There are more than one action of prolactin during pregnancy, there are 
trophic effects that cause milk making cells to reproduce and mature, 
and a milk producing action (causing the transcription of alpha 
lactalbumin which catalyzes the production of lactose and increases 
lipoprotein lipase activity to produce milk fats). Progesterone only 
blocks the alpha lactalbumin producing action of prolactin. If a mom is 
deficient in prolactin during pregnancy, her breasts might not develop 
properly. I personally don't know if giving domperidone during pregnancy 
is safe or not, but it's not ridiculous to offer it if the doctor has 
evidence to believe it's trophic effect is needed.

Catherine Watson Genna, IBCLC  NYC

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