I have just submitted the following letter to Health Canada in response to the recent domperidone advisory. If you are interested please read the consensus statement we composed and attached to this letter.
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I am writing on behalf of the authors and endorsers of the attached paper entitled ‘A Consensus Statement on the Use of Domperidone To Support Lactation’. The statement can also be found online at http://kindercarepediatrics.
We are 22 Health Professionals – Physicians, Lactation Consultants, Nurses, Researchers, Epidemiologist – with specialized expertise in supporting breastfeeding mothers and babies. We have concerns about the advisory statement regarding domperidone which you endorsed – http://www.hc-sc.gc.ca/dhp-
For over 20 years, Canadian physicians have prescribed domperidone as a galactagogue to support milk production in mothers struggling to breastfeed. Since the advisory’s release, physicians have expressed significant fear of prescribing the medication. When prescribed, pharmacists have been reticent to fill the prescriptions. There is a risk that this advisory will adversely impact Canada’s breastfeeding rates. Please review the attached consensus statement which reflects our efforts to meaningfully address this concerning situation.
In submitting this consensus statement, we would like to achieve the following 3 goals:
1) Critically evaluate the papers to which the advisory statement refers.
2) Promote and encourage high quality scientific research to better understand the safety and efficacy of domperidone when used to support breastfeeding.
3) Define a national standard of care for the use of domperidone as a galactagogue.
It is our hope that after reading this document you will consider revising the advisory. More specifically, please consider addressing the risks, or lack thereof, associated with domperidone when used solely to support lactation.
Yours sincerely,
Daniel Flanders, MD FRCPC.
On behalf of:
Dr. Yoel Abels, MD MHSc CCFP FCFP. Department of Family and Community
Medicine, University of Toronto. Medical Director, Forest Hill Family
Health Centre. Toronto, ON.
Dr. Elizabeth Asztalos, MD MSc FRCPC. Director, Neonatal Follow-up
Programme, Division of Neonatology, University of Toronto. Director,
The Centre for Mother, Infant, and Child Research, Sunnybrook Research
Institute, Sunnybrook Health Sciences Centre. EMPOWER investigator.
Toronto, ON.
Marsha Campbell Yeo, PhD NNP-BC. Maternal and Newborn Program , IWK
Health Centre. EMPOWER investigator. Halifax, NS.
Lenore Goldfarb, PhD CCC IBCLC. Herzl Family Practice Centre –
Goldfarb Breastfeeding Clinic, Jewish General Hospital. Montreal, PQ.
Dr. Michael Kramer, MD. Professor, Departments of Pediatrics, and of
Epidemiology, Biostatistics and Occupational Health. McGill
University, Faculty of Medicine, Montreal, PQ.
Dr. Orlando da Silva, MD MSc FRCPC. Associate Professor, Department of
Paediatrics, Division of Neonatal-Perinatal Medicine. Children’s
Hospital, London Health Sciences Centre. London, ON.
Dr. Hilary de Veber, MD FRCPC. Newman Breastfeeding Clinic, Toronto, ON.
Carole Dobrich, RN IBCLC. Herzl Family Practice Centre – Goldfarb
Breastfeeding Clinic, Jewish General Hospital. Montreal, PQ.
Dr. Daniel Flanders, MD FRCPC. Lecturer, Department of Pediatrics,
University of Toronto, Faculty of Medicine. Newman Breastfeeding
Clinic. Toronto, ON.
Edith Kernerman, IBCLC. Co-Director, Newman Breastfeeding Clinic. Toronto, ON.
Lynda Kirby, IBCLC. Better Breastfeeding Clinic, Toronto, ON.
Dr Cathryn Kuzyk, MD. Foothills Breastfeeding Clinic, Calgary, AB.
Dr. Aviva Lowe, MD FRCPC. Newman Breastfeeding Clinic. Toronto, ON.
Dr. Howard Mitnick, MDCM. Faculty Lecturer, Department of Family
Medicine, McGill University. Herzl Family Practice Centre – Goldfarb
Breastfeeding Clinic, Jewish General Hospital. Montreal, PQ.
Dr. Jack Newman, MD FRCPC. Assistant Professor, Department of
Pediatrics, Faculty of Medicine, University of Toronto. Co-Director,
Newman Breastfeeding Clinic. Toronto, ON.
Dr Graham Pratt, MD. Herzl Family Practice Centre – Goldfarb
Breastfeeding Clinic, Jewish General Hospital. Montreal, PQ.
Dr. Leah Roth, MD FRCPC. Better Breastfeeding Clinic. Toronto, ON.
Dr Mary-Jo Woolgar, MD CCFP IBCLC FCFP. Foothills Breastfeeding
Clinic. Calgary, AB.
Dr Anjana Srinivasan, MDCM CCFP IBCLC. Faculty Lecturer, Department of
Family Medicine, McGill University. Medical Co-Director, Goldfarb
Breastfeeding Clinic – Herzl Family Practice Centre, Jewish General
Hospital. Montreal, PQ.
Dr Meira Stern, MD. Medical Co-Director, Goldfarb Breastfeeding Clinic
– Herzl Family Practice Centre, Jewish General Hospital. Montreal, PQ.
Dr. Eitan Weinberg, MD FRCPC. Newman Breastfeeding Clinic. Toronto, ON.
Dr. Jean Zigby, MD. Herzl Family Practice Centre – Goldfarb
Breastfeeding Clinic, Jewish General Hospital. Montreal, PQ.
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