply, and if it does then go back up.
So now I am met with my original dilemma, that great oxymoron: How do I feel about medicating to breastfeed? Apparently okay for the moment. So here is another situation where I am learning more about myself through all this breastfeeding business, having to decide what is important to me and why. I’ve decided to try 90mg for a while – let’s say ten days – no higher, and see what it does.