TY - JOUR
T1 - Using domperidone to increase breast milk supply
T2 - A clinical practice survey of australian neonatal units
AU - Gilmartin, Christine E.
AU - Amir, Lisa H.
AU - Ter, Marene
AU - Grzeskowiak, Luke E.
PY - 2017/12
Y1 - 2017/12
N2 - Background: 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.
AB - Background: 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.
KW - Breast milk
KW - Breastfeeding
KW - Domperidone
KW - Galactogogue
UR - http://www.scopus.com/inward/record.url?scp=85013827885&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1070421
U2 - 10.1002/jppr.1289
DO - 10.1002/jppr.1289
M3 - Article
AN - SCOPUS:85013827885
VL - 47
SP - 426
EP - 430
JO - Journal of Pharmacy Practice and Research
JF - Journal of Pharmacy Practice and Research
SN - 1445-937X
IS - 6
ER -