What is the recommended dose of Domperidone (Motilium) for increasing breast milk supply?

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From the Research

The recommended dose of Domperidone for increasing breast milk supply is 10-20 mg three to four times daily, with most women starting at 10 mg three times daily and increasing as needed and tolerated, as supported by the most recent and highest quality study 1.

Key Considerations

  • Domperidone works by blocking dopamine receptors, increasing prolactin levels, and enhancing milk production.
  • The medication should be taken 15-30 minutes before meals for optimal absorption.
  • Important considerations include that domperidone is not FDA-approved in the United States for any indication, though it is used in many other countries for lactation support.
  • Side effects may include headache, dry mouth, abdominal cramps, and rarely cardiac arrhythmias.
  • Women with cardiac conditions, liver disease, or those taking medications that affect heart rhythm should use caution.

Evidence-Based Recommendations

  • A randomized, double-blinded, placebo-controlled trial found that domperidone treatment resulted in a significant increase in breast milk production with no adverse effects 1.
  • A systematic review and meta-analysis found that domperidone demonstrated a significant increase in daily human milk volume in mothers of preterm infants with low milk supply, without significant side effects 2.
  • However, another study highlighted the potential safety implications of using domperidone as a galactagogue, particularly with regards to cardiac effects 3.

Clinical Guidance

  • A healthcare provider should always supervise domperidone use, as individual needs vary and monitoring for effectiveness and side effects is important.
  • Treatment usually continues for 1-2 weeks to establish effect, then may be maintained for several weeks to months as needed, with gradual tapering when discontinuing.
  • The dose of domperidone may need to be adjusted based on individual response and tolerance, with careful monitoring for side effects and efficacy.

References

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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