Zipursky J, Garg R, Wang T, Smith R, Li P, Vigod SN, Gomes T, Tadrous M. (2025). Domperidone use in lactation and risk of severe postpartum mental health outcomes. Obstetrics & Gynecology.
Background
Healthcare providers frequently prescribe domperidone off-label to enhance milk production in mothers facing breastfeeding challenges. The medication works by blocking dopamine receptors, leading to increased prolactin levels and subsequently improved milk production.
Objective
This study examined whether mothers receiving domperidone for lactation support experienced any notable differences in mental health status compared to non-users.
Methods
We conducted a retrospective cohort study of people who filled a prescription for domperidone within 56 days of delivery between March 1, 2006, and March 1, 2022, in Ontario, Canada.
Results
Compared with matched postpartum individuals who did not initiate domperidone, domperidone use was not associated with psychosis (6.4/1,000 person-years vs 6.4/1,000 person-years; hazard ratio [HR] 1.00, 95% CI, 0.60–1.67) in the postpartum period. We found no association between domperidone use and ED visits or hospital admissions with mental health diagnoses (38.0/1,000 person-years vs 43.4/1,000 person-years, HR 0.88, 95% CI, 0.71–1.08).
Conclusion
Initiation of domperidone postpartum was not associated with an increased risk of new-onset psychosis or ED visits or hospital admissions with mental health diagnoses.
