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Domperidone - use for increasing milk supply Women’s Health Service Patient Information Domperidone (Motilium®) is a medication usually used for the treatment of stomach discomfort, nausea and vomiting. One side effect of this medication is it increases the hormone prolactin that stimulates the production of breast milk. Therefore it is termed a galactagogue (milk stimulant) and can be used for breastfeeding mothers to increase milk supply. Although Domperidone is not registered for use as a galactagogue in New Zealand it is often used for this purpose. Domperidone is safe to take while breastfeeding as the amount of domperidone that could be ingested by an infant through breast milk is low and there are only a few side effects reported in both adults and breastfed babies. It is important before taking this medication that you let your midwife, neonatal staff, lactation consultant or health professional know if your supply is low. They will help assess your lactation or breastfeeding and develop a plan of care to help increase your milk supply. Ensure you are: • Expressing or breastfeeding regularly – at least 3 hourly during the day and 4 hourly at night. • Have correct hand expressing technique or the use of a good breast pump and ensure you have the correct sized equipment. • Eating a well-balanced diet and drinking plenty of fluid, and resting when you can. Precautions, interactions and adverse effects It is important for your health professional to discuss the risks and benefits of using domperidone as a galactagogue to ensure that you are able to make an informed decision. Please notify your health professional if you have any known cardiac conditions such as an irregular heart rhythm (arrhythmias) or have a family history of this or you are taking any medications for your heart. Side effects Potential side effects include; • Dry mouth • Headaches which usually disappear when domperidone is stopped • Abdominal cramps Please notify your health professional if you experience any side effects. Dose The usual starting dose is 10mg three times a day. This can be increased after consultation with your health professional. Doses of up to 40mg daily can be used. It may take 3 to 4 days before you notice an effect, though some woman notice increased milk supply within a day. It can take 2 – 3 weeks to obtain maximum effect. You will be given a prescription for 2 weeks initially and this may be repeated if required. Domperidone may need to be continued for up to 8 weeks. However long term use has not been studied. GA PIB-24 V2 CapitalDocs ID: 1.101162 | Issue date: December 2015 | Review date: December 2018 Page 1 of 2 [continued] Long Term use Discuss with your health professional if needing to take domperidone for long periods of time. Discontinuing Domperidone When you want to discontinue using Domperidone, reduce your dose by just one tablet initially for 4-5 days. If there is no change in your milk supply, reduce by one more tablet and then wait a further 4-5 days. Again if no change in your milk supply, continue decreasing medication by one tablet every few days until stopped. If you are able to maintain your milk supply, continue expressing. However, if your milk supply drops significantly please recommence your previous dose and continue for a further two weeks. If you have any questions or concerns please consult with your health professional. GA PIB-24 V2 CapitalDocs ID: 1.101162 | Issue date: December 2015 | Review date: December 2018 Page 2 of 2