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Ryan RA, Bihuniak JD, Lyndon A, Hepworth AD. Information Seeking Behavior and Strategies to Increase Milk Supply Among Breastfeeding Mothers in the United States. Breastfeed Med 2024; 19:378-386. [PMID: 38488105 DOI: 10.1089/bfm.2024.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
Background: Some breastfeeding mothers try to increase their milk supply through pharmaceutical, dietary, and behavioral strategies that vary in effectiveness. Information seeking behaviors may influence which strategies mothers use. Objective: To describe where mothers obtain information about increasing milk supply, describe the perceived influence of each information source on decision-making about strategies for increasing milk supply, and explore associations between information sources and mothers' use of galactagogues (i.e., pharmaceutical and dietary strategies) and behavioral strategies. Methods: Women who were currently breastfeeding and living in the United States were recruited through Facebook advertisements to complete an online survey between December 2020 and February 2021. Descriptive statistics were calculated, and chi-square tests compared participants' use of galactagogues and behavioral strategies by information sources. Results: Participants were 1,351 breastfeeding mothers (81% non-Hispanic white; 47% first-time breastfeeding; 21% Special Supplemental Nutrition Program for Women, Infants, and Children participants). Nearly all participants (97%) obtained information about increasing milk supply from at least one source, most commonly lactation consultants (68%), Facebook (61%), search engines (50%), websites (47%), and nurses (41%). There was high variability in the perceived influence of each source on decision-making. Galactagogue use was higher among participants who obtained information from the internet (Yes: 68% vs. No: 43%, p < 0.000), social media (Yes: 65% vs. No: 40%, p < 0.000), family and friends (Yes: 65% vs. No: 53%, p < 0.000), and lactation consultants (Yes: 63% vs. No: 54%, p < 0.002). Behavioral strategies were more commonly reported among participants who accessed these same sources, maternal health care professionals (Yes: 98% vs. No: 91%, p < 0.000), and pediatricians (Yes: 98% vs. No: 94%, p = 0.001). Conclusion: Breastfeeding mothers commonly obtained information about increasing milk supply from a variety of sources. Information sources accessed were associated with mothers' use of galactagogues and behavioral strategies for increasing milk supply.
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Affiliation(s)
- Rachel A Ryan
- Public Health Nutrition, School of Global Public Health, New York University, New York, New York, USA
- Department of Nutrition and Food Studies, New York University, New York, New York, USA
| | - Jessica Dauz Bihuniak
- Department of Nutrition and Food Studies, New York University, New York, New York, USA
| | - Audrey Lyndon
- NYU Rory Meyers College of Nursing, New York, New York, USA
| | - Allison Doub Hepworth
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
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Ryan RA, Hepworth AD, Bihuniak JD, Lyndon A. A Qualitative Study of Breastfeeding Experiences Among Mothers Who Used Galactagogues to Increase Their Milk Supply. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:122-132. [PMID: 38159094 DOI: 10.1016/j.jneb.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To qualitatively describe breastfeeding experiences among mothers who used galactagogues to increase their milk supply. DESIGN One-time, semistructured phone interviews. SETTING US. PARTICIPANTS Breastfeeding mothers (n = 19) who reported ever consuming foods, beverages, or herbal supplements to increase their milk supply in a cross-sectional online survey were purposefully sampled to participate in this qualitative study. Participants were diverse in terms of race and ethnicity, education, income, infant age (0-18 months), and prior breastfeeding experience (32% first-time breastfeeding). PHENOMENON OF INTEREST Reasons for trying to increase milk supply, sources of information about increasing milk supply, and strategies tried to increase milk supply. ANALYSIS Interviews were transcribed verbatim and analyzed using reflexive thematic analysis. RESULTS Participants expressed determination and commitment to breastfeeding but unexpectedly struggled to breastfeed and increase their milk supply. They sought information from multiple sources and used individualized approaches to address milk supply concerns on the basis of recommendations from others, as well as the perceived convenience, cost, palatability, and safety of potential strategies. CONCLUSIONS AND IMPLICATIONS Results suggest a need to expand breastfeeding education and support so that lactating parents anticipate common breastfeeding challenges and are aware of evidence-based strategies for increasing their milk supply.
