Last time, we talked about Fenugreek to help increase milk supply. Another prescribed alternative is a drug called Domperidone. It is sometimes referred to by the brand name Motilium, which is a drug you will find prescribed for gastrointestinal tract disorders or nausea. Its also been used to treat spit up and weight loss in infants. The "side effect" that we can take advantage of as breastfeeding moms is that it helps the creation of the hormone prolactin which stimulates cells in the breast to produce milk.
It should be noted that Domperidone is not FDA approved for breastfeeding mothers and you should check with your general practitioner if you want to try any medication. All medication should be considered potentially dangerous - not just in general, but specifically in terms of you and your health history. In 2004, the FDA warned that domperidone can have cardiac side effects, however this warning was based on studies of seriously ill elderly patients taking the drug intravenously. That being said, if you have any underlying cardiac issues, you should not take Domperidone.
The alternatives that are FDA approved such as Metoclopramide (Maxeran and Reglan) include side effects such as fatigue, depression, involuntary body movement, and irritability and anecdotally I have had mother's report the side effects of Domperidone to be much more mild. The American Academy of Pediatrics has rated Domperidone as “usually compatible with breastfeeding” and pharmacist Tom Hale has given it the best (safest) possible rating breastfeeding mothers. Prescriptions of Domperidone usually range from 3 to 8 weeks. It usually takes at least 2 to 3 weeks to have an effect. Some mothers report an increase milk supply within 24 hours, though this is rare.
Before you turn to Domperidone, you may want to investigate some other alternatives. I have had mothers use herbal supplement, change their pumping frequency, or a combination of both and have had success. Lactation consultants specialize in creating a plan to help you with your milk supply issues and make sure you are using optimal technique with baby to make sure milks transfer is high.