Domperidone

Domperidone,orMotilium,isamedicationthatisusedfornauseaandvomiting;however,italsohasaneffectonbreastmilkproduction.Oneofitssideeffectsistoincreasethehormoneprolactin.Prolactinisthehormonethatmakesmilk.Milkproductionisdrivenbyfrequenteffectivedrainingofthebreasts,aswellasthehormoneprolactin.Itisvitallyimportantthatwomenaredrainingtheirbreastsaround8-12timesadayinordertomaximisetheirmilkproduction.Thebreastshouldbeofferedflexiblyandfrequentlyaccordingtothebaby’scues.Milktransferneedstobeoptimisedtoensuregooddrainage,andthisisbestachievedbyappropriatefitandhold.DrAndreworDrSmithcanassessthisduringanappointment.If,despitegoodfitandholdandfrequentfeeds,mum’smilksupplyisstillnotmatchingbaby’sneeds,thenDomperidonecanbeconsideredtotryandincreasesupply.TheevidencesuggeststhatDomperidoneiseffectiveformanywomen,iswelltoleratedandissafeforthebaby.Theusualstartingdoseis1tabletthreetimesaday,whichcanbeincreasedto2tablets3timesadayiftheresponseisnotsufficient.Maximumdosageis8tabletsaday.Itcantaketimeforthemedicationtowork.Sideeffects,ifpresent,aremild.Somepatientscomplainofabdominalcramping,nausea,diarrhoea,drymouth,headacheordizziness.TheevidenceislessclearabouthowlongtotakeDomperidonefor,orhowtoweanoff.TrialshavestudiedDomperidoneforupto4weeksonly,withmosttrialsonlyassessingitsuseover2weeks.Thecourseoftreatmentisbestdiscussedwithyourtreatingdoctor,dependingonyourindividualneeds.Whenthetimecomestoweanthemedication,itisbestdoneslowlytoreducethechanceofsideeffectsformumaswellasnotriskingthemilksupply.Domperidoneisnotsafeforeveryone.Itmustnotbetakenbypeoplewhohaveapastorfamilyhistoryofcardiacarrhythmias.YoumusttellyourtreatingdoctorifyouaretakinganyothermedicationsbeforestartingDomperidone.Cautionneedstobeusedwhentakingitwithcertaintypesofantibiotics,antifungals(oral)andantidepressants.Ifyourdoctorisconcerned,anECG(electrocardiogram)canbedonebeforeand/orjustaftercommencingDomperidonetomakesurethereisnoelectricaldisturbanceintheheart(QTintervalprolongation).