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Affiliation(s)
- Rachel A Ryan
- Department of Nutrition and Food Studies, New York University, New York, NY; Public Health Nutrition, School of Global Public Health, New York University, New York, NY.
| | | | | | - Audrey Lyndon
- Rory Meyers College of Nursing, New York University, New York, NY
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Kam RL, Bennetts SK, Cullinane M, Amir LH. "I didn't want to let go of the dream": Exploring women's personal stories of how their low milk supply was discovered. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 40:100953. [PMID: 38437771 DOI: 10.1016/j.srhc.2024.100953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 03/06/2024]
Abstract
PROBLEM Low milk supply is the most common reason women give for stopping breastfeeding early and yet there is a lack of understanding about these women's experiences. BACKGROUND Most women plan to breastfeed but many experience challenges such as low milk production, leading them to seek help and support. AIM To explore women's personal stories of how their low supply was discovered. METHODS Inductive template analysis was used to analyse free-text online survey responses of women from the United States of America, Australia and the United Kingdom. FINDINGS 384 women responded to the open-ended survey item between October 2021 and January 2022. We identified three themes: (i) Events and observations: From 'risk factors' to 'failure of breast changes' to 'my baby was so unhappy', (ii) Seeking support and taking action: 'I tried everything' and (iii) A rollercoaster of emotion: 'I didn't want to let go of the dream'. DISCUSSION Our findings emphasise women's need to feel heard and understood and their quest to find answers. The rollercoaster of emotions they experienced largely stemmed from a gap between the expectations and reality of breastfeeding. Some participants described accepting a different feeding journey. CONCLUSION Findings underscore the need for quality and accessible psychosocial support for women experiencing low milk supply, in addition to the provision of evidence-based advice.
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Affiliation(s)
- Renee L Kam
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia.
| | - Shannon K Bennetts
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia; Intergenerational Health Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Meabh Cullinane
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Lisa H Amir
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia; Intergenerational Health Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Breastfeeding Service, The Royal Women's Hospital, Parkville, Victoria, Australia
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McBride GM, Rumbold AR, Keir AK, Kunnel A, Buxton M, Jones S, Summers L, Stark M, Grzeskowiak LE. Longitudinal trends in domperidone dispensing to mothers of very preterm infants and its association with breast milk feeding at infant discharge: a retrospective study. BMJ Paediatr Open 2023; 7:e002195. [PMID: 37923344 PMCID: PMC10626788 DOI: 10.1136/bmjpo-2023-002195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/29/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVE This study aims: (a) to evaluate patterns of domperidone dispensing to mothers of very preterm (<32 weeks gestation) infants born before and after 2014 when international recommendations were made to limit its use and (b) to examine characteristics associated with domperidone dispensing and impacts on breast milk feeding rates at infant hospital discharge. DESIGN Retrospective audit using linked electronic medical records and hospital pharmacy records. SETTING Tertiary-referral neonatal intensive care unit at the Women's and Children's Hospital in South Australia. PATIENTS Mothers of preterm infants admitted to neonatal intensive care from January 2004 to December 2018. MAIN OUTCOME MEASURES Rate of domperidone dispensing compared pre-2014 and post-2014 recommendations using interrupted time series analyses, and breast milk feeding rates at infant discharge based on domperidone treatment status, adjusted for other factors known to influence breast milk production. RESULTS Overall, domperidone was dispensed to 691 (41%) of 1688 mothers. Prior to 2014 recommendations, the proportion of women dispensed domperidone was stable. Following the recommendations, there was a significant reduction in trend (-2.55% per half year, 95% CI -4.57% to -0.53%;), reflecting less domperidone dispensing.Breast milk feeding rates at discharge remained consistently lower in infants of women dispensed domperidone than those who were not (adjusted OR 0.58, 95% CI 0.45 to 0.75). CONCLUSION Domperidone dispensing in mothers of hospitalised very preterm infants has declined over time following international regulatory warnings. Breast milk feeding rates remain lower in mothers prescribed domperidone, suggesting further research is needed to optimise lactation support for mothers of very preterm infants.
