Recommendations on domperidone in lactating women is based on the
effects of IV high dose. 

As a Consultant Paediatrician I have asked(prescribed)well over 1000
women to take Domperidone at a dose of 10mg t.i.d for 14 days in order
to help breast feeding(to increase supply of breast milk) and think it
works well for many. I have never come across a single women developing
any symptoms suggestive of arrhythmias with this dose. I know of many
colleagues of mine who do the same and they too have a similar
experience. In Sri Lanka over 95% of babies will be breast fed within
the 1st month and about 70% will continue to breast feed even at 6
months. For a few who have initial problems domperidone help and should
we deprive those women and their babies of such benefits? It is well
known that paracetamol [acetaminophen, or Tylenol] is fatally toxic at
high doses even when taken orally but that does not prevent thousands
taking it at the proper dose for pain or fever. I recently learnt that
FDA approves the use of Polycarbonate Plastic Bottles to feed infants
though there are concerns about its safety. There FDA appears to 'assume
safety and ask to prove harm by plastic bottles' but act differently
when it comes to breastfeeding. 

Dr. A LakKumar Fernando MBBS(SL),DCH,MD(Paed),MRCP(UK),MRCPCH(UK)
Consultant Paediatrician, General Hospital, Chilaw, Sri Lanka.

http://www.cmaj.ca/cgi/eletters/171/7/725#1449 

Arly Helm, MS, IBCLC

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