Domperidone and maternal milk volume in mothers of premature newborns

Fazilla, Tengku Ellya; Tjipta, Guslihan Dasa; Ali, Muhammad; Sianturi, Pertin

doi:10.14238/pi57.1.2017.18-22

Cited by 5 publications

(19 citation statements)

References 10 publications

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“…The details are listed in Table S3. No maternal side effects were reported in four trials of domperidone 28,29,33,35 and one trial of metoclopramide 37 . Neonatal side effects were reported in three trials of domperidone 28,29,34 and two trials of metoclopramide 36,37 .…”

Section: Side Effectsmentioning

confidence: 95%

“…Furthermore, literature retrieval was re-run before the final analysis (in February 2020) and no eligible trial was found. Therefore, fifteen studies were ultimately retained for qualitative synthesis [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] , and twelve trials were entered into the meta-analysis (see Figure 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…Ten trials were conducted in highincome countries: three in Canada 28,29,34 , two in the US 39,40 , two in Finland 36,38 , one in Australia 27 , one in England 30 and one in Belgium 37 . The remaining five trials were conducted in the low-and middle-income countries, with one in Thailand 31 , Pakistan 32 , India 33 , Indonesia 35 and Iran 41 . The detailed characteristics of the included studies are summarized in Table S1.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…An inadequate introduction of protocol resulting in 'unclear risk of reporting biases' in most of studies 27,28,[30][31][32][33][36][37][38][39][40][41] . The 'unclear risk of selection biases' was observed in seven studies, with lacking the clear demonstration of allocation concealment or randomisation process 27,28,32,[35][36][37][38] . Five studies were related to the 'unclear risk of attrition biases' due to unclear reasons for participants' withdrawal 27,36,[38][39][40] .…”

Section: Risk Of Bias Of Included Studiesmentioning

confidence: 99%

“…All studies of domperidone showed significantly higher human milk volume in the domperidone group than in the placebo group [27][28][29][31][32][33][34][35] . However, the outcome of human milk volume varied in the metoclopramide compared with the placebo group.…”

Section: Human Milk Volumementioning

confidence: 99%

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Efficacy and safety of domperidone and metoclopramide in breastfeeding women: A systematic review and meta-analysis

Shen¹,

Du²,

Ouyang³

et al.

Authorea

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Background: Domperidone and metoclopramide are the most commonly prescribed galactogogues for enhancing milk production, but evidence supporting their efficacy and safety is contradictory. Objectives: To evaluate the efficacy and safety of domperidone and metoclopramide use by breastfeeding women. Search strategy: A systematic literature retrieval of Medline, Embase, Cochrane Library, PubMed, EBSCO, Web of Science, ClinicalTrials.gov and additional bibliography was conducted without time restriction. Selection criteria: Randomised controlled trials exploring the effects of domperidone and metoclopramide in breastfeeding women were included. The primary outcomes were the difference in human milk volume and maternal and neonatal side effects. Data collection and analysis: Two reviewers screened, extracted and assessed the eligible trials independently. Effect size with 95% confidence intervals were presented using random effect model. Main results: Fifteen studies were included. Pooled results demonstrated a low to moderate increase in daily human milk volume of 90.54 mL/day (95%CI 65.69, 115.39), 0.04 mL/day (95%CI 28.85, 28.93) with the use of domperidone and metoclopramide, respectively. No differences were noted in the incidence of maternal side effects with domperidone (RR1.20, 95%CI 0.74, 1.97) or metoclopramide (RR1.23, 95%CI 0.51, 2.94). Additionally, there were no significant differences in the volume of human milk and maternal side effects between the domperidone and metoclopramide group. Conclusions: Domperidone demonstrated a modest increase of 90.54 mL/day in milk production, and had a lower risk of side effects in mothers and infants, which could be considered as a suitable choice for breastfeeding women.

