004: Dr. Frank Nice on Domperidone

Breastfeeding Outside the Box

Domperidone is a pharmaceutical medication that can help increase milk production. In this interview, Frank Nice gives us the scoop on "dom". He tells us who might benefit from domperidone and who shouldn't take it. He tells us about common - and some not-so-common side effects. We learn what dosage is ecommended, and how to safely and effectively discontinue using domperidone when the time comes. And of course we discuss the big controversy around domperidone - why it is not currently FDA approved and where we are in the process of getting it approved. ? Listen to Dr. Nice's interview: Here are a few highlights from our interview:

• General dosage of domperidone is 10-20mg 4 times per day or 30mg 3 times per day. Increasing the dosage can further increase milk supply, but dosages greater than 120mg per day rarely result in additional milk production (although a few mothers have found dosages up to 240mg per day are effective).
• Although most mothers who will get a boost in milk production from domperidone notice a difference within a few days, it can take up to 4 weeks for domperidone to have an effect on milk production for some mothers.
• Although risk of cardiac arrythmia is stated by the FDA as a reason they have not approved domperidone, metoclopromide (aka Reglan) has the same very low level of risk and it is FDA approved.
• While domperidone is currently in orphan drug status in route to becoming FDA approved as a medication for breastfeeding mothers, there is also a push for FDA approval for domperidone as a treatment for gastroparesis and this may happen even sooner. Right now, we can expect to wait another 3-4 years before domperidone is FDA approved. ?

Not only is he a wealth of knowledge, Dr. Nice lives up to his name with a huge heart for mamas and babies. We are thrilled to add this amazing interview to our podcast stream. Find out more about Dr. Nice and his work at www.nicebreastfeeding.com About Dr. NiceDr. Frank J. Nice has practiced as a consultant, lecturer, and author on medications and breastfeeding for 40 years. He holds a Bachelor’s Degree in Pharmacy, a Masters Degree in Pharmacy Administration, Masters and Doctorate Degrees in Public Administration, and Certification in Public Health Pharmacy. He retired from the US Public Health Service after 30 years of distinguished service. Dr. Nice practiced at the NIH and served as a Project Manager at the FDA. He recently retired after 43 years of government service and currently is self-employed as a consultant and President, Nice Breastfeeding LLC (www.nicebreastfeeding.com).Dr. Nice has published Nonprescription Drugs for the Breastfeeding Mother, 2nd Edition and The Galactogogue Recipe Book. Dr. Nice has also authored over four dozen peer-reviewed articles on the use of prescription medications, Over-the-Counter (OTC) products, and herbals during breastfeeding, in addition to articles and book chapters on the use of power, epilepsy, and work characteristics of health care professionals. He has organized and participated in over 50 medical missions to the country of Haiti. Dr. Nice continues to provide consultations, lectures, and presentations to the breastfeeding community and to serve the poor of Haiti.