To clarify about the mom taking domperidone for 11 months. She phoned the
public health office specifically looking for support to continue taking the
drug. The LCs were very surprised to learn she had been taking it for so
long and are concerned that information may have been misinterpreted by the
medical community.  The mom was not open to counselling. There may be a
psychological dependency here which should be addressed. Obviously she has
been getting the prescription for domperidone from a physician. The
physicians have relied upon local LCs for up to date information perhaps we
have been remiss in our communications with them. The situation is
uncomfortable as we have had the expectation that while we may suggest
possible drugs to physicians we rely on them to use their expertise in
prescribing and monitoring. This is the first time this situation has arisen
locally.

 Like many of us these days I work at several jobs. One of them is as an LC
for a pregnancy outreach program, for another I have an office in the public
health unit but I am not employed as an LC. I will not have any contact with
this mom.

The greatest concern is about inadvertant pregnancy. Should the handouts
given out by the health unit be altered to include a) domperidone is not
intended for long term use but as an assist to induce lactation and b)
domperidone should not be taken if there is any likelihood of a pregnancy.
Rhoda Taylor, B.C., I.B.C.L.C.
Vancouver Island, Canada
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