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Affiliation(s)
- Grace McKenzie McBride
- The University of Adelaide, Robinson Research Institute, North Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia
| | - Alice R Rumbold
- The University of Adelaide, Robinson Research Institute, North Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia
| | - Amy K Keir
- South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia
- Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Aline Kunnel
- South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia
| | - Michael Buxton
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
| | - Susanne Jones
- South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia
- Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Laura Summers
- South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia
- Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Michael Stark
- The University of Adelaide, Robinson Research Institute, North Adelaide, South Australia, Australia
- Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Luke E Grzeskowiak
- South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia
- Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia
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Gökduman-Keleş M, Akdolun-Balkaya N, Toker E. Attitudes and counselling of healthcare professionals on increasing breast milk: cross-sectional study. ENFERMERIA CLINICA (ENGLISH EDITION) 2023:S2445-1479(23)00022-X. [PMID: 37060944 DOI: 10.1016/j.enfcle.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/05/2023] [Indexed: 04/17/2023]
Abstract
OBJECTIVE To determine the breast milk-increasing practices healthcare professionals used with their children and their recommendations to mothers. METHOD A descriptive cross-sectional study in a Mediterranean region of Turkey. It was carried out with 301 healthcare professionals working in 64 Family Health Centers between January and June 2018. The data were collected by the researchers with a questionnaire including 28 questions. RESULTS The mean age of healthcare professionals was 36.89 ± 8.5. All the healthcare professionals encountered mothers with the perception of insufficient breast milk. 73.7% of those with children had breast milk-increasing practices. Increased age negatively affected these practices (OR: 0.923), and increased education positively affected the practices (OR: 3.489). Having received training on breastfeeding and breast milk-increasing measures positively affected the use of practices (OR: 2.118). The use of breast milk-increasing practices by healthcare professionals positively affected their recommendations to mothers (OR: 2.506). CONCLUSIONS Health professionals had their own breast milk boosting practices that they recommended to women as well. This result is especially significant in terms of guiding mothers who wish to increase breast milk supply and seek reliable information and contributes to the protection of maternal and newborn health.
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Affiliation(s)
| | - Nevin Akdolun-Balkaya
- Faculty of Health Sciences, Division of Nursing, Department of Obstetrics and Gynecologic Nursing, Muğla, Turkey.
| | - Eylem Toker
- Tarsus University Faculty of Health Sciences Department of Midwifery, Tarsus/Mersin, Turkey.
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McBride GM, Stevenson R, Zizzo G, Rumbold AR, Amir LH, Keir A, Grzeskowiak LE. Women's experiences with using domperidone as a galactagogue to increase breast milk supply: an australian cross-sectional survey. Int Breastfeed J 2023; 18:11. [PMID: 36750944 PMCID: PMC9903405 DOI: 10.1186/s13006-023-00541-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/07/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Domperidone is one of the most commonly utilised pharmacological galactagogues, with evidence of increasing use in clinical practice. However, the use of domperidone as a galactagogue remains controversial, with mixed evidence on safety and efficacy, leading to variable clinical practice recommendations. We sought to evaluate contemporary patterns of domperidone use and examine maternal experiences related to perceived safety and effectiveness. METHODS In 2019, we conducted an online, cross-sectional survey of Australian breastfeeding women to examine individual experiences related to domperidone use, in addition to perceptions of safety and effectiveness. RESULTS Among 1876 survey responses, 19% (n = 355) reported using domperidone. Domperidone use was significantly higher in women who were primiparous, gave birth preterm, delivered by caesarean section, had self-perceived low milk supply, and saw a lactation consultant. Nearly 20% of women commenced domperidone use in the first week postpartum (19%, n = 67). The median duration of use was six weeks (interquartile range 3-16 weeks). Maximum reported doses of domperidone used ranged from 20 mg/day to 160 mg/day. Half (n = 178, 50%) of women reported using a dose of 30 mg/day or less, 44% (n = 155) reported using a dose between 31 and 60 mg/day, and 6% (n = 22) reported using a dose greater than 61 mg/day. Nearly half of the respondents reported domperidone as 'very' or 'extremely effective' (45%, n = 161), with only 8% (n = 27) reporting it was 'not at all effective'. Almost half (n = 172, 48%) of all women using domperidone reported side effects, including weight gain (25%), headaches (17%) and dry mouth (13%). Higher doses were associated with an increased likelihood of any side effects (≤ 30 mg/day, 38%; >31-≤60 mg/day, 48%, > 61 mg/day 73%; P < 0.004), with 31 (9%) stopping domperidone because of side effects. CONCLUSION We identified widespread variation in domperidone utilisation patterns, with domperidone broadly perceived to be effective in increasing breast milk supply. Side effects associated with domperidone treatment were common, appeared to be dose-related, and were frequently associated with treatment cessation. These findings highlight the importance of improved clinical practice recommendations and generation of evidence from additional high-quality clinical trials evaluating the efficacy and safety of domperidone. More conclusive clinical trials are needed to determine the efficacy, as well as optimal dose and duration, of domperidone use.
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Affiliation(s)
- Grace M. McBride
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia ,grid.430453.50000 0004 0565 2606SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Robyn Stevenson
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia
| | - Gabbie Zizzo
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia
| | - Alice R. Rumbold
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia ,grid.430453.50000 0004 0565 2606SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Lisa H. Amir
- grid.1018.80000 0001 2342 0938Judith Lumley Centre, La Trobe University, Melbourne, Australia ,grid.416259.d0000 0004 0386 2271Breastfeeding Service, Royal Women’s Hospital, Parkville, Australia
| | - Amy Keir
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia ,grid.430453.50000 0004 0565 2606SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Luke E. Grzeskowiak
- grid.1010.00000 0004 1936 7304Adelaide Medical School, Robinson Research Institute, University of Adelaide , Adelaide, Australia ,grid.430453.50000 0004 0565 2606SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia ,grid.467022.50000 0004 0540 1022SA Pharmacy, SA Health, Adelaide, Australia ,grid.1014.40000 0004 0367 2697College of Medicine and Public, Flinders Health and Medical Research Institute Flinders University, GPO Box 2100, SA 5001 Adelaide, Australia
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McBride GM, Stevenson R, Zizzo G, Rumbold AR, Amir LH, Keir AK, Grzeskowiak LE. Knowledge of Galactagogue Use During Breastfeeding in Australia: A Cross Sectional Online Survey. J Hum Lact 2022; 38:740-748. [PMID: 35236166 DOI: 10.1177/08903344221077131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Galactagogues have been used for centuries to induce, maintain, or increase a mother's milk supply. Recently, there has been an apparent increase in utilization and promotion of galactagogues, largely in the absence of data regarding their efficacy and safety. However, there is limited contemporary evidence about knowledge of these substances in the community or how and where individuals seek information. RESEARCH AIM To evaluate knowledge about galactagogue use during breastfeeding among birth parents, including recognition of specific substances, perceptions of safety, and common information sources. METHOD An online, prospective, cross-sectional survey of Australian birthing parents (N = 2055) who were currently breastfeeding or had previously breastfed their infants was conducted from September to December 2019. The survey included questions about recognition of galactagogues, perceptions of safety, and information-seeking behaviors. RESULTS Among participants, 47% (n = 882) were primiparous and 65% (n = 1,219) were currently breastfeeding. The most recognized galactagogues included lactation cookies (89%; n = 1,828), brewer's yeast (79%; n = 1,629), fenugreek (74%; n = 1,519), and domperidone (69%; n = 1,420). Respondents cited the internet (52%; n = 1,066), lactation support providers (46%; n = 951), midwives (42%; n = 873), general practitioners (39%; n = 802), and social media (35%; n = 714) as common information sources. Lactation support providers and breastfeeding helplines were commonly rated as helpful; whereas, general practitioners and community pharmacists were often rated as unhelpful. While most participants perceived galactagogues to be safe, herbal or dietary galactagogues were perceived to be safer than pharmaceutical galactagogues. CONCLUSIONS Our Australian community survey of individuals with current or previous breastfeeding experience identified widespread recognition of galactagogue use, with participants reporting a broad range of information-seeking behaviors and generally perceiving galactagogues as being safe to use.
