When is it appropriate to use domperidone?
Domperidone must never be used as the first approach to correcting breastfeeding difficulties. Domperidone is not a cure for all things. It must not be used unless all other factors which may result in insufficient milk supply have been dealt with first.
These other factors include:
- correcting the baby’s latch, so that the baby can obtain. as efficiently as possible, the milk which the mother has available. Correcting the latch may be all that is necessary to change a situation of “not enough milk” to one of “plenty of milk”.
- using breast compression to increase the intake of milk.
- using milk expression after feedings to increase the supply.
- correcting sucking problems, stopping the use of artificial nipples, using a Lactation Aid, and Finger Feeding and other stratagems.
Using domperidone for increasing milk production
Domperidone works particularly well to increase milk production under the following circumstances:
- it has frequently been noted that a mother who is pumping milk for a sick or premature baby in hospital has a decrease in the amount she pumps around 4 or 5 weeks after the baby is born. The reasons for this decrease are likely many, but domperidone generally brings the amount of milk pumped back to where it was or even to higher levels.
- when a mother has a decrease in milk supply, often associated with the use of birth control pills (avoid oestrogen-containing birth control pills while breastfeeding), or on occasion, for no obvious reason when the baby is 3 or 4 months old, domperidone will often bring the supply back to normal.
Domperidone still works, but often less dramatically when:
- the mother is pumping for a sick or premature baby but has not managed to develop a full milk supply.
- the mother is trying to develop a full milk supply while nursing an adopted baby.
- the mother is trying to wean the baby from supplements.
Newman-Goldfarb Protocols for Induced Lactation © 2002-2010
Jack Newman, MD, FRCPC and Lenore Goldfarb, PhD, CCC, IBCLC, ALC
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