For many breastfeeding parents, low milk supply can be a deeply emotional and frustrating experience. Whether you're exclusively pumping, nursing a preemie, or trying to relactate, you may have come across domperidone as a potential solution. This medication, originally developed to treat gastrointestinal issues, has been widely used off-label to boost lactation by increasing prolactin levels — the hormone responsible for milk production.
But before starting domperidone — and especially before stopping it — there are some important things to know.
Domperidone is a dopamine antagonist, meaning it blocks dopamine receptors. Since dopamine suppresses prolactin, reducing dopamine can lead to higher prolactin levels — and in turn, more milk production.
Many lactating parents see an increase in supply within a few days to a couple of weeks after starting domperidone. It’s often prescribed when other methods like frequent pumping, skin-to-skin contact, or herbal supplements haven’t had enough of an effect.
In many countries outside the U.S., domperidone is commonly prescribed for lactation support. While it is not approved for this use by the FDA, some U.S. providers still prescribe it through compounding pharmacies or with special protocols. It’s essential to talk with a knowledgeable healthcare provider, especially if you have a history of heart conditions, as domperidone can affect the heart's electrical rhythm (specifically the QT interval).
One of the most crucial — and often overlooked — aspects of taking domperidone is how to stop it.
Do NOT stop domperidone suddenly. This can lead to a rapid drop in prolactin, and in turn, a sudden and sharp decrease in milk supply. Even more concerning, some parents experience withdrawal symptoms such as anxiety, insomnia, or nausea — possibly due to the abrupt change in dopamine levels.
Here’s a general guide (note: always consult with your provider before changing your dosage):
Domperidone can be a valuable tool for increasing milk supply — but it’s not a quick fix, and it should be used with care. Make sure you’re working with a provider who understands both the benefits and the risks, and never stop domperidone cold turkey.
Your breastfeeding journey is uniquely yours, and every decision you make should be grounded in information, support, and compassion — for your baby, and for yourself. Talk to a lactation consultant to gain more information to help you make an informed decision. Whether you opt to proceed or opt NOT to proceed, whatever decision you make is the right decision for you.
Your local lactation consultant, providing support to York Region (Markham, Stouffville, Richmond Hill, Vaughan, Woodbridge, Newmarket and Aurora) and Durham Region (Pickering, Ajax, Oshawa, Whitby).
