'Miracle' Breastfeeding Drug Becomes Mom's Nightmare

At first, Vienna Blum, 34, loved life as a new mom to her daughter Hannah. In fact, things were going almost too perfectly: The delivery was drama-free, her 3-year-old daughter loved being a big sister, Hannah was nursing well and gaining weight quickly — she was even sleeping through the night.

But when Hannah was a little over 2 months old, she came down with a bad cold. Her interest in eating waned, and Blum, a communications director in Montreal, Canada, felt her breast milk supply dwindling. “Hannah would eat for only very short periods, she wasn’t gulping anymore, and my breasts didn’t feel as full as they used to,” Blum tells Yahoo Parenting. She had been pumping once a day since Hannah’s birth, and her yield plummeted from four ounces per session to two.

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Even after Hannah got over her cold, she didn’t act like the healthy, happy baby she once was. “She was very lethargic — she seemed more interested in sleeping than in eating because she didn’t have the energy,” Blum says. “Her rosy, chubby cheeks turned gray and sallow. It was scary.” Although her baby didn’t lose weight, she stopped gaining, and dropped from the 50th percentile to the 30th.

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In addition, Hannah began having trouble latching, and developed severe reflux. “She spit up half her food, and would cry every time she ate,” Blum says. “She was miserable.”

After a month of worrying about her daughter’s well-being, Blum started working with a lactation consultant, who diagnosed Hannah with tongue-tie and lip-tie (the latter is when the frenulum, which attaches the upper lip to the gums, prevents the baby from sucking properly). Hannah had a medical procedure to correct her tongue-tie, but breastfeeding didn’t get any easier. Blum was pumping after every feeding and topping Hannah off with a bottle, which she seemed to have an easier time eating from. Eventually, Hannah rejected the breast altogether, and Blum began exclusively pumping, barely eking out the 25-ounce minimum recommended for babies Hannah’s age.

“It was a circus, trying to juggle caring for two kids while pumping five times a day, but I didn’t want to use formula,” she said. “I was just trying to keep my head above water.”

Right around this time, the family began preparing to take a vacation to Jamaica that they’d booked long before Hannah’s nursing issues cropped up. Blum had heard that travel can trigger a dip in milk supply, and she wanted a backup plan before leaving. A few years ago, a friend had taken a drug called Domperidone to boost her breast milk supply, so Blum asked her doctor for a prescription — just in case.

Domperidone was initially developed to ease gastrointestinal disorders, but was discovered to have the side effect of increasing milk supply. “It increases prolactin — the hormone mothers produce to stimulate their breasts to make milk — by blocking dopamine secretion from the brain,” Jack Newman, MD, author of Dr. Jack Newman’s Guide to Breastfeeding, tells Yahoo Parenting. (Although Domperidone is not approved for use in the U.S., women have been able to procure it via online Canadian pharmacies.)

Blum’s doctor wrote a prescription, explaining that the medication can take a few days to start working, so if she really wanted it to be effective, she needed to commit fast. The next day, Blum began popping the pills.

On day two, Blum was ecstatic to discover that her milk supply had doubled — she went from getting 3 to 4 ounces per pump to 6 to 9. Within two weeks, her daughter started gaining weight again. “It was a miracle drug. Hannah’s color turned pink and her cheeks plumped up,” Blum says. “She was happier, too — more lively and playful — and wasn’t sleeping all the time.”

But Blum’s experience wasn’t necessarily the norm. “There have only been small studies on the impact of Domperidone on milk production, and these have found the average increase to range anywhere between 28 to 267 percent,” Nancy Mohrbacher, international board certified lactation consultant, and co-author of Breastfeeding Made Simple, tells Yahoo Parenting. For some mothers, it doesn’t work at all.

“The results can vary drastically depending on the individual,” Newman adds. “For example, Domperidone works better the longer it has been since the birth of the baby. It also works very well in a mother who once had a good supply that decreased for one reason or another, compared to a woman who never developed a robust supply in the first place.” Basically, if the issue isn’t connected to a lack of prolactin — think hypoplasia, when you don’t have enough glandular tissue to produce adequate milk — then the medicine won’t help.