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Affiliation(s)
- Grace McKenzie McBride
- Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Robyn Stevenson
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Gabriella Zizzo
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Alice R Rumbold
- Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Robinson Research Institute, University of Adelaide, Adelaide, Australia.,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Lisa H Amir
- Judith Lumley Centre, La Trobe University, Bundoora, Australia.,Breastfeeding Service, Royal Women's Hospital, Parkville, Australia
| | - Amy K Keir
- Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Robinson Research Institute, University of Adelaide, Adelaide, Australia.,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Luke Edward Grzeskowiak
- Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Robinson Research Institute, University of Adelaide, Adelaide, Australia.,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia.,SA Pharmacy, SA Health, Adelaide, Australia.,Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
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8
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Tan ML, Foong SC, Foong WC, Ho JJ. Use of Galactagogues in a Multi-Ethnic Community in Southeast Asia: A Descriptive Study. Int J Womens Health 2022; 14:1395-1404. [PMID: 36172202 PMCID: PMC9512541 DOI: 10.2147/ijwh.s366288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 08/15/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose Galactagogues are substances that increase breast-milk production. They can be medication, herbs or food. Use of galactagogues may be different among the major ethnic groups in Malaysia. The primary objective of this cross-sectional study is to determine the prevalence of galactagogues use among breastfeeding mothers in a multi-ethnic community. Patients and Methods Self-administered questionnaires were distributed between November 2016 and January 2017 to mothers attending the health clinics and private hospital paediatric clinics in Penang, Malaysia, whose infants were below 6 months of age. The questionnaire enquired about use of galactagogues, types of galactagogue used, perceived effectiveness and sources of information. It also asked mothers about what they would do to increase milk supply. Results We analyzed 322 out of 530 questionnaires distributed where 76% of mothers reported use of galactagogues; most of which were food-based: dates (66%), oats (58%) and soya bean (56%). Each major ethnic group had a different preference for galactagogues: Malays (dates), Chinese (soya bean) and Indians (oats). Only one mother used pharmacological galactagogues alone. Galactagogues were perceived to be effective by 65% of mothers who used them. Multivariate analysis showed that use of galactagogues was not related to ethnicity, education, work, perception of milk supply or use of formula milk. The most common source of information on galactagogues came from family and friends. Conclusion Use of galactagogues is common in our population, especially food-based ones, and the choice of galactagogues differs by ethnicity. Future studies on efficacy and safety galactagogues should be focused these commonly used ones. There is also a need for qualitative studies to improve our understanding of why they are widely used in this region.
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Affiliation(s)
- May Loong Tan
- Department of Pediatrics, RCSI & UCD Malaysia Campus, George Town, Penang, Malaysia
| | - Siew Cheng Foong
- Department of Pediatrics, RCSI & UCD Malaysia Campus, George Town, Penang, Malaysia
| | - Wai Cheng Foong
- Department of Pediatrics, RCSI & UCD Malaysia Campus, George Town, Penang, Malaysia
| | - Jacqueline J Ho
- Department of Pediatrics, RCSI & UCD Malaysia Campus, George Town, Penang, Malaysia
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Zizzo G, Rumbold AR, Grzeskowiak LE. "Fear of stopping" vs "wanting to get off the medication": exploring women's experiences of using domperidone as a galactagogue - a qualitative study. Int Breastfeed J 2021; 16:92. [PMID: 34886887 PMCID: PMC8656031 DOI: 10.1186/s13006-021-00438-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/16/2021] [Indexed: 11/10/2022] Open
Abstract
Background Domperidone is the most frequently prescribed medicine used to increase breast milk supply. There is considerable controversy surrounding the use of domperidone in lactation, due to limited evidence about efficacy and concerns about rare but life-threatening side-effects. Despite this, in many high-income settings such as Australia, use of domperidone among breastfeeding mothers appears to be increasing. The aim of this paper was to explore women’s experiences of using domperidone during breastfeeding. Methods Semi-structured interviews were conducted in 2019 with 15 women in Australia who reported using domperidone as a galactagogue during breastfeeding. Interviews were recorded, transcribed and analysed thematically. Results Women reported a wide variety of practices concerning the timing of initiation of domperidone use, including prophylactic use, as well as the dose and duration of use. Prolonged periods of use and unsupervised dosing were commonly reported, these practices were sometimes associated with a fear of the consequences of stopping, insufficient provision of information about the drug or feeling dismissed by health professionals. Some women indicated that when doctors refused to prescribe domperidone they responded by doctor shopping and seeking anecdotal information about benefits and risks online, leading to unsupervised practices. Women often reported high expectations surrounding the effectiveness of domperidone, and most used the medication in conjunction with food/herbal galactagogues and non-galactagogue support. Positive outcomes following domperidone use included having greater confidence in breastfeeding and pride at achieving breastfeeding goals. Conclusions This study identified a variety of practices concerning domperidone use, including potentially unsafe practices, linked in some cases to inconsistent advice from health professionals and a reliance on online, anecdotal information sources. These findings emphasise the urgent need for development of clinical practice guidelines and a greater focus on translating existing evidence concerning domperidone into clinical practice, including clinical support that is tailored to women’s needs.
