Domperidone: Stopping

1. When you are ready to start weaning from the domperidone, drop one pill, so that now, instead of nine pills a day, you will be taking eight.

2. Wait four or five days, a week if you wish. If you see no change in your milk supply, drop another pill.

3. Wait another four or five days. If you see no change in your milk supply, drop another pill.

4. Continue in this way until you are down to no pills a day. If there has been no decrease in your milk supply, or if there has been a small decrease that does not affect the breastfeeding and baby's weight gain, that's just what we hope to have happened, and many mothers manage this.

  • If, however, your supply diminishes significantly, return to the previous effective dose and do not drop any pills for a couple of weeks at least.
  • If you are keen to go off the domperidone, after a couple of weeks on the same dose, start dropping a pill a day, as in step 1 above. Some mothers, who were not able to get off the domperidone with steps 1-4 above the first time, can do it the second or the third time.
  • You may find that you have to continue a certain dose to maintain your milk supply. But following steps 1-4 above will get you to the lowest effective dose.

It is possible, however, that after two weeks of taking domperidone, you are not where you want to be. In that case, you should continue using the domperidone. If you are still not where you want to be after two to six weeks of domperidone, it is time to think some more about the domperidone.

If you are supplementing, and have managed to reduce the amount of supplement from 400 ml to 300 ml (14 ounces to 10 ounces), is it really worth taking a drug in order to do this? I would say yes, but this is up to you. If you feel it is, then continue with the domperidone, but try weaning the number of pills down to minimum number that maintain your milk supply, as above.

If you do not feel it is worth it, try weaning down as above, and if you don't see any change once you get to no pills a day, fine. However, if you do notice a real change in the milk supply as you lower the dose, maybe the domperidone is more effective than you had thought (remember, after several weeks, your baby is significantly heavier, and it may be that instead of needing 400 ml (14 ounces) without domperidone, the baby might actually need 20 ounces to maintain good weight gain, in which case the domperidone is actually doing something).

Remember: Before using domperidone, the breastfeeding should be fixed, and as quickly as possible. This means:

  • Getting the best latch possible. This alone may result in the baby getting enough milk.
  • Using compressions to increase milk intake by the baby.
  • "Finish" one side before offering the other (see Protocol for Managing Breastmilk Intake) for an explanation on how to know the baby is getting milk and the video clips on our website) to help you identify good drinking.
  • Do not limit the baby to one side if the baby is not getting enough. Switch to the other side once the baby is no longer getting milk even with the compressions.
  • Switch back and forth, as long as the baby is getting good amounts of milk.
  • Follow the Protocol for Managing Breastmilk Intake.

    Questions? Get Dr. Jack Newman's book The Ultimate Breastfeeding Book of Answers.

    Jack NewmanJack Newman graduated from the University of Toronto medical school as a pediatrician in 1970. He started the first hospital-based breastfeeding clinic in Canada in 1984 at Toronto's Hospital for Sick Children. He has been a consultant with UNICEF for the Baby Friendly Hospital Initiative in Africa, and has published articles on the subject of breastfeeding in Scientific American and several medical journals. Dr. Newman has practiced as a physician in Canada, New Zealand, and South Africa.

    Written & revised (under other names) by Jack Newman, MD, FRCPC, 1995-2005©
    Revised by Jack Newman MD, FRCPC, IBCLC & Edith Kernerman, IBCLC, 2008, 2009©