Anti-lactation pills: how effective, risks for the health of mother and baby

There are many reasons why women may need to suppress lactation (stop milk production in the mammary glands):

• Personal reasons for not breastfeeding.
• Medical necessity to stop breastfeeding.
• Voluntary resumption of lactation after completion of the breastfeeding period.
• Permanent or prolonged separation from the child.

To stop lactation while breastfeeding, you will need to interrupt the natural reflexes that promote milk production. The easiest way is to limit the removal of milk from the breast. If milk remains in the mammary gland, the body understands that there is still a supply and will reduce the production of new milk. The fuller the breasts are with milk, the faster its production will stop.

You can express milk only if there is extreme discomfort in the chest and to prevent blockage of the milk ducts and the occurrence of mastitis.

Features of cessation of lactation immediately after childbirth

Milk production will quickly cease if the breasts are well secured and supported by a bra, and milk is expressed only to prevent significant discomfort and blockage of the milk ducts. Wearing a durable, well-fitting bra is necessary both during the day and at night. This method is more physiological and effective compared to the outdated tight breast wrap. To absorb milk, absorbent pads are placed in the cups of the bra, which are replaced as they become moisturized. If the breasts are too full, the bra is replaced by a supportive breast wrap with a strip of cotton fabric that supports but does not compress the breasts. Tight compression of the breast does not reduce milk production, but causes significant discomfort. For full engorged breast syndrome (the first week after childbirth), pain and swelling can be reduced with the help of cold compresses and wraps. You can also use a cool shower and place chilled white cabbage leaves in your bra. The leaves are pre-washed and dried, and the protruding parts are cut out of them so as not to cause chest discomfort. Leaves need to be changed every 2 hours or when they become limp. Use cabbage leaves until your breasts stop overflowing with milk. For pain, nonspecific anti-inflammatory drugs such as ibuprofen can be used.

Tablets to stop lactation: principle of action

On the medicine market you can find several drugs that can affect milk secretion. The most famous are “Bromocriptine”, “Dostinex”, “Agalates”, “Bergolak”. However, despite the different brands, they contain the same active ingredients - bromocriptine or cabergoline.

These are partially or fully synthetic derivatives of the ergot alkaloid, that is, a type of mushroom. They have a direct inhibitory (suppressive) effect on the production of the main lactation hormone, prolactin. Due to this, milk secretion decreases.

To obtain a noticeable effect from taking drugs to stop lactation, the concentration of prolactin in the blood must be very high. In the life of a nursing woman, such a moment occurs immediately after childbirth, and it lasts about one to two weeks. After this, the production of prolactin starts only during breastfeeding. And the more often the child feeds, the more stable the level of this hormone. And vice versa. This means that breast milk volumes can be successfully influenced without medication, just by adjusting the number of breastfeedings.

Sometimes from nursing mothers you can hear the wording “pills for burning breast milk.” Or “pills to burn out breast milk.” These phrases have become commonplace in the mom community. They probably mean the partial or complete disappearance of milk. But from a physiological point of view, there are no processes in a woman’s body that could be described in this way. When lactation subsides, the secretion is absorbed back into the blood. New milk production slows down. This happens even when this process is accompanied by lactostasis, mastitis with elevated temperature and fever.

Conclusion: Medicines to stop milk production work in the early stages of lactation. One to two months after the birth of the baby, their use may be ineffective and even completely ineffective. However, the risks from their use remain the same during any period of breastfeeding.

Features of cessation of lactation after weeks or months of breastfeeding

If you are forced to stop breastfeeding that has already begun, measures suitable for stopping lactation immediately after birth will not be enough. A nursing mother produces about a liter of milk per day or more. In this case, it will take time to stop milk production. In this case, to prevent the occurrence of inflammatory breast diseases, you will have to gradually reduce the amount of milk expressed in order to reduce the production of hormones that cause its production. This strategy is similar to natural weaning and helps prevent the development of mastitis.

When you first stop breastfeeding, your breasts will become full. Milk will have to be expressed in volumes and on a schedule, as with breastfeeding, only gradually reducing the amount of milk expressed and increasing the pauses between expressions. You can try to do one less pumping every 3-4 days if there is no significant discomfort in the breast. After some time, there will come a point when you can express milk twice a day, and then only once a day, and finally once every few days, and stop expressing completely.

Medications to stop lactation

The need to suppress “mature” lactation may arise for one reason or another: lack of time, health status, etc. Under natural conditions, lactation stops on its own after a certain period of time. This does not require any special means or measures. Therefore, drug interruption of breast milk production is practiced in an extremely limited number of cases.

