Metoclopramide to augment lactation, does it work? A randomized trial.
Author(s): Fife S, Gill P, Hopkins M, Angello C, Boswell S, Nelson KM
Affiliation(s): Department of Obstetrics and Gynecology, Aultman Health Foundation, Canton, Ohio, USA.
Publication date & source: 2011-11, J Matern Fetal Neonatal Med., 24(11):1317-20. Epub 2011 Mar 17.
Publication type: Research Support, Non-U.S. Gov't
OBJECTIVES: The objective of this study was to investigate the efficacy of metoclopramide on augmentation of milk production in mothers of premature newborns. METHODS: This was a randomized, double-blind, placebo-controlled trial. Women who delivered at </=34 weeks of gestation, with no prior breastfeeding experience, singleton pregnancy, and no contraindications to using metoclopramide were eligible for entry. Twenty-five women were randomly assigned to receive 10 mg of metoclopramide or placebo three times daily for 8 days starting within 36 h of birth. Certified lactation nurses provided breastfeeding education. Breast milk expressed at each pumping session over the 8 days of treatment was recorded. RESULTS: Data from 18 patients were available for analysis. Milk production in both groups increased rapidly during the first 4 days and then more gradually to an average for the last 4 days of 633 +/- 168 (9) ml/day [mean +/- SEM (n)] for the placebo group and 459 +/- 91 (10) ml/day for the metoclopramide group. Analysis with a repeated-measures ANOVA indicated a significant increase in milk production during the 8-day measurement period [within subjects p < 0.001]; however, there was no significant difference in milk production between the two groups [between subjects p = 0.427]. Side effects were similar between groups. CONCLUSION: In mothers with preterm babies, metoclopramide treatment does not augment (sample size had 80% power for detection of 50% difference) the breast milk production. Maternal interest, education, and support are recognized as mainstay in accomplishing successful lactation.