Drugs affecting milk supply during lactation

There are morbidity and mortality benefits for infants who are breastfed for longer periods. Occasionally, drugs are used to improve the milk supply. Maternal perception of an insufficient milk supply is the commonest reason for ceasing breastfeeding. Maternal stress or pain can also reduce milk supply. Galactagogues to improve milk supply are more likely to be effective if commenced within three weeks of delivery. The adverse effects of metoclopramide and domperidone must be weighed against the benefits of breastfeeding. Dopamine agonists have been used to suppress lactation. They have significant adverse effects and bromocriptine should not be used because of an association with maternal deaths.