Luckily, Hannah was benefiting from the milk surge, and Blum felt much better too, having not experienced any of the drug’s side effects, which can include headache, dry mouth, abdominal discomfort, or weight gain. “I was more relaxed and confident as a mother,” she says. “I had been plagued by a constant undercurrent of stress about Hannah’s well-being. I was finally able to let go of that and just enjoy my child, which was an incredible release.”

However, in January, after Hannah turned 6 months old, Blum decided to stop breastfeeding and switch to formula. She still planned to breastfeed occasionally, but since milk would no longer be her daughter’s primary food source — Hannah was also on solids — she tossed her remaining Domperidone tablets.

But two days after she stopped taking the medication, Blum started feeling strange, both physically and mentally. “I was in a constant state of anxiety — every time I got into my car, I was terrified that I was going to have an accident,” she says. “I also thought that people were gossiping about me and judging me. If Hannah cried while we were out, I was convinced that everyone was staring at me and talking about what a terrible parent I was.”

She couldn’t pinpoint the source of her seemingly out-of-the-blue panic. “At first I attributed it to sleep deprivation, or guilt from using formula,” she says. “Then I thought maybe I was getting my period.”

Things got so bad that Blum stopped leaving the house, and made up excuses to avoid seeing friends and family. “I lost my appetite — all I ate was toast, peanut butter, and coffee,” she says. “I was shaky, exhausted, and impatient. My clothes felt like they were woven with shards of glass, and I wanted to crawl out of my skin. I was sick to my stomach all of the time, and there was a perpetual pit of dread deep inside of me.”

The littlest things seemed too overwhelming for her to cope with, and she felt that she was failing as a mother. “I remember trying to help my older daughter dress for preschool one morning, which is normally one of our favorite times of the day because we play beauty parlor,” she says. “She was trying to decide which dress she should wear, and I told her I didn’t care, that she could go in pajamas as far as I was concerned. Then I walked out of the bedroom. I just gave up.”

Another time, Blum blew up at her mother-in-law. “She was going on and on about something irrelevant — which normally I can tolerate,” Blum says. “But I told her, ‘Stop talking. I cannot handle you right now. I need silence.’ I had reached my breaking point.”

After several days, Blum told her mom how she was feeling. Her mother, who has a master’s degree in public health, asked if she’d stopped taking Domperidone, because her symptoms sounded similar to those associated with drug withdrawal. So Blum looked online and discovered that other women had also experienced withdrawal post-Domperidone — particularly if they’d quit cold turkey, rather than tapering off.

Blum hadn’t thought to consult her doctor before she stopped taking Domperidone — and neither her doctor nor pharmacist had warned her about decreasing the number of pills she took gradually. But when she told her doctor about her symptoms, she was advised to just ride it out — a scenario Newman calls all too common. “Most mothers get very poor advice from health professionals with regard to preventing and overcoming breastfeeding problems, because the majority of doctors receive virtually zero training in this area,” he says.

He adds that some mothers occasionally develop anxiety and sleeplessness after they take Domperidone for many months and then stop it suddenly or too rapidly. “Still, it’s superior to other milk supply drugs because it doesn’t enter the brain in any significant amount, and as a result is less likely to cause mood disorders,” he says, adding that Blum’s reaction is “exceedingly unusual” and can’t definitively be blamed on the drug. “We’ve seen mothers who stopped breastfeeding cold turkey, who never took Domperidone, who also had similar reactions.”

Mohrbacher says that moms who want to stop breastfeeding — whether or not they’re taking medication — should gradually wean their babies over the course of a few weeks. “Drop one feeding, wait a few days, then drop another and wait, and so on,” she says. Since women experience a release of the feel-good hormone oxytocin each time they breastfeed, this prevents a sudden crash in their happiness fix, while at the same time reducing the risk of breast-related health issues like mastitis.

Once Blum had nailed down the cause of her anxiety, she was proactive in improving things. She applied essential oils to help her relax, and everytime a wave of anxiety hit, she indulged in something comforting: a bath, magazine, phone call to a friend or a mug of warm milk with cinnamon.

It was two weeks before Blum began turning a corner, and a full month until she was back to her old self. Yet despite her experience, Blum has few regrets about taking Domperidone. “I wish I had reduced my dose gradually, but it allowed me to feed my baby from my body, which is incredible,” she says. “I would do it again in a heartbeat.”

(Photo: Vienna Blum)

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