Domperidone to Increase Breast Milk

Nursing moms need to ensure a good milk supply.

Ensuring an adequate milk supply is one of the primary concerns of a breastfeeding mom. In most cases, there is no need to worry, but sometimes a mother's milk supply is truly compromised and she is not able to keep up with the demands of her baby. For those moms, increasing milk production becomes a quest that sometimes needs to be solved with prescription medication. One of the most commonly prescribed options is domperidone.

The Facts

Domperidone is widely available under the brand name Motilium. Its original use was the treatment of digestive problems, such as nausea and vomiting. Increased milk production was merely a favorable and useful side effect. Additionally, domperidone does not readily pass the blood-brain barrier that separates the body's blood from the cerebrospinal fluid, so it is less likely to cause side effects within the central nervous system. This makes it a safer prescription-drug option for nursing moms.

Function

Domperidone increases a woman's milk supply through its depression of dopamine production in the hypothalamus. Dopamine inhibits the secretion of prolactin, a milk-producing hormone, from the pituitary; less dopamine means more prolactin and, ultimately, more milk.

Significance

Domperidone can be a useful lactation-boosting tool for many new nursing mothers. One example is a mom who is pumping breast milk to feed an infant who is hospitalized because of prematurity or illness. Sudden decreases in supply are common for these moms, and domperidone can help them through the low spots.

Similarly, moms who begin a birth control pill regimen, usually at three or four months postpartum, often experience a dip in supply, which can be corrected quickly with domperidone. Finally, moms with major breastfeeding obstacles to overcome, including those who have had breast surgery where the milk ducts were severed and those attempting to induce lactation to feed an adopted child may find domperidone helpful.

Considerations

There are ways to increase breast milk production without using drugs. Traditional methods include troubleshooting--making sure baby has a good latch, mom is putting baby to breast often enough and varying positions or holds at each feeding, etc.--and pumping between feedings, because milk production is based on the concept of supply and demand.

Time Frame

Domperidone is commonly prescribed to be taken in several doses over the course of a day. The regimen recommended by Dr. Jack Newman, an internationally acclaimed breastfeeding expert, is usually 30 mg, three times daily or up to 40 mg four times daily. Because it takes a few days to affect milk supply, the regimen should be followed for at least a week or two before making a decision to continue. Milk supply should increase steadily until around the third week, when the effects of the drug peak.

Warning

Side effects of domperidone can include fatigue, irritability, depression, headache, abdominal cramps, dry mouth and cessation of periods. Domperidone also has been associated with certain cardiac symptoms, including cardiac arrhythmia. In June 2004, the United States FDA warned against using domperidone as a galactagogue (lactation-boosting agent) specifically because of this. No side effects have been reported in infants nursed by mothers on a regimen of domperidone.

References

• Defining Your Own Success - Breastfeeding After Breast Reduction Surgery; Diana West; 2001
• BreastfeedingOnline.com