Can a Controversial Pill Help Women Breastfeed?


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Breastfeeding is the most natural act in the world, right? Except when it’s not. Eighty percent of nursing moms experience some sort of lactation difficulty, according to a recent study — a large percentage that I can easily believe. After giving birth to my son, I was wholly committed to breastfeeding. But despite six weeks of pumping every two hours, popping plant-based fenugreek pills, and downing Mother’s Milk tea, I produced barely a splatter of milk. 

It now appears that a controversial pill could’ve solved my troubles — along with those of all the other women with lactation issues — without worries of harmful side effects.

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Australian doctors are encouraging the medical community to reconsider the use of an off-label drug called domperidone, a dopamine-receptor blocker that has a surprising side effect of boosting a woman’s breastmilk supply by triggering the release of the hormone prolactin. “There are currently calls for domperidone to be banned for use or heavily restricted because of claims it also puts mothers’ lives at risk, but there is absolutely no evidence of this,” research fellow Luke Grzeskowiak of the University of Adelaide in Australia writes in the current edition of the Journal of Human Lactation.

Although domperidone has never been FDA-approved in the United States, European and Canadian doctors prescribe it regularly to treat nausea and vomiting in people who suffer from gastrointestinal-tract disorders. Upon learning that women were popping the pills to boost milk supply in 2004, the FDA issued a warning about “cardiac arrhythmias, cardiac arrest and sudden death” and “unknown risk to infants” associated with the drug. But Grzeskowiak refutes these claims, writing, “Its use in older and sicker patients compared with nursing mothers is completely different.”

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And American women, despite government warnings, can and do still obtain the drug with a doctor’s prescription and purchase it through compound pharmacies or Canadian websites. Internet message boards are rife with debate among women who have taken the drug. “I LOVE IT!!! It works great!” wrote one user on Circle of Moms. Noted another: “I used it for 4 months, and was able to breastfeed my daughter until she was 1 without formula. I never would have been able to do that without the medication… It worked very well for me when nothing else did.” One user even triggered her milk supply eight months postpartum.  

Still, some cite headache and weight gain as side effects, and one woman claimed she developed a neurological disorder called myoclonic, which caused her limbs to jerk uncontrollably. Others claim to have experienced no boost in their milk production whatsoever. 

The medical community is equally divided on the drug. According to the American Academy of Breastfeeding Medicine, “There is no direct correlation between baseline prolactin levels and rates of milk synthesis or measured volumes of milk production.” But many lactation coaches encourage its use for women who struggle to produce.

“There’s so much misinformation about domperidone. But the bottom line is that it works for many women with low breast-milk supplies,” Diana West, an international board-certified lactation coach, tells Yahoo Parenting. “The one study that got the public worried was done on 30 men who took the drug for gastro issues and developed heart arrhythmia. For nursing women, it’s had an excellent track record for 30 years.”

According to West, while the drug does enter the bloodstream, it doesn’t cross the blood barrier of either the mother or the baby, so there is no concern for developing emotional or neurological problems as a result.

Still, the decision to turn to drugs in order to nurse remains a deeply personal one. My OB was stumped by my own breastfeeding difficulties, and my lactation coach actually told me about domperidone, promising that my supply would “skyrocket” with it. But the unknown health risks weren’t worth it to me. So, in the end, I supplemented with formula.

It was, incidentally, the best decision I could have made. My son is healthy, happy, and hitting all his milestones early, and I couldn’t have asked for a better outcome. Plus, not obsessing about my supply freed me up to enjoy more important things, like bonding with my new baby. And isn’t that the best part of being a new mom anyway?