Friday morning

Nova:
"Mm what time is it." Damn it is 5 o'clock in the morning why am I awake I do not know man now I know why I have a really big headache let go and see if James have anything medicine that can help me. I went to his medicine cabinet and this is what I found what is this.

Nova:
And this just images that they are together. Also I am going to make up a medicine which is not real it will be chlorpromazine, galactogogues and also domperidone I will tell you then name after.

Google:
Chlorpromazine, the first antipsychotic, was first used in 1952. "For the first time an effective treatment for schizophrenia and related disorders was available," says the British Association for Psychopharmacology (BAP). But BAP notes that the side effects of some antipsychotics can include sexual dysfunction, muscle stiffness-and weight gain.

In an article published by the National Center for Biotechnology Information (NCBI), researchers found that "most antipsychotics cause weight gain [and] the risk appears to be highest with olanzapine and clozapine."

There are several reasons for this. "Antipsychotics are also known to impair glucose metabolism, increase cholesterol and triglyceride levels and cause arterial hypertension, leading to metabolic syndrome," reports the NCBI, which lists other contributing factors such as sitting down too much and unhealthy eating habits driven by excess hunger.

So that how James make me hungry in the middle of the night man I do not know if I should be mad at home right now.

Google
A galactagogue, or galactogogue, also known as a lactation inducer or milk booster, is a substance that promotes lactation in humans and other animals. It may be synthetic, plant-derived, or endogenous. They may be used to induce lactation and to treat low milk supply

Google:
Breastfeeding is recommended as the optimal form of nutrition for term and preterm infants. There are many health advantages to breastfeeding for both you and your baby. However, mothers who wish to express milk for their hospitalised newborns are faced with numerous stressful situations. Your baby may have been born early. You may be from a rural or regional area and you or your baby; or both of you may have been transferred to Brisbane for specialised care. It may also be some time until your baby can begin breastfeeding. All of these things can affect how well your body produces breast milk at this time.

Even if you are expressing frequently, your milk supply may not increase, and when this happens, it might help to also take domperidone.

Sometimes medicines, taken for other purposes, have the effect on increasing breast milk as one of their side effects. They stimulate the release of prolactin, which in turn stimulates breast milk production. This is how domperidone will help with your milk supply.

Domperidone is the most effective medicine used to improve breast milk supply. It was developed to treat nausea, vomiting, indigestion and gastric reflux, but has been found to be effective when used to increase milk supply. Domperidone is currently widely used In Australia and around the world for this purpose even though it was not originally marketed for this. This is called off-label use. Your doctor will consider the following before prescribing domperidone:

Whether you have been provided adequate support from a lactation consultant, and they agree there is a persistent breast milk supply problem that may benefit from using domperidone.
Other medical conditions (particularly a significant personal or family history of cardiac arrhythmias or abnormal heart rhythms), the use of medicines that affect the rhythm of the heart (QT-prolonging medications), and any medicines that may increase the side effects or action of domperidone.
The risks and benefits of using domperidone to increase your breast milk supply to ensure that you make an informed choice. You will be asked to sign a consent form showing that you have been given this leaflet and sufficient information about domperidone.
Using the lowest effective dose and only increasing the dose based on you, or your baby's response. Dose increases are managed by a doctor that normally cares for you, not the hospital doctor.
How to ensure that it is working to increase milk supply, and what side-effects or adverse reactions to look for.

Google:
Domperidone is used together with frequent expressing. It will work best for you if you are expressing regularly with an electric breast pump - this is at least eight times per day with no breaks longer than five hours.
Domperidone is normally taken by the breastfeeding mother every eight hours (three times per day). A suggested regime would be at 6am, 2pm and 10pm. Check with the lactation consultant or pharmacist on the best way to fit this medicine into your and your baby's routine.

Google:
The usual starting dose is 10 mg (one tablet) every eight hours (three times per day e.g. 6 am, 2 pm and 10 pm). The starting dose at the hospital should never exceed 30mg (3 tablets) in each 24 hours.
Once your milk supply is well established, keep taking the dose of one tablet (10mg) every eight hours (three times per day) for one more week; then it may be possible to gradually reduce the medicine slowly over a few days and then stop. It is advisable to contact the lactation consultant before you plan to stop this medication, to review your milk supply, and then talking to the doctor who prescribed it to give you a weaning plan.
The dose may change, depending on each woman's individual response. Rarely, doses of up to 60mg (6 tablets) are used in each 24 hours, prescribed by the GP.
How should I take it?
The tablets can be swallowed with some water, or dispersed in a small amount of water (5 mL), which is then swallowed, followed by some water.
People taking domperidone for gastric conditions usually take it about half an hour before meals, but this is not necessary for use in improving breast milk supply.

