UBC Abbotsford-Mission Family Practice Residency Program

Domperidone: Banned in the US & Not Approved for Breastfeeding

Mary Cassatt, Louise Nursing Her Child, 1898, Fondation Rau pour le Tiers Monde, Zürich, Switzerland.

“Domperidone, which blocks dopamine in the brain, is approved in Canada as an aid to speed up digestion, but it also has a side effect: lactation. Doctors and midwives routinely prescribe it off-label for this purpose. More than 120 million prescriptions for domperidone were filled in 2020, according to Health Canada.

Thousands of mothers describe it in online forums as a wonder drug that helped them produce enough milk to breastfeed their babies.

‘It kind of sounded like a miracle drug,’ said Emily Matreal, 29, who lives just outside Detroit and took domperidone in 2021 to help her breastfeed her son, Conner.

Health Canada told CBC that although the agency is aware the drug is routinely prescribed to stimulate lactation, it is not approved for that purpose.

CBC spoke with nine women in Canada, the U.S. and Australia who say they had debilitating psychological side effects when they tried to come off the drug. They described extreme anxiety, panic attacks, insomnia and intrusive thoughts so severe they were left unable to function or care for their children, often for months. Some were forced to stop working or move in with family. At least one attempted to take her own life. They all say no one warned them these things could happen.

Multiple experts interviewed by CBC said they believe such side-effects are rare. 

‘It’s very unpredictable,’ said researcher Janet Currie, who wrote her doctoral thesis on postpartum domperidone prescriptions in British Columbia. She says she’s helped between 15 and 20 postpartum women with severe psychological side effects slowly taper off the drug in the last year.

‘No one can tell you exactly in advance whether you’ll have these symptoms and how intense they will be.’

Domperidone is not approved as a lactation aid anywhere in the world and there are no large-scale clinical trials that shed any light on how often these side effects occur.”

Learn more via Banned in the U.S., not approved for breastfeeding — why are so many moms taking this drug? via CBC News,

UBC Abbotsford-Mission Family Practice Residency Program

Extreme Cold & Warming Centres: December 5th

Environment and Climate Change Canada has issued arctic outflow, winter storm, wind and snowfall warnings for multiple areas in BC.

Warming Centres: In response to this weather event, Warming Centres may be opened for the public at the discretion of local governments and First Nations in affected areas.Temporary Winter Shelters and Extreme Weather Response Shelters are operated by BC Housing and their partners for anyone who is homeless or at risk of homelessness.

Temporary Winter Shelters and Extreme Weather Response Shelters are operated by BC Housing and their partners for anyone who is homeless or at risk of homelessness:

Communities that have opened additional Warming Centres in response to this event, as of December 5th, 2022, include:

Connect with your local government or First Nation for more information about extreme cold resources and supports available in your community.

Extreme cold safety and preparedness

Contact a healthcare provider, or call HealthLinkBC at 8-1-1, if you are experiencing mild, cold-related illness. Call 9-1-1 in case of medical emergency.

UBC Abbotsford-Mission Family Practice Residency Program

JAMA: Role Reversal

The Anatomy of the Brain Artist: Sir Charles Bell

“’Helmet, helmet!’ squealed my daughter, excitedly. I followed behind as she ran to the back door, ready to start the day. The bike ride to her daycare center had become our shared morning ritual, a ritual that I had started long before she entered the world 16 months ago. The bike ride to the research laboratory or hospital had become one of the most cherished parts of my days. The ride gave me time to reflect on the day ahead and to be present. Now it is something that my daughter has come to love as much as I do.

I watched my daughter run inside and then hopped back on my bicycle, heading to the hospital on my first day as a third-year medical student. To say I was nervous was an understatement. I timidly found the neurology resident in the crowded work room. Together with another medical student, resident, and attending physician, we made up the team that treated patients who had been admitted with strokes. The senior resident told me I would be caring for JoAnne, a 92-year-old woman with a left posterior circulation stroke, resulting in almost complete loss of movement, sensation, and pain in the right side of her body.

As a medical student, I was expected to perform a full neurologic examination on this patient in the presence of the entire stroke team. Because I had just been thrust into the medical school clinical period after 4 years of working on my PhD thesis in a basic science laboratory, my confidence in my clinical skills was meager. I internally recited the neurologic examination as I trotted to JoAnne’s room followed by the rest of the team and the patient’s nurse. Am I sweating? What’s the first part of the neuro exam again? I walked in to find a small, frail-appearing woman lying on the bed. She looked somber with glassy blue eyes staring off into the distance. I introduced myself as the third-year medical student who would be taking care of her. She turned to me and gave me the smallest nod. Was that a smile? I started the examination with what I knew best, the cranial nerves. I watched her eyes move slowly from side to side and then up and down. Did I see neglect of the right side? Now to the deep tendon reflexes. As I swung the reflex hammer and met her biceps tendon, she winced in pain. Should I keep going or should I stop? I needed the information… right? I stopped with the reflex hammer in mid-air and looked to my attending physician for an answer as I cut the reflex examination short.”

Read more on Role Reversal via JAMA A Piece of My Mind.