Effects of Domperidone in Increasing Milk Production in Mothers with Insufficient Lactation for Infants in the Neonatal Intensive Care Unit.

Breast milk is the optimum for all infants, but hospitalization in the neonatal intensive care unit can cause separation of mothers and infants, which often interferes with milk secretion. Some reports show that domperidone is effective in promoting milk secretion. However, the Food and Drug Administration in the United States cautioned to not use domperidone for increasing milk volume because domperidone carries some risk of cardiac events, including QT prolongation, cardiac arrest, and sudden death. In contrast, it is used in Canada, Australia, and the United Kingdom with safety. The pharmacodynamics and pharmacokinetics of drugs may vary by race or ethnic origin, and it is not known whether domperidone is effective or safe for Japanese. In this study we report the effects of domperidone for Japanese mothers with insufficient lactation. Ten mothers were enrolled in a pilot study. After confirming that there were no abnormal findings on the electrocardiogram, the mothers were administered domperidone. Seven of 10 who took domperidone increased their milking volume. Prolactin was increased in 9 of 10 mothers. Adverse events were observed in two mothers, one headache and one abdominal pain; all symptoms were mild and improved promptly; and there were no adverse cardiac events. These results are consistent with reports from other countries. Domperidone may tentatively be considered effective for increasing milk secretion in Japanese mothers as in other populations. Our preliminary study of 10 cases indicates the need for further studies with larger sample sizes to assess the efficacy and safety of domperidone.

Evidencia actual del efecto del cardo mariano como galactogogo / Nowadays evidence on the use of milk thistle as a galactogogue

La lactancia materna exclusiva hasta los 6 meses de vida es el mejor alimento para los recién nacidos. Sin embargo, existe una tasa de abandono de la lactancia materna exclusiva elevada en nuestro medio, en muchas ocasiones relacionada con una producción insuficiente de leche. En la actualidad existe un producto a base de cardo mariano que actúa como galactogogo, aumentando la producción láctea. En este trabajo se ha realizado una revisión bibliográfica sobre el efecto del cardo mariano como galactogogo, y se ha encontrado tan sólo un estudio que lo afirma. Tras la lectura crítica del estudio, se puede concluir que no existe evidencia científica suficiente al respecto

Exclusive breastfeeding until 6 months is the best food for newborns; however, there is a high drop-out rate of exclusive breastfeeding in our environment. This neglect is usually related to insufficient milk production. Actually, there is a new product based on milk thistle which acts as a galactogogue, increasing milk production. This study presents a literature review on the effect of milk thistle as galactogogue, finding that there is only one study in which the pharmaceutical industry supports that assertion. After critical reading and analysis of the study many doubts appear about the methodology used, so we can conclude that there is no evidence enough about it

Maternal medication, drug use, and breastfeeding.

This article reviews the necessary skills required for clinicians to make informed decisions about the use of medications in women who are breastfeeding. Even without specific data on certain medications, this review of kinetic principles, mechanisms of medication entry into breast milk, and important infant factors can aid in clinical decision making. In addition, common medical conditions and suitable treatments of depression, hypertension, infections and so forth for women who are breastfeeding are also reviewed.

Medications and breast-feeding: Current concepts.

OBJECTIVES: To describe the various factors that come into play when a breast-feeding mother is taking medications, including use of prescription drugs, over-the-counter medications, recreational drugs, galactogogues, and herbal remedies and to provide a framework used for counseling breast-feeding women. SETTING: Community and hospital pharmacy and health care settings. PRACTICE DESCRIPTION: Consultative services provided to breast-feeding mothers who had been prescribed or were using medications. MAIN OUTCOME MEASURES: Use of pharmacokinetic factors, maternal and child factors, a list of questions to ask breast-feeding mothers, and a stepwise approach to counsel breast-feeding mothers on the compatibility of using medications while breast-feeding. RESULTS: By positive intervention of pharmacists and health care providers, up to 1 million breast-feeding mothers, who must use medications, can continue to breast-feed while taking medications. CONCLUSION: Objectively weighing the benefits of drugs and breast-feeding versus the risks of drugs and not breast-feeding, in most cases, allows for pharmacists to give current and practical advice to mothers and other health professionals who counsel mothers.