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Concerns About Safety, Benefits of Breastfeeding Drugs


August 8, 2012 — The two most popular breastfeeding drugs are Reglan and Domperidone, two drugs that are intended to treat stomach aches. Lactation specialists claim the drugs increase prolactin, the hormone that triggers breast-milk production. Unfortunately, the studies backing up this claim are weak, and the side effects of Reglan and Domperidone can be very serious — including depression, cardiac disorders, and a permanent muscle-twitching disorder.

In 2004, the FDA warned that women should not take Domperidone to increase breast-milk production. Domperidone is not approved for any purpose in the U.S., but some women purchase the drug through online pharmacies and international retailers. Unfortunately, there have been reports of cardiac arrhythmias, cardiac arrest, and sudden death in patients using the intravenous form. Furthermore, the drug label specifically warns against using it for breastfeeding. One reason is because the drug is excreted in breast-milk and exposes an infant to unknown risks.

In 2009, the FDA placed a Black Box warning on Reglan to warn of tardive dyskinesia, which involves involuntary, repetitive movements — including lip smacking, rapid eye movements, grimacing, tongue protrusion, blinking, and more. It is rarely possible to reverse the symptoms.

Furthermore, recent studies suggest there is little evidence that Reglan or Domperidone actually help women make more milk. In 2011, the American Academy of Breastfeeding Medicine published a report that found not evidence linking the drugs to increased prolactin, milk production, or volume of milk. They also noted that other studies of the drugs for breastfeeding were of poor quality.

Public pressure is increasing on new mothers to breastfeed their babies. New York City Mayer Michael Bloomberg has started a campaign to promote breastfeeding — including subway advertisements and banning free samples of formula in maternity wards.

Research suggests that the nutrients in breast-milk prevent illnesses and infections in an infant. Early breast milk contains a thick yellow substance called colostrum, which is rich in nutrients and antibodies. Within a few days, colostrum changes into mature breast milk, which contains a combination of fat, sugar, water, and protein. Breast-milk is also easier to digest than formula.

Despite the benefits, a study published in Pediatrics in June 2012 found that many women fall short of their breastfeeding goals, which may be one reason why some women start using breastfeeding drugs. The study found that while 85% of new mothers planned on exclusive breastfeeding for at least three months, just 32% actually did, and 40% breastfed exclusively for less than one month.


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