(Brand names: Motilium, Motillium, Motinorm, Costi)
Like metoclopramide (Reglan), domperidone works in breastfeeding women by inhibiting dopamine. Dopamine is itself an inhibitor of prolactin – the milk-making hormone. But unlike Reglan, domperidone is not approved for increasing milk supply in any country and is not FDA-approved for any use in the USA. In 2004 the FDA issued a letter of warning advising breastfeeding women to avoid domperidone. In the same warning it notified pharmacies that the sale of domperidone is illegal and that shipments of the drug from other countries would be searched and seized.
This ban on domperidone makes it illegal for your doctor to prescribe the drug or for any pharmacy based in the USA to sell it to you.
The FDA ban and subsequent warning have sparked controversy since studies show that the side effects of domperidone are significantly less severe than Reglan in breastfeeding women. In fact The American Academy of Pediatrics have approved the use of domperidone in breastfeeding mothers and it has been given a “safest” rating in the Medications and Mothers’ Milk reference.
Like metoclopramide (Reglan), domperidone probably won’t be of any help to your breast milk production if your prolactin levels are already normal. If your prolactin levels are already normal then inhibiting dopamine won’t be of any additional help. It’s also likely that mothers who practice good breastfeeding techniques like those suggested on this website, won’t see any additional benefit of taking domperidone.
Domperidone is secreted into breast milk and while initial studies have not found any significant effect on newborns, a medical review has been started in Britain after lethal levels of sodium have been found in children who have taken the drug. Additionally a 2008 study showed that domperidone delayed the electrical repolarization rate of the heart following each heartbeat – a condition that could lead to irregular heartbeat, palpitations, fainting or death, however no heart changes in the rhythm of the heartbeat were observed and these infants were given domperidone directly – not through their mother’s breast milk.
Side effect of domperidone on the mother are increased appetite and weight gain, abdominal cramping and headaches.
If you are interested in experimenting with domperidone, the first problem to solve (if you live in the USA) is how to acquire the drug. Do you or family or friends live near or in Canada? If so you may be able to buy domperidone directly or indirectly from a Canadian pharmacy. If getting the drug is possible, I recommend seeing your doctor for a blood test to check your prolactin levels. If your results show low prolactin then domperidone could certainly help your milk supply without the severe side effects that come with metoclopramide (Reglan).
As an alternative to domperidone, consider an all-natural herbal treatment for low milk supply such as Lactiful Supply Max or other herbal solutions that can increase milk supply in breastfeeding moms.