Lactation suppression refers to the act of suppressing lactation by medication or other non pharmaceutical means. The breasts may become painful when engorged with milk if breastfeeding is ceased abruptly, or if never started. This may occur if a woman never initiates breastfeeding, or if she is weaning from breastfeeding abruptly. Historically women who did not plan to breastfeed were given diethylstilbestrol and other medications after birth to suppress lactation. However, its use was discontinued, and there are no medications currently approved for lactation suppression in the US and the UK.
Video Lactation suppression
Reasons
After birth, some women may desire to stop the production of breast milk, for example when the mother decides to bottle feed from birth, or in the case when the infant dies or is surrendered at birth. Additionally, women who are breastfeeding may need to stop breastfeeding abruptly, for instance if she is taking medication contradicted for breastfeeding or undergoes surgery. The abrupt weaning process may lead to severe engorgement, extremely painful breasts, and possibly mastitis. Up to one third of women who do not breast-feed and who use a brassiere or binder, ice packs, or analgesics may experience severe breast pain. Specific studies of nonpharmacologic methods of lactation suppression were limited and inconclusive. Available data suggest that many women using currently recommended strategies for treatment of symptoms may nevertheless experience engorgement or pain for most of the first postpartum week.
Maps Lactation suppression
Methods
Medication
In the past, hormonal therapies, such as diethylstilbestrol and bromocriptine were used, but these are no longer recommended due to side effects (e.g. DES is a known carcinogen). In some countries, cabergoline (Dostinex(TM)) is used for this purpose. Estrogen containing birth control pills may have the same side effect. Pseudoephedrine may also suppress lactation is it is contraindicated for breastfeeding since it may cause low supply. There are no FDA approved medications for this purpose in the US. Drugs that have been used in the past have shown severe potential side effects such as thromboembolism, cerebral accident, and myocardial infarction have been reported with their use and are not recommended for lactation suppression. Spitz et al. in a 100-year review of all available information concluded that there was nothing new or helpful to assist with the mammary involution or milk suppression process or to treat the pain or discomfort of severely engorged breasts.
Other methods
By simply not stimulating the breasts after birth, after a few days the production of milk will decease. If breastfeeding has already been established, the production of milk typically takes longer to decrease and may take several weeks. Women may experience pain and discomfort from engorgement. This discomfort is may be relieved by hand-expressing milk or the use of a pump to reduce engorgement and prevent mastitis. The discomfort can also be treated with analgesics, cooling packs and chilled cabbage leaves. However, as much as one third of all women will experience severe pain in this process.
Historically, binding the breasts by use of tight-fitting bras or ace bandages was used, but Swift et al. concluded that breast binding should be discontinued as a method of lactation suppression and use of support bras encouraged. This breast binding approach should be discouraged as this may cause blocked milk ducts and mastitis.
By using cabbage leaves. The Cochrane review of three studies on this subject concluded that there was no statistically significant evidence that interventions were associated with a more rapid resolution of symptoms; in these studies women tended to have improvements in pain and other symptoms over time whether or not they received active treatment.
According to the Cochrane review conclusions, some interventions such as hot/cold packs, Gua-Sha (scraping therapy), acupuncture, cabbage leaves and proteolytic enzymes may be promising for the treatment of breast engorgement, but there is insufficient evidence to justify widespread implementation.
See also
- Hypothalamic-pituitary-prolactin axis
- Prolactin modulator
References
Source of the article : Wikipedia
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