Study protocol: A double blind placebo controlled trial examining the effect of domperidone on the composition of breast milk [NCT00308334]

被引:10
作者
Campbell-Yeo M.L. [1 ,2 ]
Allen A.C. [1 ,3 ]
Joseph K.S. [3 ]
Ledwidge J.M. [1 ]
Allen V.M. [3 ]
Dooley K.C. [4 ]
机构
[1] Neonatal Intensive Care Unit, IWK Health Centre, Dalhousie University, Halifax, NS
[2] McGill University, Montreal, QC
[3] Perinatal Epidemiology Research Unit, Department of Obstetrics, Dalhousie University, Halifax, NS
[4] Laboratory Services, IWK Health Centre, Dalhousie University, Halifax, NS
关键词
Preterm Infant; Breast Milk; Metoclopramide; Neonatal Intensive Care Unit; Prolactin Level;
D O I
10.1186/1471-2393-6-17
中图分类号
学科分类号
摘要
Background: Domperidone, a drug that enhances upper gastric motility, is an anti-dopaminergic medication that also elevates prolactin levels. It has been shown to safely increase the milk supply of lactating women. To date, researchers have analyzed the effects of domperidone on lactating woman with respect to the quantity of their milk production, adverse effects, and drug levels in the breast milk. However, the effect of domperidone on the macronutrient composition of breast milk has not been studied and current guidelines for fortification of human milk for premature infants do not distinguish between those women using or those not using domperidone. The purpose of this study is to evaluate the effect of domperidone (given to lactating mothers of very preterm infants) on the macronutrient composition of breast milk. Methods/Design: Mothers of infants delivered at less than 31 weeks gestation, who are at least 3 weeks postpartum, and experiencing lactational failure despite non-pharmacological interventions, will be randomized to receive domperidone (10 mg three times daily) or placebo for a 14-day period. Breast milk samples will be obtained the day prior to beginning treatment and on days 4, 7 and 14. The macronutrient (protein, fat, carbohydrate and energy) and macromineral content (calcium, phosphorus and sodium) will be analyzed and compared between the two groups. Additional outcome measures will include milk volumes, serum prolactin levels (measured on days 0, 4, and 10), daily infant weights and breastfeeding rates at 2 weeks post study completion and at discharge. Forty-four participants will be recruited into the study. Analysis will be carried out using the intention to treat approach. Discussion: If domperidone causes significant changes to the nutrient content of breast milk, an alteration in feeding practices for preterm infants may need to be made in order to optimize growth, nutrition and neurodevelopment outcomes. © 2006 Campbell-Yeo et al; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 84 条
[31]  
Lucas A., Morley R., Cole T.J., Gore S.M., A randomized study of human milk versus formula and later development in preterm infants, Arch Dis Child, 70, (1994)
[32]  
Rogan W.J., Gladen B.C., Breast-feeding and cognitive development, Early Hum Dev, 31, (1994)
[33]  
Chatterton R.T., Hill P.D., Aldag J.C., Belknap S.M., Jinman M.J., Relation of plasma oxytocin and prolactin concentration to milk production in mothers of preterm infants: Influence of stress, J Clin Endocrinol Metab, 85, pp. 3661-3668, (2000)
[34]  
Aono T., Shioji T., Shoda T., Kurachi K., The initiation of human lactation and prolactin response to suckling, J Clin Endocrinol Metab, 4, pp. 1101-1106, (1997)
[35]  
Fuchs A., Physiology and endocrinology of lactation, Obstetrics, Normal and Problem Pregnancies, pp. 137-157, (1999)
[36]  
Lefrak L., Dowling D., Nutrition: Physiologic basis of metabolism and management of enteral and parenteral nutrition, Comprehensive Neonatal Nursing, pp. 345-370, (1998)
[37]  
Hill P.D., Aldag J.C., Chatterton R.T., The effect of sequential and simultaneous breast pumping on milk volume and prolactin levels: A pilot study, J Hum Lact, 12, pp. 193-199, (1996)
[38]  
Engel J.A., Lundborg A.A., Behavioral and biochemical effects in offspring of nursing rats exposed to dopamine receptor antagonists, Vol I of 13th Congress of the Collegium Internationale NeuroPsychopharmacologicum, 22, (1982)
[39]  
Laduron P., Leysen J., Domperidone: As specific in vitro dopamine-antagonist devoid of in vitro ventral dopaminger activity, Biochem Pharmacol, 28, pp. 2161-2167, (1979)
[40]  
Brouwers J., Assies J., Wiersings W.M., Huizing G., Tytgat G., Plasma prolactin levels after acute and sub chronic oral administration domperidone and of metaclopramide: A cross over study in healthy volunteers, Clin Endocrinol, 12, pp. 435-440, (1980)