Using domperidone to increase breast milk supply: a clinical practice survey of Australian neonatal units

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dc.contributor.authorGilmartin, C.
dc.contributor.authorAmir, L.
dc.contributor.authorTer, M.
dc.contributor.authorGrzeskowiak, L.
dc.date.issued2017
dc.description.abstractBackground: Domperidone may be used off-label to increase breastmilk supply. In the absence of manufacturer dosage recommendations, there is a need to compare the clinical practice guidelines used in Australian hospitals. Aim: To compare existing clinical practice guidelines regarding the use of domperidone for increasing maternal breastmilk supply within Australian neonatal units (NNUs). Methods: An electronic survey was distributed from April to July 2015 to relevant staff at each Level III NNU across Australia. Results: Responses were received from 16 of 22 (73%) NNUs. All 16 (100%) NNUs considered domperidone their first line pharmacological agent of choice in the management of low milk supply, with 12 (75%) having a clinical guideline. Of the NNUs with a guideline, 11 (92%) recommended a standard maintenance dose of 10 mg three times daily (TDS). Duration of treatment was specified in 10 (83%) guidelines. Seven of 10 (70%) recommend a minimum duration of at least 2 weeks treatment before evaluating a response. Three of 11 (27%) guidelines that recommended 10 mg TDS permitted an increase to 20 mg TDS depending on response. Ten of 12 (83%) guidelines were modified in the previous 2–3 years, with eight revising their maximum dose to 30 mg/day, one limiting treatment duration to 7 days, and one removing the authority of NNU doctors to prescribe domperidone. Conclusion: While all Australian neonatal units consider domperidone first-line for pharmacological management of low milk supply, variability across clinical guidelines may suggest a lack of reliable evidence or awareness of evidence on which to base practice.
dc.description.statementofresponsibilityChristine E. Gilmartin, Lisa H. Amir, Marene Ter, Luke E. Grzeskowiak
dc.identifier.citationJournal of Pharmacy Practice and Research, 2017; 47(6):426-430
dc.identifier.doi10.1002/jppr.1289
dc.identifier.issn1445-937X
dc.identifier.issn2055-2335
dc.identifier.orcidGrzeskowiak, L. [0000-0001-8554-4696]
dc.identifier.urihttp://hdl.handle.net/2440/110250
dc.language.isoen
dc.publisherSociety of Hospital Pharmacists of Australia
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1070421
dc.rights© 2017 The Society of Hospital Pharmacists of Australia
dc.source.urihttps://doi.org/10.1002/jppr.1289
dc.subjectDomperidone; breastfeeding; galactogogue; breast milk
dc.titleUsing domperidone to increase breast milk supply: a clinical practice survey of Australian neonatal units
dc.typeJournal article
pubs.publication-statusPublished

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