Google:
When should the medicine start working and how will I know?
Most breastfeeding mothers see an improvement in milk supply usually starting after the first week.
If you are regularly expressing and taking the medication, the milk supply should improve within 3-4 weeks. If this doesn't happen, the lactation consultant and doctor will want to review your use of the medicine.
Staying on the medicine long term has no benefit once the initial increase in milk occurs.

How does domperidone work to improve breast milk supply?
Breastfeeding is recommended as the optimal form of nutrition for term and preterm infants. There are many health advantages to breastfeeding for both you and your baby. However, mothers who wish to express milk for their hospitalised newborns are faced with numerous stressful situations. Your baby may have been born early. You may be from a rural or regional area and you or your baby; or both of you may have been transferred to Brisbane for specialised care. It may also be some time until your baby can begin breastfeeding. All of these things can affect how well your body produces breast milk at this time.

Even if you are expressing frequently, your milk supply may not increase, and when this happens, it might help to also take domperidone.

Sometimes medicines, taken for other purposes, have the effect on increasing breast milk as one of their side effects. They stimulate the release of prolactin, which in turn stimulates breast milk production. This is how domperidone will help with your milk supply.

Domperidone is the most effective medicine used to improve breast milk supply. It was developed to treat nausea, vomiting, indigestion and gastric reflux, but has been found to be effective when used to increase milk supply. Domperidone is currently widely used In Australia and around the world for this purpose even though it was not originally marketed for this. This is called off-label use. Your doctor will consider the following before prescribing domperidone:

Whether you have been provided adequate support from a lactation consultant, and they agree there is a persistent breast milk supply problem that may benefit from using domperidone.
Other medical conditions (particularly a significant personal or family history of cardiac arrhythmias or abnormal heart rhythms), the use of medicines that affect the rhythm of the heart (QT-prolonging medications), and any medicines that may increase the side effects or action of domperidone.
The risks and benefits of using domperidone to increase your breast milk supply to ensure that you make an informed choice. You will be asked to sign a consent form showing that you have been given this leaflet and sufficient information about domperidone.
Using the lowest effective dose and only increasing the dose based on you, or your baby's response. Dose increases are managed by a doctor that normally cares for you, not the hospital doctor.
How to ensure that it is working to increase milk supply, and what side-effects or adverse reactions to look for.
How do I get domperidone?
The best person to manage prescribing domperidone and monitoring therapy is a general practitioner (GP), who is able to review your history, current conditions and medicines and if domperidone is suitable for you.
Your own GP is the best option, but if you are admitted at QCH, you many need to see a GP nearer to the hospital. Find a GP Brisbane can help with this.
If you cannot make a GP appointment and be seen by the close of business the following work day, a QCH prescriber who can treat adults can start domperidone for you (if it is appropriate to do so). They can only provide a prescription for twenty-five tablets, and can only write a dose of one tablet three times a day. The hospital pharmacy can dispense 25 tablets on this prescription, which is enough for one week. You will need to organise a GP visit before these tablets run out, for the GP to take over your care.
You will need to take this information leaflet to your doctor as you will require a prescription for this medication.

Google:
When and how should I take domperidone?
Domperidone is used together with frequent expressing. It will work best for you if you are expressing regularly with an electric breast pump - this is at least eight times per day with no breaks longer than five hours.

Domperidone is normally taken by the breastfeeding mother every eight hours (three times per day). A suggested regime would be at 6am, 2pm and 10pm. Check with the lactation consultant or pharmacist on the best way to fit this medicine into your and your baby's routine.

How much should I take?
The usual starting dose is 10 mg (one tablet) every eight hours (three times per day e.g. 6 am, 2 pm and 10 pm). The starting dose at the hospital should never exceed 30mg (3 tablets) in each 24 hours.
Once your milk supply is well established, keep taking the dose of one tablet (10mg) every eight hours (three times per day) for one more week; then it may be possible to gradually reduce the medicine slowly over a few days and then stop. It is advisable to contact the lactation consultant before you plan to stop this medication, to review your milk supply, and then talking to the doctor who prescribed it to give you a weaning plan.

The dose may change, depending on each woman's individual response. Rarely, doses of up to 60mg (6 tablets) are used in each 24 hours, prescribed by the GP.

How should I take it?
The tablets can be swallowed with some water, or dispersed in a small amount of water (5 mL), which is then swallowed, followed by some water.
People taking domperidone for gastric conditions usually take it about half an hour before meals, but this is not necessary for use in improving breast milk supply.

