From the Guidelines
To reduce breast milk production, the most effective approach is gradual weaning, which involves reducing the frequency and duration of breastfeeding or pumping sessions over time. This method is supported by the principle that breast milk production operates on a supply and demand basis, where less stimulation and milk removal lead to decreased production as the body recognizes milk is no longer needed in the same quantity 1.
Key Steps for Gradual Weaning
- Start by eliminating one feeding session every 2-3 days, beginning with the feeding your baby seems least interested in.
- Apply cold compresses to the breasts for 15-20 minutes several times daily to help reduce engorgement and discomfort.
- Wear a supportive, non-binding bra continuously to help decrease stimulation.
- Certain medications, such as cabergoline (Dostinex) 0.25mg twice daily for 2 days, which inhibits prolactin production, may be prescribed by healthcare providers 1.
- Herbs like sage tea (1-2 cups daily) or peppermint tea may help reduce milk supply for some women.
- Avoid nipple stimulation and expressing milk unless absolutely necessary for comfort, as this signals the body to produce more milk.
- Decongestant medications containing pseudoephedrine may reduce milk production as a side effect but should only be used under medical supervision.
Considerations for Medications
While certain medications like diuretics (furosemide, hydrochlorothiazide, and spironolactone) may reduce milk production, they are generally not preferred in breastfeeding women due to their potential effects on milk supply and the baby 1. Clonidine, on the other hand, may reduce prolactin secretion and could conceivably reduce milk production in the early postpartum period, with minimal secretion into milk and no reports of neonatal toxicity during breastfeeding 1.
Lifestyle Adjustments
Lifestyle modifications, including minimizing smoking and alcohol intake, can also impact breast milk production. For instance, cigarette smoking or the use of nicotine products is associated with reduced production of milk and shorter lactation 1. Therefore, breastfeeding mothers should be encouraged to stop smoking and minimize secondhand exposure.
By following these steps and considering the potential effects of medications and lifestyle adjustments, women can effectively reduce their breast milk production while prioritizing their health and the health of their baby.
From the FDA Drug Label
Use of cabergoline for the inhibition or suppression of physiologic lactation is not recommended (see PRECAUTIONS section). The prolactin-lowering action of cabergoline suggests that it will interfere with lactation. The best way to reduce breast milk production is not to use cabergoline, as it is not recommended for this purpose.
- Instead, consider alternative methods such as:
- Gradual reduction of frequency and duration of breastfeeding or pumping
- Applying cold compresses or cabbage leaves to the breasts
- Wearing a tight-fitting bra
- Avoiding nipple stimulation 2
From the Research
Methods to Reduce Breast Milk Production
To reduce breast milk production, several methods can be employed, including:
- Pharmaceutical methods: Dopamine agonists such as bromocriptine and cabergoline have been shown to be effective in suppressing lactation 3.
- Non-pharmaceutical methods: The use of ice and a tight bra has been compared to pharmaceutical therapy, with the non-pharmaceutical method resulting in more engorgement and milk leakage, but a shorter lactation process 4.
- Alternative treatments: Cold cabbage leaves, cold gel packs, and herbal compresses have been studied as potential treatments for breast engorgement, with some evidence suggesting their effectiveness 5.
- Compresses: The alternating application of cold and hot compresses has been found to have a significant role in reducing breast engorgement among lactating mothers 6.
Comparison of Methods
The effectiveness of different methods for reducing breast milk production varies:
- Bromocriptine has been shown to be effective in suppressing lactation, but may have adverse effects such as nausea and vomiting 3.
- Cabergoline has been found to be more effective and better tolerated than bromocriptine in suppressing lactation 3.
- Non-pharmaceutical methods such as ice and a tight bra may be less effective in reducing engorgement, but can shorten the lactation process 4.
- Alternative treatments such as cold cabbage leaves and cold gel packs may be effective in reducing breast engorgement, but the evidence is limited 5.
Considerations for Reducing Breast Milk Production
When considering methods to reduce breast milk production, it is essential to: