Domperidone and Breastfeeding: Insights and Considerations

As a parent and someone who's been around many breastfeeding mothers, I've seen firsthand the challenges that come with breastfeeding, particularly when it comes to milk supply. Domperidone often comes up in these discussions, and it's crucial to understand its role and implications.

Understanding Domperidone's Role in Lactation

The Basics of Domperidone

Domperidone works by increasing prolactin levels, essential for milk production. However, it's vital to remember that it's not a first-line solution for breastfeeding difficulties. It's a medication that should be considered only after exploring and addressing other factors affecting milk supply.

Key Points to Remember

  • Not a First Approach: Always explore other solutions before considering domperidone.
  • Under Medical Supervision: Consult a healthcare provider before using domperidone.

Efficacy and Safety Concerns

While domperidone can be effective, especially for mothers with preterm babies, its safety profile warrants careful consideration. Side effects like cardiac risks are significant concerns.

Important Safety Notes

  • Potential Side Effects: Be aware of possible cardiac risks and other side effects.
  • Consult Healthcare Providers: Always discuss with a medical professional before starting domperidone.

Domperidone vs. Other Galactagogues

A Comparative Look

Domperidone isn't the only galactagogue available. Comparing it with others like metoclopramide and herbal options can help in making an informed decision.

Comparing Options

  • Domperidone: More effective than metoclopramide with fewer side effects.
  • Herbal Galactagogues: Fenugreek and milk thistle are popular but lack extensive clinical trial data.

Navigating the Regulatory Landscape

Understanding FDA Guidelines

In the U.S., domperidone isn't approved by the FDA for lactation enhancement, reflecting the need for caution and informed decision-making.

Key Regulatory Points

  • Not FDA Approved: Domperidone is not approved in the U.S. for lactation purposes.
  • Use with Caution: The Cochrane Review recommends careful use, considering potential cardiac risks.

Practical Aspects of Using Domperidone

Real-World Use and Observations

Though not without risks, many mothers report positive experiences with domperidone, citing increased milk production and minimal side effects.

Observations from Mothers

  • Increased Milk Production: Many mothers have reported a significant increase in milk supply.
  • Side Effects: A small percentage report mild side effects, while the majority find it tolerable.

In conclusion, while domperidone can be a helpful solution for some breastfeeding mothers struggling with milk supply, its use should be carefully considered. It's not a one-size-fits-all solution and should come after trying other methods and under the guidance of a healthcare provider. As with any medication, weighing the benefits against potential risks is key.

Questions? Email Jack Newman at, or Edith Kernerman at or consult: Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA) or our DVD, Dr. Jack Newman’s Visual Guide to Breastfeeding; or The Latch Book and Other Keys to Breastfeeding Success; or L-eat Latch & Transfer Tool, or the GamePlan for Protecting and Supporting Breastfeeding in the First 24 Hours of Life and Beyond.  See our website at  To make an appointment email and respond to the auto reply or call 416-498-0002.

Handout. Domperidone 1, Revised May 2008
Written and Revised by Jack Newman, MD, FRCPC 1995-2005
Revised by Edith Kernerman, IBCLC, and Jack Newman, MD, FRCPC © 2008

 This handout may be copied and distributed without further permission,
on the condition that  it is not used in any context that violates
the International WHO Code on The Marketing of Breastmilk Substitutes


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