Domperidone:
How it works and how it compares to Reglan

Several medications have, as a side effect, the production of breastmilk. Digitalis, cholopramzine and other major tranquilizers are just a few of them. With medical management, it is not necessary to have been pregnant in order to produce breastmilk.

Domperidone is an anti-emetic or anti-nausea drug that was initially prescribed for people with upper gastrointestinal problems. Domperidone is not a hormone but it has a side effect that results in an increase in prolactin levels. It was discovered that, when some women would take the drug, this increase in prolactin levels could in turn cause lactation.

As with most drugs, very little of the domperidone ends up in the breastmilk. The baby gets only minute amounts. There is another similar drug that is found in the US called Reglan (Metoclopramide). However, it is not recommended for long-term use in lactating women. It crosses the blood-brain barrier and can cause neurological problems and depression. Note that, according to the the American Academy of Pediatrics classification, Reglan (metoclopramide) is a drug “whose effect on nursing infants is unknown or may be of concern.”

Domperidone is not known to cross the blood-brain barrier in significant amounts and is used to treat chronic conditions that require its long-term use. It is not known to cause depression. Since domperidone does not cross the blood-brain barrier it is much safer for mother and baby. They even give domperidone to babies in Canada suffering from from severe regurgitation. Right now domperidone is not widely available in the US except at a few compounding pharmacies, but domperidone has been approved for use in breastfeeding mothers by the American Academy of Pediatrics.