International Board of Certified Lactation Consultant (IBCLC) Practice Exam

Which galactagogue may cause agitated depression and dizziness in nursing mothers?

1. Domperidone

2. Metoclopramide

3. Fenugreek

4. Blessed thistle

The correct answer is: Metoclopramide

Metoclopramide is a medication that is often used as a galactagogue to increase milk supply in nursing mothers. While it can be effective for this purpose, it is important to note that it may also have side effects that can significantly impact a mother's mental and physical well-being. Among these potential side effects are agitated depression and dizziness. The mechanism of metoclopramide involves acting as a dopamine antagonist, which can influence mood and cause neurological side effects. In some nursing mothers, especially those who may be more sensitive to these effects, the medication can lead to increased feelings of agitation or depression. Dizziness is another common side effect, which can affect a mother's ability to care for her infant effectively. Other options listed, such as domperidone, fenugreek, and blessed thistle, have different profiles. Domperidone, while also utilized for lactation support, is generally better tolerated with fewer central nervous system side effects. Fenugreek and blessed thistle are herbal remedies and while they may cause some gastrointestinal discomfort, they are less likely to result in severe neurological effects compared to metoclopramide. This distinction makes metoclopramide noteworthy in discussions regarding potential adverse reactions in nursing mothers.