Google:
Domperidone is the most effective medicine used to improve breast milk supply. It was developed to treat nausea, vomiting, indigestion and gastric reflux, but has been found to be effective when used to increase milk supply

Google:
Galactogogues are medications that aid in initiating and maintaining adequate milk production. Most exert their pharmacologic effects through interactions with dopamine receptors, resulting in increased prolactin levels and thereby augmenting milk supply. Metoclopramide remains the galactogogue of choice due to its documented record of efficacy and safety in women and infants. Domperidone crosses the blood brain barrier and into the breast milk to a lesser extent than metoclopramide, decreasing the risk of toxicity to both mother and infant possibly making it an attractive alternative. Traditional antipsychotics, sulpiride and chlorpromazine, have been evaluated, but adverse events limit their use. Human growth hormone, thyrotrophin-releasing hormone, and oxytocin have also been studied. Finally, a natural product, fenugreek, has been purported to be effective in anecdotal reports. Use of this agent may be warranted after considering risks versus benefits.

Nova:
Oh wow ok umm this is too much for me right like let make a smoothie and this is what we are making healthy rainbow breakfast smoothie.

10m prep
4 servings

Ingredients:
750ml (3 cups) almond milk
2 frozen bananas, peeled, sliced
35g (1/3 cup) rolled oats
1 tbsp honey
100g frozen pineapple pieces
30g baby spinach
80ml (1/3 cup) frozen acai puree
100g frozen blueberries
200g frozen mango
1 fresh mint sprig, leaves picked
125g frozen raspberries
100g hulled strawberries

Step 1
Place the almond milk, banana, oats and honey in a blender and blend until smooth. Pour evenly among 4 jugs.

Step 2
Add pineapple and spinach to 1 jug then pour into the blender and blend until smooth. Pour evenly among 4 large glasses.

Step 3
Add acai and blueberries to another jug then pour into the blender and blend until smooth. Pour evenly among glasses.

Step 4
Add mango and mint to another jug then pour into the blender and blend until smooth. Pour evenly among glasses.

Step 5
Add raspberries and strawberries to remaining jug then pour into the blender and blend until smooth. Pour evenly among glasses then serve.

Nova:
And this is the picture I am going to read more maybe.

After a bit

Nova:
I am going to bed but not in my bed night guys.

When James wake up

James:
Mm what time is it it is 8 clock u should get up now even if I do not want to. I got dress did everything I think now it is time to wake up Nova. "Nova baby time to wake up..Nova." That is wired she is not in her room where is she? I went to the living room sitting on the chair in the kitchen with my medicine I think she wanted more about them and it look like she found a look of information. "Hey baby it is time to wake up."

Nova:
"Morning mum MUM."

James:
"Morning Nova and it look like you were research on male breastfeeding."

Nova:
"Yeah I did but what is it called mum since you have 3 different ones?"

James:
"Because I have 3 different medicine in one it is called clogaloggudpmp."

Nova:
"That is for chlorpromazine, galactogogues and also domperidone for them?"

James:
"Yeah baby it is for all of them."

Nova:
"Wow mum that is a lot."

James:
"Yeah baby it look like you found a lot."

Nova:
"That because I did and it really help me."

James:
"Yeah I do now stop looking and come and eat you have an hour before you have to go to the hospital."

Nova:
"Ok mum... wait did you say eat?"

James:
"Shh yes I will make something and I want you to eat it."

Nova:
"Can we not do that please."

James:
"Nope we are doing it."

Nova:
"Why?"

James:
"Because I said so."

Nova:
"Agh fine it is not like I have a choice."

James:
"No you do not and good because you were going to do it no matter what."

Nova:
"Yeah for some reason I already knew that James."

James:
"James who is James in this house Nova?"

Nova:
"I do not know James you tell me I think I loss my mum."

James:
"Oh really can you tell me how does she look like?"

Nova:
"Better yet why don't I show you a picture maybe that will help."

James:
"Sure."

Nova:
"So this is what my mum look like."

James:
"Don't you mean your dad because he is a male?"

Nova:
"Yes he is a male but I call him mum."

James:
"Why was is that?"

Nova:
"My mum was not a good woman to me she was never my mum in a first place so that why I call him mum."

James:
"Aww that is so sweet and I am sorry to hear about your mum."

Nova:
"Well thank you very much and don't be it is ok."

Mum:
"Baby where are you?"

Nova:
"Mum where are you?"

Mum:
"Here I am baby I lose you are you ok?"

Nova:
"I am ok."

Mum:
"Good I love you."

Nova:
"And I love you too... thank you for helping me find my mum."

Mum:
"Yes thank you."

James:
"And we are dome now I will be in the kitchen."

Nova
"Ok."

James:
"Nova did you lose your dad."

Nova:
"More then you know mum I miss him so much."

James:
"Shh it is ok shh I am sorry baby."

Nova:
"It is ok mum I love you anyways."

James:
"And I love you too."

Nova:
"I think my dad put us together mum j really do think that."

James:
"I think he did too Nova I really do."