Creator: Dr. Sudhakar Palanisamy
Published: 2020-09-13T00:30:04-04:00

Patient's Query

Hi doctor,

We have an 11 weeks old daughter whose weight is 6.7 kg and height of 63 cm. She was born full-term. She was breastfed from day one. Over her first eight weeks, she started rejecting direct breastfeeding. For the last two weeks, my wife has been only pumping, and we give her a bottle feed. Our concern is, we have tried several formula almost five different ones ranging from non-dairy versions to normal ones. After taking the formula feed, our daughter has vomited almost everything, which is unusual for her while breastfeeding.

Some days like today, she vomited nearly 140 ml, which is more than her feed. My wife's breast milk supply is drastically slowing down, and the daughter's milk requirement is increasing. In this case, what should we do? We would request a video call with you as we live in a place where we do not have reliable child health doctors.

Answered by Dr. Sudhakar Palanisamy

Hi,

Welcome to icliniq.com.

I can understand your concern. It is a common complaint, but it is so frustrating for parents. First, we will try to improve breast milk output.

1. Baby sucking from the breast is the best stimulus, but few reasons when the baby does not suck, like flat or inverted nipple, and rarely, the baby can have tongue problems.

2. If you cannot make the baby suck, you can try expressing breast milk through a pump every two to three hours. The most important reason milk will start decreasing in this way is if it causes pain during pumping. Make sure you give appropriate pressure so that there is no pain.

3. Have a good sleep, decrease stress and worry, drink lots of fluids, a non-vegetarian diet can improve milk output significantly.

4. Try drugs that will enhance milk output like Tablet Perinorm (Metoclopramide) 10 mg, two tablets three times a day.

5. If all these fail, then go for formula feed. There are several hydrolyzed formula feed which baby may tolerate. But first, try these measures, then we will decide on the formula.

Let me know if you have further queries. Take care. I will be available tomorrow for a video call.

Patient's Query

Hi doctor,

Thank you for your quick response. Please see our answers to your responses below and further advice. Everything is noted, and we will try to do it according to that. Regarding the medicine you have advised, we did some research online, and it shows that it is a drug used to treat stomach conditions and gastrointestinal issues. Will this medicine help in the generation of more breast milk. Further to this, will there be any side effects seen in my daughter and my wife while she is on this medication? We are waiting for your reply.

Answered by Dr. Sudhakar Palanisamy

Hi,

Welcome back to icliniq.com.

It is nice that you had done some research. Yes, Perinorm is medicine for vomiting. It acts on inhibiting dopamine receptors in the brain, so it helps to prevent vomiting (where we use only one tablet). But the same dopamine inhibits prolactin secretion (which is required for milk production). So this drug has a side effect of increasing milk production in ordinary people. But we use this to our advantage. So that is the detailed explanation. As for side effects concerned, it is safe for your baby and mother, and we are prescribing it for a long time without any issues. And yes, it should increase breast milk production. But the effect varies based on the individual. I hope this cleared your doubt.

Patient's Query

Hello doctor,

Thanks for reassuring that this medication can be used for my wife’s situation and is safe. However, in my city, most pharmacies have the following drug Metoclopramide, which is an alternative to tablet Perinorm.

Answered by Dr. Sudhakar Palanisamy

Hello,

Welcome back to icliniq.com.

You can use the Metoclopramide of any brand; there are no issues in that.

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