Domperidone for increasing breast milk supply

DOMPERIDONE FOR INCREASING BREAST MILK SUPPLY  

What is Domperidone?

Domperidone is a prescription medicine generally used for nausea and vomiting. However, in your case it is being considered for an off-licence prescription use to help increase breast milk supply.

Before prescribing Domperidone other measures to increase milk supply should be in place, including:

• A breastfeeding assessment by someone skilled in breastfeeding support which will look at:
• Your positioning and attachment
• How often your baby is feeding
• Feeding at least 8 - 10 times within a 24 hour period (including overnight)

What a good breastfeed should look like:

• Baby is feeding at least 8 - 10 times within a 24 hour period
• Feeding is comfortable for the mother and there is no nipple pain.
• There are wet and dirty nappies (at least 6 heavy nappies and 2 yellow poos in

      a baby over 6 days old)

• Can see and hear the baby swallowing milk.
• Baby comes off the breast settled.

If you are expressing:

• How often you are expressing: are you expressing at least 8-10 times within a 24 hour period (including at least once between 24:00 – 04:00 hours).
• Using the correct flange for your nipple size.
• Use the double pump function on your electric pump, as there is research to prove that this is more effective than single pumping.
• Avoiding going longer than 4 hours overnight without expressing.
• Having regular skin-to-skin with baby for long periods of time as this will boost milk stimulating hormones, oxytocin and prolactin.

How does it work?

Domperidone increases the level of the hormone prolactin which is involved in breast milk production. Expressing or breastfeeding frequently while taking Domperidone may help increase your breast milk supply.

When is it appropriate to use Domperidone?
Taking Domperidone to increase breast milk supply should only be done under medical supervision. Domperidone may be considered for use when breast milk supply is low and when extra breastfeeding or expressing are not enough to increase milk supply. It is rarely used before seven days after birth.

When should Domperidone not be used?
The prescription of Domperidone should be avoided in the following situations:

• Where either mother or baby has any evidence or history of cardiac abnormalities (specifically arrhythmias) 
• Where severe hepatic or renal impairment has been identified in mother or baby
• Where either mother or baby has  high or low levels of potassium, or low levels of magnesium
• Where there has been a previous allergy or intolerance to domperidone
• Where mother has previously had a prolactinoma, or has a history of gastrointestinal perforation or obstruction.

Domperidone should not be used in those who are taking certain (but not all) medicines such as:

• Some antibiotics
• Some antifungals
• Heart medicines
• Some antidepressants and antipsychotic medicines.

What is the usual dosage?
To increase breast milk production, you will use 10mg of Domperidone (one tablet) three times a day for seven days. We are only able to offer you one seven day course. Please be aware that the information sheet will advise you not to breast feed when taking this drug. Please discard this information.

How long does it take to work?
It may take a week before you notice an increase in breast milk supply and two to four weeks to achieve the maximum effect. It is important to keep breastfeeding and/or expressing during this time. Keep in touch with your breastfeeding specialist(s) such as the infant feeding team, doctor, or health visitor for ongoing advice.

What are the side effects?
Side effects are rare – they include stomach cramps, dry mouth, or headache, and occasionally Domperidone is associated with depressed mood. If you have palpitations or faint (or feel faint) while taking this medicine, seek immediate medical attention.

Very small amounts of Domperidone pass into breast milk so it is very unlikely that your baby will have side effects from the medicine. No side effects have been reported in infants of breastfeeding mothers using Domperidone. This leaflet does not include information about all known side effects.

Tell your doctor or pharmacist if you experience anything unusual or if you feel unwell.

Following your seven-day course of Domperidone
Once your seven-day course of Domperidone has come to an end, please continue to breastfeed or express. A member of the Infant  Feeding Team / Health Visiting Team will contact you to see how feeding / expressing is going and offer further feeding support if required.

We are unable to offer a 2nd course of Domperidone

Remember Domperidone will only work when also breastfeeding and / or expressing a minimum of 8 times within a 24 hour period, including overnight and ensuring you are effectively emptying your breasts after each feed / pump.

Further Support
For further support please speak to a member of the Infant Feeding Team on 07775027151 / or email sft.infantfeedingco@nhs.net

Facebook group - South Wiltshire and Surrounds Breastfeeding Support.

National Breastfeeding helpline: 0300 100 0212 (24/ 7)

Association of Breastfeeding Mother (ABM): 0300 330 5453

The National Childbirth Trust (NCT): 0300 330 0700

La Leche League:  0345 120 2918

Breastfeeding Network UK: https://www.breastfeedingnetwork.org.uk/

Note. This document uses the term women throughout, but this term should be taken to also include people who do not  identify as women but who are pregnant, in labour and in the postnatal period.

Our Maternity Information Leaflets for parents and service users are reviewed regularly by parents and service users. If you have any comments/feedback about this leaflet or are interested in looking at future leaflets, please contact our Maternity & Neonatal Voices Partnership (MNVP)  www.bswmaternityvoices.org.uk