%0 Journal Article
%T Effect of Domperidone on Insufficient Lactation in Puerperal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
%A Alla Osadchy
%A Myla E. Moretti
%A Gideon Koren
%J Obstetrics and Gynecology International
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/642893
%X Background. There is a controversy within the medical community regarding the role of domperidone as a galactagogue and the drug has been removed from the US market owing to safety concerns. Objective. To perform a systematic review and meta-analysis of the available data assessing the effect of domperidone on breast milk production in women experiencing insufficient lactation. Study Selection. Randomized controlled trials (RCTs) examining the effect of domperidone on breast milk production of puerperal women were eligible for inclusion. Data Analysis. Absolute and relative changes from baseline were calculated for individual studies and pooled using a random effects model. Results. Three RCTs including 78 participants met the inclusion criteria. All showed a statistically significant increase in breast milk production following treatment with domperidone. The analysis of pooled data demonstrated a statistically significant relative increase of 74.72% ( ) in daily milk production with domperidone treatment compared to placebo. No maternal or neonatal adverse events were observed in any of the trials. Conclusions. Evidence from a few small RCTs of moderate to high quality suggests that domperidone produces a greater increase in breast milk supply than placebo. 1. Introduction The benefits of breastfeeding are well recognized for both the mother and baby; thus, efforts should be made to promote initiation, duration, and exclusivity of breastfeeding [1]. The recently published survey of Canadian women who gave birth and were residing with their infants at the time of the interview has found that breastfeeding intention and initiating rates were fairly high, 90% and 90.3%, respectively, among women of this representative sample [2]. However, reported exclusive breastfeeding rates at three and six months fell substantially¡ª51.7% and 14.4%. While factors that affect breastfeeding success are multiple and nonmodifiable at times, the early recognition and timely management of modifiable risk factors is warranted to improve lactation performance [3]. Various nonpharmacological interventions have been shown to be effective and hence are incorporated in the current clinical recommendations for promoting breastfeeding [1]. Among them are individual and group breastfeeding education provided by lactation specialists, peer counseling, in-person, or telephone support. Pharmacological interventions to improve lactation, mainly dopamine antagonists, are usually recommended only after nonpharmacological modalities have failed, and this is largely due to scarcity of
%U http://www.hindawi.com/journals/ogi/2012/642893/