Is Domperidone safe while breastfeeding?
Here is what NIH LactMed, the U.S. National Library of Medicine's authority on medicines and breastfeeding, reports about Domperidone. This is a summary of that source — not our own verdict.
Effects on the breastfed infant
One paper reported 2 studies. In one, 8 women received domperidone 10 mg 3 times daily from day 2 to 5 postpartum. In the other, 9 women received domperidone 10 mg 3 times daily for 10 days from week 2 postpartum. No side effects were reported in any of the breastfed (extent not stated) infants.[ 45 , 46 ] Eleven women took domperidone 10 mg 3 times daily for 7 days to increase the supply of pumped milk for their preterm neonates. No side effects were reported in their infants.[ 47 ] In a study of 90 mothers who received domperidone 10 mg three times daily for 2 or 4 weeks while providing milk for their preterm infants, there was no apparent difference in the frequency or types of adverse events that occurred in their infants, whether taking the active drug or placebo.[ 48 ] A transgender woman took and spironolactone 50 mg twice daily to suppress testosterone, domperidone 10 mg three times daily, increasing to 20 mg four times daily, oral micronized progesterone 200 mg daily and oral estradiol to 8 mg daily and pumped her breasts 6 times daily to induce lactation. After 3 months of treatment, the estradiol regimen was changed to a 0.025 mg daily patch, and the progesterone dose was lowered to 100 mg daily. Two weeks later, she began exclusively breastfeeding the newborn of her partner. Breastfeeding was exclusive for 6 weeks, during which the infant's growth, development and bowel habits were normal. The patient continued to partially breastfeed the infant for at least 6 months.[ 4 ] A transgender woman was taking spironolactone 100 mg twice daily, progesterone 200 mg daily and estradiol 5 mg daily. She started on domperidone 10 mg three times daily to increase milk supply. She was able to pump 3 to 5 ounces of milk daily one month after starting. The dose of domperidone was increased to 30 mg three times daily after 8 weeks because of a decreased milk supply. Her milk supply returned to 3 to 5 ounces of milk daily. By 6 months, her milk supply had decreased to abo
Effects on milk supply
Domperidone increases serum prolactin in lactating and nonlactating women.[ 21 , 50 - 52 ] This effect is thought to be caused by the drug's antidopaminergic effect. In nonpregnant women, domperidone is less effective than the same dose of oral metoclopramide in raising serum prolactin; however, in multiparous women their effects are similar.[ 50 , 52 ] Domperidone has caused galactorrhea in nonpregnant women and in one male, nonbreastfed infant.[ 53 - 60 ] One paper, which was published twice in 2 different journals,[ 45 , 46 ] reported two separate small studies. In the first study, 15 women with a history of defective lactogenesis were given either oral domperidone 10 mg (n = 8) or placebo (n = 7) 3 times daily from day 2 to 5 postpartum. The patients were apparently not randomized, and blinding was not mentioned in the paper. No instruction or support in breastfeeding technique was provided. The groups had similar serum prolactin levels at the start of the study. Baseline serum prolactin levels were higher in the treated women from day 3 to 5 postpartum. Suckling-induced serum prolactin increases were higher in the treated women than in the placebo group from day 2 postpartum onward. Milk yield was calculated by weighing the infants before and after each nursing for 24 hours. Increase in milk yield were greater in the treated mothers from day 2 onward; however, the lower average milk yield in the placebo group was due to 3 women with very low milk output. Average infant weight gain was correspondingly greater in the treated group. At 1 month postpartum, all treated mothers were nursing well, but 5 of 7 untreated mothers had inadequate (not defined) lactation. No correlation was found between baseline serum prolactin or the increase in prolactin and milk production. In the same paper(s), 17 primiparous women who had insufficient lactation (30% below normal) at 2 weeks postpartum were studied using the same methodology as above. Mothers were given either oral domp
Levels in milk
Maternal Levels. Thirty breastmilk samples were obtained from 6 mothers taking domperidone 10 mg 3 times daily and 28 milk samples were obtained from 5 mothers taking domperidone 20 mg 3 times daily. The average concentrations of the drug in breastmilk were 0.28 mcg/L with the lower dosage and 0.49 mcg/L with the higher dosage. The authors estimated that a fully breastfed infant would receive daily dosages of 0.04 and 0.07 mcg/kg daily, respectively, at these maternal dosages. The estimated weight-adjusted maternal dosages were 0.012% and 0.009%, respectively.[ 21 ] A double-blind, controlled trial compared two dosages of domperidone for increasing milk supply in mothers of preterm infants. Mothers took either 10 mg or 20 mg three times daily. Drug concentrations in breastmilk were measured once between days 10 and 15 three hours after a dose. Milk domperidone concentrations were 3.4 mcg/L with the 10 mg dose (n = 4) and 6.9 mcg/L with the 20 mg dose (n = 3).[ 22 ] A woman was taking domperidone 40 mg 4 times daily for 7 months to enhance milk production. She submitted 5 milk samples over a 24-hour period for analysis. Using the average of the concentration values resulted in an estimated daily infant dosage of 1 mcg/kg and a relative infant dose of 0.05%. Using the highest value of 8.4 mcg/L, the RID was 0.06%.[ 44 ] Infant Levels. Relevant published information was not found as of the revision date.
Source: NIH LactMed (National Library of Medicine).
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.