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Domperidone has no officially established dosage for increasing milk supply, but most published studies have used 10 mg three times daily for 4 to 10 days (30 mg per day). [36] The US Food and Drug Administration (FDA) has expressed concerns about serious adverse side effects and concerns about its effectiveness. [34]
Synthetic galactagogues such as domperidone and metoclopramide interact with the dopamine system in such a way to increase the production of prolactin; specifically, by blocking the D 2 receptor. [3] There is some evidence to suggest that mothers who are unable to meet their infants' breastfeeding needs may benefit from galactogogues.
Dopamine agonists are currently the preferred medication for suppressing lactation, which work by suppressing prolactin production. [3] Cabergoline (Dostinex™) is currently most effective option currently available, as it is available as a single dose (as opposed to bromocriptine which must be taken twice daily for 2 weeks.) [4] It may be prescribed in the case of breast abscess.
The mother's use of medications and herbs should be evaluated, as some substance suppress lactation. [5] The Academy of Breastfeeding Medicine protocol for low milk supply recommends that the mother be evaluated for medical causes of the problem, [5] however health professionals and breastfeeding counsellors often do not do this. [2]
High levels of prolactin during pregnancy and breastfeeding also increase insulin resistance, increase growth factor levels (IGF-1) and modify lipid metabolism in preparation for breastfeeding. During lactation, prolactin is the main factor maintaining tight junctions of the ductal epithelium and regulating milk production through osmotic balance.
Breastfeeding and medications is the description of the medications that can be used by a breastfeeding mother, and the balance between maternal health and the safety of the breastfeeding infant. [ 1 ] [ 2 ] Medications, when administered to breastfeeding mothers, almost always are transferred to breast milk, albeit usually in small quantities ...
Whereas D 2 receptor agonists suppress prolactin secretion, dopamine D 2 receptor antagonists like domperidone and metoclopramide have the opposite effect, strongly inducing the pituitary secretion of prolactin, and are sometimes used as prolactin releasers, for instance to correct hypoprolactinemia (low prolactin levels) in the treatment of lactation failure. [2]
Cracked nipple (nipple trauma or nipple fissure) [1] is a condition that can occur in breastfeeding women as a result of a number of possible causes. Developing a cracked nipple can result in soreness, dryness or irritation to, or bleeding of, one or both nipples during breastfeeding.