From the Research
Domperidone should be prescribed at a dose of 10 mg three times daily to increase milk supply in lactating women, as this dose has been shown to be effective in increasing milk production with minimal side effects, as demonstrated in the most recent and highest quality study 1.
Key Considerations
- The medication usually takes 3-7 days to show initial effects, with maximum benefit often seen after 2-4 weeks of consistent use.
- Treatment duration varies but commonly ranges from 3-8 weeks, with some women requiring longer courses.
- Domperidone works by blocking dopamine receptors, which increases prolactin levels and subsequently enhances milk production.
- When discontinuing, the dose should be gradually tapered rather than stopped abruptly to prevent sudden drops in milk supply.
- Common side effects include headache, dry mouth, and abdominal cramps.
Important Notes
- It's essential to note that domperidone is not FDA-approved in the United States for any indication, though it's used in many other countries for lactation support.
- Before starting domperidone, other non-pharmacological approaches should be tried first, including frequent breastfeeding, proper latch techniques, breast compression, and adequate hydration and nutrition.
- A systematic review and meta-analysis 2 also supports the use of domperidone in breastfeeding women with low milk supply, particularly in those with preterm infants.
- However, the FDA has cautioned against the use of domperidone due to potential cardiac risks, including QT prolongation, cardiac arrest, and sudden death, as highlighted in a commentary 3.