1. Introduction
The benefits of breastfeeding are well recognized for both the
mother and baby; thus, efforts should be made to promote
initiation, duration, and exclusivity of breastfeeding [1]. The
recently published survey of Canadian women who gave
birth and were residing with their infants at the time of
the interview has found that breastfeeding intention and
initiating rates were fairly high, 90% and 90.3%, respectively,
among women of this representative sample [2]. However,
reported exclusive breastfeeding rates at three and six months
fell substantially—51.7% and 14.4%. While factors that
affect breastfeeding success are multiple and nonmodifiable
at times, the early recognition and timely management
of modifiable risk factors is warranted to improve lactation
performance [3]. Various nonpharmacological interventions
have been shown to be effective and hence are
incorporated in the current clinical recommendations for
promoting breastfeeding [1]. Among them are individual
and group breastfeeding education provided by lactation
specialists, peer counseling, in-person, or telephone support.
Pharmacological interventions to improve lactation, mainly
dopamine antagonists, are usually recommended only after
nonpharmacological modalities have failed, and this is
largely due to scarcity of available evidence and potential
safety issues with pharmaceutical galactagogues [4, 5].
Domperidone, a peripheral dopamine receptor antagonist,
is believed to enhance breast milk production
by increasing prolactin secretion [6–8]. It has a favorable
safety profile when compared to metoclopramide,
another dopamine receptor antagonist, with only rare extrapyramidal
side effects owing likely to poor blood-brain
barrier penetration of domperidone [9–11]. The drug is well
tolerated with relatively few side effects reported including
headache, dry mouth, and abdominal cramps [10, 12].While
domperidone is not available for any indication in the United
States due to arrhythmia concerns, it is approved in Canada
and other countries as a prokinetic agent. Moreover,