Domperidone withdrawal in a breastfeeding woman
Bibliographic record
Abstract
Domperidone is a peripheral dopamine D2-receptor antagonist with both gastrokinetic and antiemetic activity via its inhibitory effects on dopamine receptors in gastrointestinal smooth muscle and the chemoreceptor trigger zone.1 Health Canada–approved indications include the management of symptoms associated with upper gastrointestinal motility disorders, as well as the prevention of gastrointestinal symptoms associated with the use of dopamine agonists in Parkinson disease.2 Despite a lack of official indication, domperidone has also been used to improve lactation in nursing mothers by stimulating prolactin release from the pituitary gland.1,3-6 Its efficacy as a galactogogue has been shown in a few small randomized controlled trials of moderate to high quality, and no maternal or neonatal adverse events have been observed in any of the trials.3-6 Current practice suggests doses of 60 mg per day (20 mg 3 times daily) up to 160 mg per day (40 mg 4 times daily) to improve breast milk volume.2,7 It is generally recommended to taper domperidone upon discontinuation to prevent engorgement or a sudden drop in milk supply, but there are few reports regarding the negative effects of abruptly discontinuing domperidone, as well as tapering schedule recommendations.8 We report a case of domperidone withdrawal in a nursing woman, along with a tapering schedule that appears to decrease the likelihood of withdrawal symptoms. We believe this case will shed light on the importance of tapering domperidone as well as provide a description of the symptoms of domperidone withdrawal in this population.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".