Efek Domperidon terhadap Produksi Asi pada Ibu yang Melahirkan Bayi Prematur: Uji Klinis Acak Tersamar Ganda

Abstract

Background Mothers of premature newborns often have difficulty in givingadequate breastmilk volume. Domperidone is an antagonist of peripheral dopamine‟s receptor that is believed to increase breast milk production. There is still no research on the effect of domperidone on maternal milk production in mothers of premature newborns in Indonesia. Objective To evaluate the effect of domperidone on milk production in mothers of premature newborns who failed to lactate. Methods A randomized controlled trial was conducted during July 2012 to December 2012 in perinatology unit Haji Adam Malik Hospital, Medan. The subjects were gave counseling to increase milk production for 7 days. If the subjects failed to lactate then the study begin. Fifty subjects were assigned to receive either domperidone or placebo for 7 days. Milk volume was measured daily every 2 hours (from 7 am to 9 pm). Milk volume was measured on 24hours before starting therapy, on the seventh day and tenth day (3 days after stopped therapy). Results Fifty subjects were available for analysis (25 in domperidone group and 25 in placebo group). After 7 days of domperidone therapy, breastmilk volume means were 181.6 (SD 80.2, 95% CI 69.36-148.93) ml in domperidone group and 72.4 (SD 57.8, 95% CI 70.67-148.93) ml in placebo group (P<0.0001). There was no significant difference breastmilk volume means between 7th days and 3rd days after stopped therapy (P 0.65) Conclusion Domperidone increases milk production in mothers of premature newborns who failed to lactate.

Latar belakang Ibu yang melahirkan bayi prematur sering mengalami kesulitan untuk mendapatkan produksi ASI yang adekuat. Domperidon merupakan suatu antagonis reseptor dopamin perifer yang dipercaya dapat meningkatkan produksi ASI. Penelitian mengenai efek pemberian domperidon terhadap produksi ASI pada ibu yang melahirkan bayi prematur di Indonesia belum didapatkan. Tujuan Untuk mengetahui efek domperidon terhadap produksi ASI pada ibu yang melahirkan bayi prematur yang gagal laktasi. Metode Uji klinis acak tersamar ganda telah dilakukan pada bulan Juli 2012 sampai Desember 2012. Di unit perinatologi rumah sakit Haji Adam Malik Medan. Subyek diberikan konseling laktasi untuk meningkatkan produksi ASI selama 7 hari. Bila subyek gagal laktasi maka studi dimulai. Lima puluh subyek bersedia mendapatkan obat domperidon atau plasebo selama 7 hari. Volume ASI diukur setiap 2 jam (mulai pukul 07.00 pagi sampai pukul 9.00 malam). Volume ASI diukur pada 24 jam sebelum pemberian obat, hari ke 7 dan hari ke 10 (3 hari setelah berhenti pengobatan). Hasil Lima puluh subyek dianalisis (25 orang kelompok domperidon dan 25 orang kelompok plasebo). Setelah 7 hari pemberian domperidon, rerata volume ASI 181.6 (SB 80.2, KI 95% 69.36-148.93) ml pada kelompok domperidon dan 72.4 (SB 57.8, KI 95% 70.67-148.93) ml pada kelompok plasebo (P<0.0001). Volume ASI pada 7 hari dan 3 hari setelah berhenti pengobatan domperidon tidak berbeda bermakna. Kesimpulan Pemberian domperidon dapat meningkatkan produksi ASI pada ibu yang melahirkan bayi prematur yang gagal laktasi