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Section: Side Effectsmentioning

confidence: 95%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Risk Of Bias Of Included Studiesmentioning

confidence: 99%

Section: Human Milk Volumementioning

confidence: 99%

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Efficacy and safety of domperidone and metoclopramide in breastfeeding women: A systematic review and meta-analysis

Shen¹,

Du²,

Ouyang³

et al.

Authorea

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Human Milk Expression After Domperidone Treatment in Postpartum Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2018

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Background: Insufficient milk production is among the most cited reasons by mothers for discontinuing breastfeeding. Medications that can increase milk production, such as domperidone, an off-label galactagogue, are often prescribed. Domperidone is controversial as it is not approved for any purpose in the United States and is approved only for gastrokinetic purposes in Canada and other countries. Research aim: The aim was to update the existing literature on the efficacy of domperidone as a galactagogue compared to placebo when given to mothers with insufficient human milk production. The primary outcome is the change in expressed human milk volume per day from baseline. Methods: The authors independently searched the literature from inception to May 2018. The search included any randomized controlled trials examining the efficacy of domperidone increasing mothers’ expressed human milk, measured via a human milk pump. Both authors independently assessed quality and risk of bias and extracted relevant data. Meta-analysis on expressed human milk volume per day was performed. Results: Seven studies met the inclusion criteria for review; two were excluded from the meta-analysis due to quality grading and insufficient reporting of the outcome of interest. Five studies ( N = 239) were combined in the meta-analysis. The effect size showed an increase in the mean difference of expressed human milk volume in mothers given domperidone, 93.97 mL per day (95% CI [71.12, 116.83 mL]; random effect, T2 0.00, I2 0%). Conclusion: This meta-analysis reports a significant improvement in expressed human milk volume per day with the use of domperidone in mothers experiencing insufficient human milk production.

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RETRACTED: Galactogogues use Among Mothers With Preterm Births: A Systematic Review and Meta-Analysis

Ezenwa

Bello

Oyenusi³

et al. 2020

J Hum Lact

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Background Preterm mothers face unique challenges—the stress of preterm delivery and their premature babies’ inability to suckle directly from the breasts, culminating in poor milk supply. Galactogogues are substances believed to enhance human milk production. Evidence for their use in preterm mothers is insufficient. Research aims To (a) evaluate the influence of galactogogues on milk production among mothers with preterm birth, and (b) assess the safety of galactogogues for mother-infant dyads. Methods A systematic search was conducted between January 2018 and May 2019 in nine electronic databases, with manual searches through reference lists of included articles. Randomized controlled trial studies addressing outcome measure of milk quantification were selected. Seven trials met the inclusion criteria and, using the Clinical Appraisal Skills program checklists and the modified Cochrane Collaboration tool for assessing risk of bias, each trial was critically appraised for content, bias in methodology, and reporting. Results Four herbal substances (fenugreek, silymarin, silymarin/galega, and stinging nettle) and domperidone used in intervention studies were analyzed. Fenugreek and silymarin used in isolation did not yield significant increase in milk production, while the combination herbal mixtures silymarin/galega and stinging nettle herbal tea increased milk production. Domperidone use resulted in an acute increase in milk production, which was not sustained with prolonged use. The reviewed studies reported no serious adverse effects on mother-infant dyads. Conclusion Herbal galactogogues may be more effective for longer term use, although there is still limited evidence to support its prescription to preterm mothers. Larger studies are required.

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Domperidone and maternal milk volume in mothers of premature newborns

Abstract: Background Mothers of premature newborns often have diffi-

Cited by 5 publications

References 10 publications

Efficacy and safety of domperidone and metoclopramide in breastfeeding women: A systematic review and meta-analysis

Efficacy and safety of domperidone and metoclopramide in breastfeeding women: A systematic review and meta-analysis

Human Milk Expression After Domperidone Treatment in Postpartum Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

RETRACTED: Galactogogues use Among Mothers With Preterm Births: A Systematic Review and Meta-Analysis

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