At our institution, we care for women who have high risk infants and run into low milk supply issues frequently due to the stress of having their infant hospitalized, etc.

I tend to prescribe domperidone 20 mg po Q 8 hrs, once maximum/stable supply is reached (which can take days to weeks), wean to 20 mg po BID for 3 days, if supply remains stable, wean to 20 mg once a day for 3 days, then off completely. If at any point their supply decreases, I have them stay at the dose that they were stable at and try again in a week or two to wean to a smaller dose.  I have had women have to continue to take some dose of domperidone the entire time they are lactating and they have not reported any issues/side effects.

Another great resource for galactogogue information is the Academy of Breastfeeding Medicine's website, www.bfmed.org, completely physician based, they develop evidence-based protocols, the galactogogue protocol is #9.

Pamela K. Murphy, PhD, MS, CNM, IBCLC
Medical University of South Carolina

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www.breastfeedingconferences.com

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