1) Example 1: When domperidone use is unlikely to benefit the baby
Consider a mother of a two-month-old baby who has a very low milk supply and can only make 250 millilitres (8 U.S. fluid ounces) a day. Even if domperidone increased her milk supply by 20%, she would still make only 300 ml (10 oz) a day. Her baby needs roughly 800 ml (27 oz) each day to grow well and would still need about 500 ml (17 oz) of milk supplement.
The increase in the mother’s milk production would not substantially decrease the amount of supplement this baby would need. The medication would have been effective but the benefits for the baby would be very limited. Given the risks of side-effects with medication and the benefits of a small increase in milk production, we would advise this mother to stop the medication.
2) Example 2: When domperidone use would benefit the baby
Consider the same mother. However, if her baby were premature and very small (for example, weighing 2,000 grams or 4 lb 6 oz) and only needed 300 ml (10 oz) of milk a day, the use of domperidone would allow the baby to receive only the mother’s milk and avoid other milk.
In this case, there are definite benefits for the baby. We would recommend that this mother continue with domperidone until it is no longer helpful.