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Affiliation(s)
- Gabriella Zizzo
- Faculty of Health and Medical Science, The University of Adelaide, Adelaide, Australia
| | - Alice R Rumbold
- Faculty of Health and Medical Science, The University of Adelaide, Adelaide, Australia.,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Luke E Grzeskowiak
- Faculty of Health and Medical Science, The University of Adelaide, Adelaide, Australia. .,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia. .,Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia. .,SA Pharmacy, SA Health, Adelaide, Australia.
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10
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McBride GM, Stevenson R, Zizzo G, Rumbold AR, Amir LH, Keir AK, Grzeskowiak LE. Use and experiences of galactagogues while breastfeeding among Australian women. PLoS One 2021; 16:e0254049. [PMID: 34197558 PMCID: PMC8248610 DOI: 10.1371/journal.pone.0254049] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/19/2021] [Indexed: 02/05/2023] Open
Abstract
Background Galactagogues are substances thought to increase breast milk production, however evidence to support their efficacy and safety remain limited. We undertook a survey among Australian women to examine patterns of use of galactagogues and perceptions regarding their safety and effectiveness. Methods An online, cross-sectional survey was distributed between September and December 2019 via national breastfeeding and preterm birth support organisations, and networks of several research institutions in Australia. Women were eligible to participate if they lived in Australia and were currently/previously breastfeeding. The survey included questions about galactagogue use (including duration and timing), side effects and perceived effectiveness (on a scale of 1 [Not at all effective] to 5 [Extremely effective]). Results Among 1876 respondents, 1120 (60%) reported using one or more galactagogues. Women were 31.5 ± 4.8 years (mean ± standard deviation) at their most recent birth. Sixty-five percent of women were currently breastfeeding at the time of the survey. The most commonly reported galactagogues included lactation cookies (47%), brewer’s yeast (32%), fenugreek (22%) and domperidone (19%). The mean duration of use for each galactagogue ranged from 2 to 20 weeks. Approximately 1 in 6 women reported commencing galactagogues within the first week postpartum. Most women reported receiving recommendations to use herbal/dietary galactagogues from the internet (38%) or friends (25%), whereas pharmaceutical galactagogues were most commonly prescribed by General Practitioners (72%). The perceived effectiveness varied greatly across galactagogues. Perceived effectiveness was highest for domperidone (mean rating of 3.3 compared with 2.0 to 3.0 among other galactagogues). Over 23% of domperidone users reported experiencing multiple side effects, compared to an average of 3% of women taking herbal galactagogues. Conclusions This survey demonstrates that galactagogues use is common in Australia. Further research is needed to generate robust evidence about galactagogues’ efficacy and safety to support evidence-based strategies and improve breastfeeding outcomes.
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Affiliation(s)
- Grace M. McBride
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Robyn Stevenson
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Gabriella Zizzo
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Alice R. Rumbold
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Lisa H. Amir
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
- Breastfeeding Service, Royal Women’s Hospital, Parkville, Australia
| | - Amy K. Keir
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Luke E. Grzeskowiak
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
- The Robinson Research Institute, University of Adelaide, Adelaide, Australia
- South Australian Health and Medical Research Institute, Adelaide, Australia
- SA Pharmacy, SA Health, Adelaide, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
- * E-mail:
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