Analysis of a Pharmacy Developed, Outpatient Lactation Consultant Initiated Domperidone Programme

Katherine Chinnery; Stephanie Wai Khuan Teoh; Tamara Lebedevs; Myra Kildunne; Nabeelah Mukadam

doi:10.34763/jmotherandchild.20242801.d-23-00093

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Analysis of a Pharmacy Developed, Outpatient Lactation Consultant Initiated Domperidone Programme

Journal of Mother and Child

Volume 28 (2024): Issue 1 (February 2024)

By: Katherine Chinnery , Stephanie Wai Khuan Teoh , Tamara Lebedevs , Myra Kildunne and Nabeelah Mukadam

Open Access

|Apr 2024

Abstract

Background

Domperidone is a commonly prescribed galactagogue used off-label for lactation insufficiency. Prescriber unfamiliarity or safety concerns can lead to therapeutic delay and potential early breastfeeding discontinuation. To facilitate access, the study site pharmacy department developed a Structured Administration and Supply Arrangement (SASA) for International Board-Certified Lactation Consultants (IBCLC) to screen and initiate domperidone using a checklist.

Material

To validate a domperidone screening tool via analysis of its use and compliance, together with a staff satisfaction survey.

Methods

Records were extracted from the REDCap® database for women with documented domperidone supply between 06/05/2022 and 27/01/2023 and reviewed with medical records. A staff survey was distributed assessing compliance and attitudes towards the SASA.

Results

Records of supply revealed that 34% (17/50) of patients were referred to a physician, revealing a discrepancy between database documentation and checklists, as no referrals were documented. Overall staff satisfaction with the SASA was rated 4.6 out of 5. 77.7% (7/9) felt confident counselling and supplying domperidone with the SASA in place. 88.9% (8/9) felt confident using the checklist to identify the appropriateness of therapy and referral to a physician.

Conclusions

The system in place allows the IBCLCs to initiate and supply domperidone in a timely manner to breastfeeding mothers with lactation insufficiency. The support tools, including domperidone SASA, REDCap® documentation database and the checklist domperidone as a Galactagogue Checklist, can be greatly appreciated by the LCs. Continued discussion with IBCLCs to refine and improve the SASA and associated education package will result in more consistent compliance.

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Articles in this issue

DOI: https://doi.org/10.34763/jmotherandchild.20242801.d-23-00093 | Journal eISSN: 2719-535X | Journal ISSN: 2719-6488

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Language: English

Page range: 23 - 32

Submitted on: Oct 9, 2023

Accepted on: Feb 23, 2024

Published on: Apr 19, 2024

Published by: Institute of Mother and Child

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

Lactation,

Breastmilk,

Breastfeeding,

Domperidone, Lactation Consultant,

Pharmacy,

International Board-Certified Lactation Consultants (IBCLC)

Related subjects:

Medicine,

Clinical medicine,

Pediatrics and juvenile medicine,

Paediatric haematology and oncology,

Public health

© 2024 Katherine Chinnery, Stephanie Wai Khuan Teoh, Tamara Lebedevs, Myra Kildunne, Nabeelah Mukadam, published by Institute of Mother and Child
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 28 (2024): Issue 1 (February 2024)