From the Guidelines
Leaking milk from the breasts during the second trimester of pregnancy is a normal physiological process and does not require treatment. This condition is often referred to as colostrum production, which is stimulated by pregnancy hormones, particularly prolactin, as noted in various studies on breast changes during pregnancy 1. The production of colostrum is a natural process that prepares the breasts for lactation after birth, providing the baby with essential antibodies and nutrients.
To manage any discomfort or leakage associated with colostrum production, several strategies can be employed:
- Using nursing pads inside the bra to absorb the fluid and prevent clothing stains.
- Wearing a supportive, well-fitting bra to help with breast tenderness.
- Avoiding the expression or stimulation of the breasts, as this can increase colostrum production.
It's essential to note that the amount of colostrum produced varies significantly among women, with some experiencing noticeable leakage and others having little to none 1. However, if any of the following symptoms occur, it is crucial to consult a healthcare provider:
- Excessive leakage
- Unusual color of the fluid (other than clear or yellowish)
- Pain
- Fever
- Breast lumps
These symptoms could indicate an infection or another issue that requires medical attention. In the context of breast cancer during pregnancy, as discussed in the management guidelines 1, chemotherapy and certain surgical procedures can affect lactation, but this does not directly relate to the normal physiological process of colostrum production in the second trimester.
From the Research
Causes of Milk Coming Out from Breast in Second Trimester
- Hormonal changes during pregnancy, particularly the increase in estrogen and prolactin levels, can cause milk production and leakage from the breast 2
- Hyperprolactinemia, a condition characterized by elevated prolactin levels, can also lead to milk production and leakage from the breast 3, 4, 5
Treatment of Milk Coming Out from Breast in Second Trimester
- Dopamine agonists, such as cabergoline and bromocriptine, are commonly used to treat hyperprolactinemia and can help reduce milk production and leakage from the breast 3, 4, 5
- Cabergoline is often preferred over bromocriptine due to its higher efficacy and better tolerability 4, 5
- The optimal effective doses of cabergoline and bromocriptine can vary, but studies have shown that cabergoline can be effective at lower doses and with fewer side effects 6
Management of Hyperprolactinemia during Pregnancy
- Hyperprolactinemia can be managed during pregnancy with dopamine agonists, but the treatment should be individualized and monitored closely to minimize potential side effects 3, 2
- The goal of treatment is to reduce prolactin levels and alleviate symptoms, while also ensuring the safety of the mother and the fetus 2