Many drugs act radically, immediately interrupting the production of breast milk. This does not have the best effect on both the mother’s body and the child’s body (if he has been breastfed for some time). The best thing is to gradually stop the process.

Drugs are resorted to last. The reason for this is the presence of a large number of contraindications and side effects from their use. In addition, mothers should not expect that breast milk production will stop overnight. Thus, a rather unpleasant situation arises: stagnation of milk is harmful and brings a lot of painful sensations, but at the same time, the active ingredients of the drugs are concentrated in breast milk, so under no circumstances should you put the baby to the breast from the moment you first take the medicine.

In general, these types of drugs are used only in exceptional cases:

• Late pregnancy termination.
• Severe mastitis (purulent) with a confirmed tendency to generalize.
• The presence of serious diseases and pathologies in the mother: HIV, tuberculosis, malignant neoplasms.
• Diseases in the child: phenylketonuria, etc.

In all other cases, doctors do not recommend taking specialized medications, and if interruption of lactation is still necessary, approach the selection of medications only under the supervision of a specialist.

The most aggressive agents are those containing hormonal substances. Such drugs “shatter” hormonal levels and can cause the development of secondary pathologies.

One of the drugs with this effect is levodopa. It has become a kind of classic in stopping lactation and has been used for a long time. The drug actively inhibits the turnover of dopamine in the body and reduces the production of the hormone serotonin (i.e., the drug has a pronounced dopaminergic effect).

Levodopa has a lot of severe side effects, so at the moment it is practically not used. Previously, the drug was prescribed according to the following regimen: 1/2 gram 2 times a day. The course of admission is 10 days. But, as already mentioned, the drug was very difficult to tolerate by patients, since multiple side effects occurred: tachycardia, bradycardia, headache and dizziness, loss of consciousness, nausea, etc. Levodopa significantly increases blood pressure and is therefore contraindicated in hypertensive patients. The drug also had a pronounced hepatotoxic effect and inhibited kidney function. Obviously, the cost of taking such a drug could be high.

At the moment, preference is given to drugs based on specific female hormones (gestagens and estrogens), in some cases in combination with male sex hormones and drugs that inhibit the production of prolactin.

Hormonal drugs to stop lactation

Despite the fact that hormonal drugs are relatively safe, the number of side effects and contraindications to their use is no less. Taking hormonal drugs is always a heavy blow to the body. Therefore, before taking them, it is necessary to consult with several specialized specialists: an endocrinologist and a gynecologist.

Preparations based on female sex hormones are contraindicated for:

• Degenerative and hyperplastic processes in the mammary gland.
• Menstrual irregularities (current or in the past).
• Male pattern hair growth.
• High blood pressure (hypertension).
• Phlebological diseases.
• Kidney, liver failure.
• Diabetes mellitus of both types.

Preparations based on male hormones (androgens) are not used independently; this can be fraught with sexual dysfunction and a host of endocrinological problems. They are used only in combination with female sex hormones. The main medication is testosterone propinate solution.

In other cases, doctors prescribe medications based on gestagens. Progestogens are specific active substances (hormones) produced in the second phase of the menstrual cycle and not throughout pregnancy. Gestagens, like estrogens, are contraindicated in these cases. But at the same time, gestagens have much fewer side effects, which is why they are used more often in modern medical practice.

The most common drug is Norkolut (norethisterone). It is taken as follows: 20 mg per day for the first three days, then the dose is reduced to 15 mg and the drug is taken at this dosage for the next 4 days. For the next 2 days, the drug is taken in a dosage that is 5 mg less than the previous one (10 mg). Thus, the general course of treatment is 10 days.

In some cases, other drugs are recommended (Duphaston and some others).

Drugs that inhibit prolactin production

Of all the drugs to stop lactation, those that inhibit the production of the hormone prolactin are considered the safest. Prolactin is synthesized in the pituitary gland (it is a pituitary hormone) and stimulates the active production of breast milk in a woman.

To inhibit prolactin synthesis, two hormones are used in medical practice: bromocriptine (trade name Parlodel) and cabergoline (trade name Dostinex). Parlodel has an intense effect due to interaction with the receptors of the endocrine system. Method of use: 1 tablet 2 times a day (dosage - 2.5 mg per tablet). Bromocriptine should be taken for 14 days.

Of course, you cannot do without side effects. Parlodel causes headache, dizziness, nausea, and a drop in blood pressure when the body position changes. Despite this, the incidence of adverse effects is relatively low.

The drug also has a number of contraindications:

• Heart damage (previous heart attack, heart failure, etc.).
• Hypertension stages 2-3.

