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Disclaimer: The information in this post is for educational purposes only. I am not a doctor. It is not intended to be a substitute for professional medical advice. None of the opinions are meant to diagnose or treat any disease or illness. You should always consult your healthcare provider.

Domperidone for Breastfeeding – Is It Safe?

You’re ready to throw in the towel. You dread attempting to feed your sweet precious baby you’ve longed for. Breastfeeding makes you feel like a failure like nothing else in life ever has.

Sound familiar? Many moms (including myself!), struggle with low supply for one reason or another. Sometimes it’s recommended to use domperidone for breastfeeding because many claim it increases supply. Does it? Is it safe?

Grab a piece of chocolate – or some wine if you’re dairy-free – and let’s pretend we’re having a chat away from screaming babies. It’s all gonna be ok, mama. I promise.

Domperidone for Breastfeeding - Is It Safe? #nursing #medicine #milk #supply #homeremedy

Domperidone for Breastfeeding – Is It Safe?

What Is Domperidone?

Domperidone (Motilium) is a drug commonly prescribed for patients suffering with stomach disorders. It is also used to prevent nausea and vomiting caused by some medications (cancer patients may use this drug to counteract some of their medications). Wait…what? “But I want to increase my supply,” you say!

One of the side effects of domperidone is that it often increases the prolactin production by the pituitary gland, which for lactating women who are desperately trying to increase their supply is a good thing!

Is It Safe?

The side effects listed are headache, dizziness, dry mouth, nervousness, flushing, or irritability in the first few days as the body adjusts to the medication. Also, trouble sleeping, stomach cramps, hot flashes, leg cramps, chest pain, slow/fast/irregular heartbeat, swelling of the feet or ankles, difficulty urinating, swelling of the breasts or discharge from the nipple in men or women, menstrual changes, sexual difficulties.

In 2004, the FDA issued a statement declaring it unsafe to use domperidone for breastfeeding. (They issued this statement the day the National Breastfeeding Campaign began that year.) Their reasons include two deaths from intravenous use of this drug (which means incredibly high doses – breastfeeding mothers’ doses would come nowhere near what a cancer patient’s might be and would be taken orally anyway). It is not, according to the FDA, safe for any reason and is therefore not available by prescription in the US.

However, the side effects listed for a mainstream, over-the-counter drug like Tylenol (acetaminophen) are supposedly rare and include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. (source)

Yet the FDA shares that from 1998 to 2003 acetaminophen accounted for nearly 50% of acute liver failure (ALF) cases associated with accidental overdosing. There were also 458 deaths related to acetaminophen-associated overdoses over a 9-year period.

And it’s still on the market. Available without prescription.

Metoclopramide (Reglan) is a drug that can be obtained in the United States and is often prescribed to lactating mothers to help increase supply. However, a major side effect is severe depression because this drug crosses the blood-brain barrier. Coupled with a new mother’s proclivity to post-partum depression, this can be a dangerous combination. Other side effects include diarrhea, sedation, gastric upset, nausea, seizures, and extrapyramidal effects (twitching, etc.) (source)

Canadian Dr. Jack Newman has many concerns with the FDA’s statement about domperidone due to his experience in legally prescribing it to his patients and the overwhelming lack of even minor side effects. You can read his convincing article addressing their statement here.

Additionally, the American Academy of Pediatrics approved domperidone for breastfeeding. And in 2014 it was listed as a “Lactation Risk Category L1” in Medications and Mothers’ Milk by Thomas Hale, PhD!

When To Use It?

Sometimes I hear women immediately recommend one drug or another to a mother battling low milk supply. However, drugs of any kind should be our last resort. So to the mother considering using domperidone for breastfeeding supply (or any other drug), I always recommend working with a lactation consultant to determine when it may be time to introduce a drug like domperidone. And the following should be considered and evaluated to increase breast milk naturally:

  • Increase skin-to-skin – as much as possible 24 hours a day, 7 days a week.
  • Assess the baby’s latch – if the baby isn’t latching properly, the milk is not being removed correctly and is therefore going to cause a diminished supply and a hungry baby.
  • Remove the use of artificial nipples like bottles (and pacifiers) and use a lactation aid, instead, to encourage more milk removal from the breast.
  • Consider getting bloodwork done for thyroid issues.
  • Add lactogenic herbs and/or foods into your diet.
  • Try pumping in between feedings (or pumping for longer/different intervals) to encourage your body to produce more milk.

In other words, every other possible option should be exhausted before using a prescription drug.

(More information on starting domperidone for breastfeeding and stopping.)

How To Purchase It?

Some local compound pharmacies may still be able to fill a prescription if you find a doctor willing to write a script for it. It can also be ordered from this website as it is an over-the-counter medicine in other countries like Canada, Australia, etc.

My Experience with Domperidone for Breastfeeding

In the fall of 2011 I gave birth to spontaneous triplets. Due to many contributing issues like a c-section, intravenous medications, epidural, and not being able to pump for several hours after their birth, my body got a slow start to producing milk for three babies. I had bloodwork run by an excellent endocrinologist, took gobs of herbs and other lactogenic foods, did skin-to-skin as much as possible during their one-month NICU stay, etc. I was barely making enough milk for one baby.

I sat down with my OB and told him about domperidone for breastfeeding. He’d never heard of it but was willing to listen to me. We researched it online in the exam room and he weighed the pros and cons, wrote me a prescription, and I filled it at my local pharmacy. I began taking it immediately and noticed an increase in my expressed milk.

I was able to teach each of my babies to breastfeed by the time they were three months old. I used domperidone for quite some time before weaning off of it and was able to breastfeed all three of my babies until they were 31 months old!

Medicine is rarely an option for me as I choose to use a natural and alternative approach to healing. However, the minimal side effects and few cons domperidone had, compared with the almost certain use of full-time formula for potentially all of the babies, made this decision easier for me. I became convinced that, for our family, domperidone was safer than the use of infant formula. (While we did utilize donor breast milk for a time, I could not always guarantee its availability for all of my babies.)

For more information on getting off to a good start breastfeeding multiples, check out my book: Breastfeeding Twins, Triplets and More!

What are your thoughts on domperidone for breastfeeding? Would you use it? Have you? Share with other mamas below!

Disclaimer: I am not a doctor or lactation consultant. My experience and research led me to the conclusion that domperidone for breastfeeding can indeed be safe for many women seeking to increase their supply. Please discuss this with your doctor and lactation consultant prior to using.

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Jennifer Fountain is the founder of Growing Up Triplets and is a contributor to other blogs, including Breastfeeding Place. She writes about raising their three-year-old-triplets, taking the family back to living simply, and endeavoring to honor God in the midst of it all. She has been married to her hubby, David, for nearly five years and is madly in love with him! You can follow Jennifer and the three peas on Google+FacebookTwitterPinterest and the blog.

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