Exploring the Prescribing Process of Domperidone for Low Milk Supply: A Qualitative Study Among Mothers, IBCLCs, and Family Doctors.
Lara A Tauritz Bakker, Liset van Dijk, Patricia M L A van den Bemt
PMID 33180685WHAT IT FOUND
Mothers and lactation consultants said a published domperidone protocol made family doctors more willing to prescribe, but doctors often skipped history, exam, ECG, and follow-up; some mothers used higher doses or imported pills.
Key findings
01Giving family doctors the published domperidone protocol made them less reluctant to prescribe it for low milk supply.
02All but one of 13 family doctors said they did not know domperidone could be used for lactation before a mother asked.
03Of 17 mothers prescribed domperidone, 13 had no ECG.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Participants were recruited through a website and social media, and mothers were selected by convenience, so they may not represent all mothers, lactation consultants, or family doctors. The study only included mothers advised domperidone after the 2016 protocol, so it says nothing about mothers who were refused before that time or never asked. It reports what participants said they did or experienced, not observed prescribing, verified medical records, or measured milk supply outcomes. 50% of interviewed mothers worked in health care, which may have affected how they sought domperidone and how doctors responded. Pharmacists were not included, although they influenced dosing and dispensing in the described process. Nurses were not participants, although maternity and pediatric nurses were mentioned in some prescribing conversations. The study was in the Netherlands and treated a journal article as a national protocol, and it is unclear whether doctors accepted it as such.
Declared interests
The first author was a final-year medical student, and the study was her compulsory research project for an MD degree. The other authors declared no conflicts, and there was no financial support.
The easy way to misread this
Do not read mothers' reports of full milk supply as proof domperidone worked. This study explored experiences and prescribing processes, not verified treatment outcomes, and family doctors did not evaluate whether domperidone was working.