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Longer-term breastfeeding outcomes associated with domperidone use for lactation differs according to maternal weight

  • Pharmacoepidemiology and Prescription
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Abstract

Purpose

To examine differences in longer-term breastfeeding outcomes among mothers of preterm infants according to domperidone exposure status, as well as examine the potential for effect modification according to maternal weight.

Methods

Retrospective cohort study of 198 mothers of very preterm infants (born ≤ 30 weeks’ gestation) who initiated breastfeeding and whose infants survived until hospital discharge. Data on domperidone use were obtained from hospital pharmacy records, with the primary outcome defined as continuation of breastfeeding at infant discharge from the Neonatal Unit. The relationship between domperidone exposure and breastfeeding status was investigated using multivariable regression analysis, adjusting for potential confounders. Additional pre-determined analyses were undertaken following stratification according to maternal weight to investigate the presence of effect modification.

Results

No overall difference was observed in the proportion of mothers continuing to breastfeed at the time of infant discharge from the Neonatal Unit according to whether or not they received domperidone (aRR 0.99; 0.86–1.13). Notably, effect modification was observed according to maternal weight, with use of domperidone associated with a reduced likelihood of breastfeeding at discharge among women ≥ 70 kg (aRR 0.72; 0.54–0.97), but not among those < 70 kg (aRR 1.16; 0.92–1.46).

Conclusions

Despite experiencing low milk supply, longer-term breastfeeding outcomes were similar between women who did and did not use domperidone. Differences in domperidone effectiveness according to maternal weight have important implications for clinical practice given the increasing prevalence of overweight/obesity in reproductive-age women and their higher risk of low milk supply, highlighting the importance of further research in this area.

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Funding

LEG receives salary support through an Australian National Health and Medical Research Council (NHMRC) Early Career Fellowship (APP1070421). LHA receives salary support through an Australian National Health and Medical Research Council (NHMRC) Translating Research into Practice Fellowship (APP1132522). Funders had no role in any aspects of the study.

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Authors and Affiliations

  1. Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia

    Luke E. Grzeskowiak & Lisa G. Smithers

  2. Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia

    Luke E. Grzeskowiak

  3. SA Pharmacy, Flinders Medical Centre, SA Health, Adelaide, SA, Australia

    Luke E. Grzeskowiak

  4. Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia

    Lisa H. Amir

  5. School of Public Health, University of Adelaide, Adelaide, SA, Australia

    Lisa G. Smithers

Authors
  1. Luke E. Grzeskowiak
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  2. Lisa H. Amir
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  3. Lisa G. Smithers
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Corresponding author

Correspondence to Luke E. Grzeskowiak.

Ethics declarations

The study was approved by the Women’s and Children’s Health Network Human Research Ethics Committee.

Conflict of interest

The authors declare that they have no conflict of interest.

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Cite this article

Grzeskowiak, L.E., Amir, L.H. & Smithers, L.G. Longer-term breastfeeding outcomes associated with domperidone use for lactation differs according to maternal weight. Eur J Clin Pharmacol 74, 1071–1075 (2018). https://doi.org/10.1007/s00228-018-2470-0

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  • DOI: https://doi.org/10.1007/s00228-018-2470-0

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