What stops breast lactation after delivery and are medications, such as Cabergoline (Cabergoline), recommended?

From the Guidelines

Breast lactation can be stopped after delivery through gradual weaning, and medications are generally not recommended as first-line treatment, but in cases where medical suppression is necessary, cabergoline is the most commonly used medication. For mothers who need to stop lactation quickly after delivery, gradual weaning, expressing only enough milk for comfort, wearing a supportive bra, applying cold compresses, and taking pain relievers like ibuprofen or acetaminophen are preferred approaches. Some key points to consider when stopping lactation include:

• Gradual reduction of breastfeeding to avoid discomfort and engorgement
• Use of supportive measures such as cold compresses and pain relievers
• Avoidance of estrogen-containing medications due to increased risk of blood clots
• Consideration of cabergoline as a medical suppression option, typically given as a one-time dose of 1 mg orally within 24 hours after delivery, as seen in recent studies 1. In terms of medication safety during lactation, studies have shown that certain medications such as ibuprofen, diclofenac, and naproxen are considered safe to use during breastfeeding 1. However, it's essential to consult with a healthcare provider before taking any medication while breastfeeding, especially in cases where the mother has a medical condition such as heart failure, as certain medications may be contraindicated or require careful monitoring 1. Ultimately, the decision to stop lactation and the approach used should be individualized and based on the mother's unique needs and circumstances.

From the FDA Drug Label

Cabergoline is not indicated for the inhibition or suppression of physiologic lactation Use of bromocriptine, another dopamine agonist for this purpose, has been associated with cases of hypertension, stroke, and seizures.

The medication cabergoline is not recommended to stop breast lactation after delivering. In fact, it is not indicated for this purpose. Another dopamine agonist, bromocriptine, has been used for lactation inhibition, but it has been associated with serious side effects such as hypertension, stroke, and seizures 2.

From the Research

Lactation Inhibition

• Lactation can be inhibited using medications such as cabergoline, which is a synthetic ergoline that shows high specificity and affinity for the dopamine D2 receptor 3.
• Cabergoline is a potent and very long-acting inhibitor of prolactin secretion, and its prolactin-lowering effects occur rapidly 3.
• The use of cabergoline for lactation inhibition has been studied in various populations, including women living with HIV, and has been shown to be effective and well-tolerated 4, 5.

Medications for Lactation Inhibition

• Cabergoline is considered a first-line therapy for the prevention or suppression of puerperal lactation due to its efficacy and safety profile 3.
• The recommended dose of cabergoline for lactation inhibition varies, but a single oral dose of 1mg has been shown to be effective in preventing lactation in women living with HIV 4, 5.
• Other medications, such as bromocriptine, have also been used for lactation inhibition, but cabergoline has been shown to be more effective and better tolerated 3, 6.

Efficacy and Safety of Cabergoline

• Cabergoline has been shown to be highly effective in inhibiting lactation, with success rates ranging from 78% to 100% 4, 5.
• The medication is generally well-tolerated, with mild and transient adverse effects reported in some studies 3, 4, 5.
• Cabergoline has been shown to be safe and effective in women living with HIV, with no reported clinically significant drug-drug interactions with antiretroviral medications 4, 5.