Information from LLLC re Health Canada advisory regarding Domperidone

By Audy, 11 March, 2012

Canadian mothers may have questions concerning news that Health Canada has issued a warning regarding the use of Domperidone.

The warning states The manufacturers of domperidone, in collaboration with Health Canada, would like to inform healthcare professionals that the gastrointestinal motility modifier domperidone should be initiated at the lowest possible dose in adults. Recent epidemiological studies have shown that the use of domperidone may be associated with an increased risk of serious ventricular arrhythmias or sudden cardiac death, particularly in patients taking daily doses greater than 30 mg, and in patients older than 60 years of age.” Although the media discussion about this warning has talked about the off-label use of domperidone in mothers to increase milk supply, the warning does not address this issue. 

Domperidone is approved in Canada as a medication to modify upper gastric motility. Use of domperidone for increasing milk supply, through the drug side effect of increasing prolactin levels, is an “off-label use” of this medication in Canada.

Because the medication is frequently used for this purpose, La Leche League Canada believes it would be valuable for mothers and their babies if research studies could be done on the safety and effectiveness of domperidone in lactating women. 

La Leche League Canada Leaders are volunteers who provide information and support for breastfeeding mothers. They do not diagnose, prescribe or make recommendations about medications or dosages. If mothers have questions about a domperidone prescription they should discuss this with their health care providers who prescribed the medication.

In the majority of cases, a mother will be able to produce enough milk to meet her baby’s needs simply by breastfeeding in response to her baby’s cues. When milk production doesn’t seem to be adequate, changes to breastfeeding techniques and management should be considered first. These changes are usually effective and often work quickly.  La Leche League Leaders and lactation consultants are able to help mothers with ideas for increasing milk production. 

If these techniques are not sufficient, mothers may want to consult with their health care providers about using herbal supplements or prescription medication to increase milk production. Their doctors should be able to help them assess whether the medication is safe and appropriate for them. For some mothers, the additional use of a medication prescribed by her doctor will make a significant difference in providing her baby with mother’s milk.  Mothers breastfeeding premature babies or adopted babies, in particular, may find this helpful. La Leche League Canada Leaders can provide mothers in these situations with support, encouragement and additional information.