Efficacy and safety of domperidone and metoclopramide in breastfeeding
women: A systematic review and meta-analysis
Abstract
ABSTRACT Background: Domperidone and metoclopramide are the most
commonly prescribed galactogogues for enhancing milk production, but
evidence supporting their efficacy and safety is contradictory.
Objectives: To evaluate the efficacy and safety of domperidone and
metoclopramide use by breastfeeding women. Search strategy: A systematic
literature retrieval of Medline, Embase, Cochrane Library, PubMed,
EBSCO, Web of Science, ClinicalTrials.gov and additional bibliography
was conducted without time restriction. Selection criteria: Randomised
controlled trials exploring the effects of domperidone and
metoclopramide in breastfeeding women were included. The primary
outcomes were the difference in human milk volume and maternal and
neonatal side effects. Data collection and analysis: Two reviewers
screened, extracted and assessed the eligible trials independently.
Effect size with 95% confidence intervals were presented using random
effect model. Main results: Fifteen studies were included. Pooled
results demonstrated a low to moderate increase in daily human milk
volume of 90.54 mL/day (95%CI 65.69, 115.39), 0.04 mL/day (95%CI
28.85, 28.93) with the use of domperidone and metoclopramide,
respectively. No differences were noted in the incidence of maternal
side effects with domperidone (RR1.20, 95%CI 0.74, 1.97) or
metoclopramide (RR1.23, 95%CI 0.51, 2.94). Additionally, there were no
significant differences in the volume of human milk and maternal side
effects between the domperidone and metoclopramide group. Conclusions:
Domperidone demonstrated a modest increase of 90.54 mL/day in milk
production, and had a lower risk of side effects in mothers and infants,
which could be considered as a suitable choice for breastfeeding women.
Keywords: domperidone; metoclopramide; galactogogues; human milk; side
effects