Domperidone for Treatment of Low Milk Supply in Breast Pump–Dependent Mothers of Hospitalized Premature Infants

Haase, Barbara; Taylor, Sarah N.; Mauldin, Jill; Johnson, Teresa S.; Wagner, Carol L.

doi:10.1177/0890334416630539

Cited by 13 publications

(14 citation statements)

References 30 publications

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“…In a 2001 study, 30% of mothers reported this as the major reason for discontinuation,15 while another study of participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in the US reported that 46% who stopped breastfeeding before the recommended age did so because of perceived inadequate milk supply 20. Consequently, mothers (notably, adoptive mothers seeking to induce lactation) and health care workers involved in supporting them have sought other modes of lactation support to address this concern, including using galactagogues: foods, medicines, herbal supplements, and teas purported to have lactogenic properties 21–27. Breastfeeding women have accessed herbal medicines for the purpose of aiding lactation historically and in diverse settings 24,26–41.…”

Section: Introductionmentioning

confidence: 99%

“…In first-time mothers, delayed onset of lactogenesis II can be common, and has been associated with risk of early discontinuation of breastfeeding 31. Currently, breastfeeding mothers in the US have very limited access to pharmacological interventions for increasing milk supply, and physicians may only prescribe these “off-label” or not for their intended use; the US Food and Drug Administration has not approved any pharmaceutical products for lactation 27. In contrast, Canadian women frequently utilize prescription medication for lactation support 68…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Maternal experiences with and sources of information on galactagogues to support lactation: a cross-sectional study

Bazzano¹,

Cenac²,

Brandt³

et al. 2017

IJWH

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An increase in the marketing and use of herbal galactagogues among breastfeeding mothers in the US has raised the issue of how best to provide support and information on the use of these products, particularly in light of limited availability of certified lactation counselors and continued suboptimal rates of breastfeeding globally. Currently, no cross-sectional data are available on the experiences and attitudes of mothers regarding the use of herbal and pharmaceutical galactagogues for lactation in the US. The findings of an online survey of 188 breastfeeding mothers on experiences with and sources of information on galactagogues are presented. Most mothers (76%) reported that while breastfeeding, they felt as though they were not making enough milk to meet the needs of their child, and yet 54% also indicated that they had not supplemented with formula. A large proportion of respondents reported utilizing galactagogues to increase lactation and finding them useful. The results indicated that most women learned about galactagogues from the Internet or by word of mouth through friends. Lactation consultants were the third-most reported sources of information on these products. While many respondents reported perceiving galactagogues as innocuous, more evidence on safety and efficacy is needed to support women properly who seek out and use them. Large-scale studies of the prevalence of galactagogue use in the US and rigorous evaluation of use globally are needed to ensure that mothers who choose to breastfeed may safely avail themselves of all options when counseling support is insufficient.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Maternal experiences with and sources of information on galactagogues to support lactation: a cross-sectional study

Bazzano¹,

Cenac²,

Brandt³

et al. 2017

IJWH

View full text Add to dashboard Cite

show abstract

“…This includes women taking medications that inhibit the metabolism of domperidone and/or also prolong the QTc-interval (e.g., fluconazole, erythromycin), and women with a personal or family history of cardiac arrhythmia or family history of unexplained sudden death. Clinical protocols regarding the use of domperidone in clinical practice have been developed and serve to facilitate safer prescribing practices and minimize potential adverse reactions in mothers and their hospitalized premature infants [72].…”

Section: Efficacy and Safety Of Galactagoguesmentioning

confidence: 99%

What Evidence Do We Have for Pharmaceutical Galactagogues in the Treatment of Lactation Insufficiency?—A Narrative Review

2019

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Inadequate breast milk supply is a frequently reported reason for early discontinuation of breastfeeding and represents a critical opportunity for intervening to improve breastfeeding outcomes. For women who continue to experience insufficient milk supply despite the utilisation of non-pharmacological lactation support strategies, pharmacological intervention with medications used to augment lactation, commonly referred to as galactagogues, is common. Galactagogues exert their pharmacological effects through altering the complex hormonal milieu regulating lactation, particularly prolactin and oxytocin. This narrative review provides an appraisal of the existing evidence regarding the efficacy and safety of pharmaceutical treatments for lactation insufficiency to guide their use in clinical practice. The greatest body of evidence surrounds the use of domperidone, with studies demonstrating moderate short-term improvements in breast milk supply. Evidence regarding the efficacy and safety of metoclopramide is less robust, but given that it shares the same mechanism of action as domperidone it may represent a potential treatment alternative where domperidone is unsuitable. Data on remaining interventions such as oxytocin, prolactin and metformin is too limited to support their use in clinical practice. The review provides an overview of key evidence gaps and areas of future research, including the impacts of pharmaceutical galactagogues on breast milk composition and understanding factors contributing to individual treatment response to pharmaceutical galactagogues.

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“…Nonpharmacological interventions remain the first line in managing insufficient human milk supply, although prescribing medications and recommending herbal galactogogues are common [ 7 ]. Women who discontinue breastfeeding as a result of insufficient human milk supply might be provided with adequate educational interventions regarding breastfeeding practices and/or might then be prescribed pharmacological agents to increase their human milk supply.…”

Section: Introductionmentioning

confidence: 99%

Which Benefits and Harms of Using Fenugreek as a Galactogogue Need to Be Discussed during Clinical Consultations? A Delphi Study among Breastfeeding Women, Gynecologists, Pediatricians, Family Physicians, Lactation Consultants, and Pharmacists

Shawahna

Qiblawi

Ghanayem

2018

Evidence-Based Complementary and Alternative Medicine

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Background Breastfeeding women with hypogalactia are commonly recommended to use fenugreek as a galactogogue. This study aimed to achieve formal consensus among breastfeeding women and healthcare providers on which potential harms and benefits of using fenugreek need to be communicated and discussed during clinical consultations. Methods A two-iterative round Delphi technique was used in two separate panels of breastfeeding women (n = 65) and healthcare providers (n = 56) to achieve formal consensus on a list of 24 and 16 items related to potential harms and benefits of fenugreek. Results About 70% of the healthcare providers recommended quite often herbal remedies for breastfeeding women and about 68% of the women had been recommended to use herbal remedies many times by their healthcare providers. Consensus was achieved on 21 potential harms and 14 potential benefits of using fenugreek to enhance human milk supply that need to be discussed with breastfeeding women during consultations. Conclusion Probably, potential harms and benefits of recommending fenugreek as herbal galactogogue for breastfeeding women seeking recommendations to increase their human milk supply need to be discussed during clinical consultations. Further observational studies are needed to assess what is being discussed in daily consultations when herbal remedies are recommended.

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Domperidone for Treatment of Low Milk Supply in Breast Pump–Dependent Mothers of Hospitalized Premature Infants

Cited by 13 publications

References 30 publications

Maternal experiences with and sources of information on galactagogues to support lactation: a cross-sectional study

Maternal experiences with and sources of information on galactagogues to support lactation: a cross-sectional study

What Evidence Do We Have for Pharmaceutical Galactagogues in the Treatment of Lactation Insufficiency?—A Narrative Review

Which Benefits and Harms of Using Fenugreek as a Galactogogue Need to Be Discussed during Clinical Consultations? A Delphi Study among Breastfeeding Women, Gynecologists, Pediatricians, Family Physicians, Lactation Consultants, and Pharmacists

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