During the treatment period, even healthy people are advised to constantly monitor their blood pressure levels. Also, under no circumstances should the drug be taken simultaneously with other medications based on ergot alkaloids.

Another option is taking the drug Dostinex. Unlike all the previously listed drugs, it has a rapid and intense effect, which manifests itself almost from the first hours after the first use.

After just 2-3 hours from the moment of administration, the concentration of the hormone prolactin changes in the blood. Its synthesis is rapidly declining. In addition, the drug has a prolonged effect: a certain effect, even after a single dose, lasts for about a month.

To suppress lactation, one tablet is prescribed. The course of treatment is 2 days. The tablet must be divided into two parts and taken half every 12 hours.

In some cases, it is necessary to prevent lactation without waiting for it to begin. Then the drug is prescribed in a dosage of 1 mg (whole tablet) for 2 days.

In addition to the contraindications that exist for Parlodel, Dostinex has several more:

• Diseases of the gastrointestinal tract: gastritis, bleeding of the stomach or intestines, liver failure, hepatitis, cirrhosis of the liver, stomach ulcer.
• Mental illnesses.

The presence of at least one of the diseases is an absolute contraindication. Therefore, before taking Dostinex, it is important to undergo a full examination by specialized specialists.

Side effects when taking the drug are extremely rare, but they still exist.

• Nervous system disorders (autonomic disorders): dizziness, headache, interruptions in heart function, nausea, etc.
• Gastrointestinal tract disorders: exacerbation of gastritis, heaviness and pain in the stomach, dyspeptic manifestations.
• Depression.
• Cardiovascular system disorders: arrhythmia, decreased or increased blood pressure.

In case of individual intolerance to the drug or overdose, mental disorders may develop: psychosis, hallucinations.

Before starting to take special medications to suppress lactation, it is recommended to exclude the presence of pregnancy. In some cases, women deliberately interrupt lactation in order to become pregnant while already pregnant. During pregnancy, the use of Dostinex or any other drugs is strictly prohibited.

All drugs to suppress lactation are very serious and can cause irreparable harm to health. Therefore, of course, you should not prescribe therapy yourself. This is fraught with serious consequences for both the mother’s body and the baby itself. Consultation with a specialist is required.

The strategy for suppressing lactation is selected individually by gynecologists and endocrinologists. At the moment, prolactin inhibitors are the most widely used, as they are the safest of the entire group of drugs for suppressing breast milk production. In practice, cabergoline is most used because it is easier to tolerate by patients than bromocriptine. However, if intolerance is observed or the patient has contraindications for taking the drug, other medications are prescribed. In this case, sex hormones and their derivatives are prescribed.

Specific names are selected by the doctor based on the results of ultrasound and data from an in-person examination. Less preferable than inhibitors, but still less dangerous than other drugs, are gestagens. Male sex hormones are rarely used and only in combination with estrogens to reduce their concentration, and therefore the likelihood of adverse reactions.

How to quickly stop lactation?

The speed of cessation of lactation depends on a number of factors:

• The baby's age and the amount of milk produced.
• Stage of pregnancy when it is terminated (lactation is possible after termination of pregnancy after the 18th week).
• The amount of milk expressed, milk flowing out.
• Pressure on the nipples (during work, sports, sex).
• Presence of next pregnancy.

Some mothers take weeks to stop breastfeeding. For others, the process takes only a few days. However, milk stains on your bra can sometimes be noticed several months or even years after you think that lactation has stopped: for each mother, the process of stopping lactation occurs individually.

Be prepared for leaks!

Even after the cessation of lactation or in its last stages, unexpected copious discharge of milk from the breast is possible. This can happen when hugging a partner, when having sex with him, when being sexually aroused, when thinking about a child, when touching the breast. To prevent unexpected milk leaks, wear absorbent pads in your bra. Keep a spare supply of such gaskets with you. Wear dark-colored tops so that milk stains are not as noticeable. Take a spare set of clothes with you, especially for more important occasions.

Express some milk before leaving the house. If you feel milk leaking, cross your arms over your chest to stop the flow.

In all cases, get advice from a breastfeeding specialist on how best to stop lactation in your case.

Early end of lactation

There is no consensus on the timing of breastfeeding, but it is clearly established that the minimum period of breastfeeding is 6 months, that is, until the baby begins to be given complementary foods. Most often, early cessation of lactation occurs at the request of the woman or for medical reasons, which can be divided into unconditional and conditional. For unconditional medical indications, cessation of lactation is mandatory, but for conditional indications, only in some cases.

Important! The minimum period of breastfeeding is 6 months, that is, until the baby begins to be given complementary foods.

Unconditional:

• late miscarriage or stillbirth;
• maternal alcohol or drug addiction;
• prescribing chemotherapy to treat the disease;
• HIV infection;
• herpes of the breast or nipples;
• active stage of tuberculosis;
• taking medications prohibited while breastfeeding;
• lactose intolerance of the newborn.

Conditional:

• severe diseases of internal organs;
• deviations in the development of the mother’s mammary glands and nipples;
• mastitis.

Call a breastfeeding specialist to your home

At the Group’s children’s medical centers, we know that the most convenient place for breastfeeding consultations is your own cozy home:

• A specialist will come to you at a convenient time. You don't have to go to the clinic and wait in line. Consultations can also be held directly in the maternity hospital (if visits are permissible) or in a medical center.
• A familiar home environment makes consultation easier for both mother and child.
• At home, the consultant will be able to devote more time to both the child and the parents.
• The consultant is always a phone call away: day and night (at night you can call the contact center or write to the consultant, the consultant will answer as soon as possible), on weekdays and on weekends.
• Support from a specialist is not one-time consultations, but accompaniment: the consultant will visit the mother and baby again, if necessary, after 2-4 weeks to check how feeding is going and the baby’s weight gain.

In addition to calling a breastfeeding specialist to your home, you can call doctors of the main specialties: pediatrician, surgeon, allergist, urologist, pulmonologist, hematologist, dermatologist, ophthalmologist, ENT doctor, orthopedist, gastroenterologist and osteopath. You can also take tests, perform physiotherapy and massage at home. Infant swimming consultants can advise you at home and conduct a master class.

Find out about the special offer “Comprehensive examination at home”: the convenience of this program is that you can choose from a list of pediatric doctors exactly those specialists that your child needs and an individual set of medical services with a 20% discount!

Advantages of calling Virilis Group specialists to your home

• Travel to any area of ​​the city and region without restrictions.
• No insurance, registration or citizenship is required to receive medical care.
• Providing assistance to children of any age.
• Experience in responsible treatment of children in St. Petersburg since 1991.
• 6 own children's medical centers with 650 specialists in 49 specialties.
• Possibility of diagnostics and continuation of treatment in our clinics.
• Coordination with other doctors of the VIRILIS Group of Companies clinics: we are a single team, and not individual doctors from a “mobile” clinic.
• 24/7 contact center.
• Issuance of official medical certificates and documents.
• Possibility of purchasing a package of a comprehensive medical program for a child, including the “Emergency Care” and “Comprehensive Examination at Home” packages.
• Special medical programs for newborns and infants.

Safety issues and WHO recommendations

The instructions for some cabergoline-based drugs indicate a contraindication or cautious use during breastfeeding. Suppression of physiological postpartum or already established milk production with their help is possible only if medically necessary. In other words, pills to “stop” lactation should be prescribed exclusively by a doctor.

The World Health Organization strongly recommends a physiological method of ending lactation. It comes down to the following measures.

• Periodic pumping. Only small volumes of secretion when the chest feels full.
• Comfortable underwear. For bust support.
• Symptomatic help. To alleviate the condition, painkillers, for example, are acceptable.

This scheme is also suitable for exceptional situations: stillbirth, abortion, death of a child shortly after birth. And also in case of HIV infection in the mother and other diseases in which breastfeeding is contraindicated.

Side effects

Pharmacological interruption of milk production is no longer considered useful. Back in 1989, the US Food and Drug Administration declared anti-lactation drugs ineffective. They do not warn, but inhibit milk secretion. And, moreover, they are accompanied by dangerous risks to the health and life of a woman.

Undesirable side effects from taking cabergoline, bromocriptine and their analogues include: headaches, dizziness, fainting, depressive symptoms, nausea, vomiting, breast pain, hallucinations, angina pectoris, heart attack, stroke, damage to the heart valves, impaired liver function and other complications from various organs and systems.

Contraindications

Moreover, no studies have been conducted on the effects of cabergoline on lactating women and their infants. It is unknown whether the substance is excreted into mother's milk and in what quantity. Drugs to suppress prolactin production have an extensive list of contraindications:

• pregnancy;
• hypersensitivity to the components of the drug;
• arterial hypertension;
• cardiac dysfunction;
• pathologies of the cardiovascular system;
• liver and lung problems;
• psychoses.

If a woman wants to cope with unwanted milk production using a medicinal method, she should definitely consult a doctor. Such a decision must be supported by adequate and reliable information. Including the possible need to periodically empty your breasts. While the mother is taking the drug, she should be under medical supervision.