Means and pills for stopping lactation - Causes, symptoms and treatment. MF.
Breast milk is the most valuable product for a child of the first years of life. The role of natural feeding is difficult to overestimate. Currently, many women knowingly approach the issue of feeding a baby and try to maintain and prolong lactation for a long period of time. Nevertheless, sooner or later, most mothers face the issue of stopping breastfeeding because of employment or health problems. Prolonged feeding is contraindicated in osteoporosis. Hyperprolactinemia in history is not a contraindication to breastfeeding by itself, but if a woman has an adenoma of the pituitary gland, then it must be observed during pregnancy and lactation in the endocrinologist. Breastfeeding can lead to a significant increase in neoplasm, which will require the cessation of lactation.
From the point of view of an endocrinologist, lactation must undergo natural phases and result in an involution. Terms of breastfeeding are individual. To reduce the risk of type 1 diabetes in a child, it should be fed with breast milk up to 9 months minimum. And to reduce the risk of osteoporosis in a woman in the future, lactation should be completed around the baby's age 1 year 3-6 months. Further breastfeeding is possible only with good nutrition and medication support.
Lactation is a natural process that favorably affects a woman's hormonal health. It is especially useful that all stages of breastfeeding pass physiologically. However, the number of pregnancies, births and lactation for life directly affect the frequency of detection of a pituitary microaden without hormonal activity, due to the fact that pregnancy and lactation cause hypertrophy of hormonal cells. These conditions present increased requirements for glands of internal secretion. Microadenoma without signs of growth and activity does not require treatment.
In a number of cases, women do not even begin to feed the baby after childbirth, but they have milk too. In this situation, of course, as soon as possible to slow down the lactation. I would like, that the moment of stopping the formation of milk was as painless as possible. There are a number of measures and means for stopping lactation. This is a natural gradual excommunication, and herbal preparations, and medicines. In this article we will dwell on each method in detail.
Gradual weaning
Breastfeeding is a natural process, having its successive stages from becoming and before the involution of lactation. The natural extinction of breastfeeding occurs gradually and rarely begins until the moment when the child is not yet a year and two months old. Determine that the involution of lactation has already begun, you can by the condition of the mammary glands - they do not fill with milk and remain mild all day. If the baby is not applied to the breast, the milk becomes smaller, although the child's needs are growing. The mother feels physically tired after each feeding. Excommunication from the breast during this period will be the least painful for both mother and baby.
But often enough a woman is forced to stop feeding her baby before the involution of lactation occurs. In the event that the child is large enough( at least 9-11 months), the method of gradual weaning from the breast will help the mother and child to easily pass the period of cessation of lactation. Gradual excommunication stretches for 2-3 months. Every two weeks, the number of feedings is reduced by one time. By the end of the period, only feeding before night sleep remains. Then this method of milk is removed. The method is the least painful for both the mother and the baby, because there is a gradual burnout of milk in conditions of psychological comfort.
Simultaneous weaning from the chest
However, more often a woman does not have several months to stop breastfeeding.
Then the excommunication occurs simultaneously. Unfortunately, neither the child nor the mother are fully prepared for such drastic changes. In order to distract the baby during the period of excommunication for 2-3 days, it is advised to take him to relatives, that is, to ensure that the child does not see his mother. Of course, this method can become too much stress for a child for whom weaning is combined with the "loss" of the mother. In any case, except for psychological experiences, the process of one-moment excommunication is accompanied for the mother and strong physical discomfort. Tides of milk continue, the chest is subjected to severe stretching, pain appears. Sometimes mastitis can develop. To reduce over-stretching, it is recommended to tighten the breast - for example, with a stretch bandage or a dense bra. From the second day, you can slowly express the milk, but only until the disappearance of pain in the chest. If you express milk by a lot, then the tides will continue for a long time. And if you do everything right, then usually after 3-5 days the milk stops being. These days the woman should strongly limit herself in the liquid, especially in warm and hot( soup, tea).Camphor oil can be used. It is recommended in the form of compresses or for oral administration, and you can also do breast massage using this oil. This method is recommended by experienced midwives, as it was actively and successfully used in Soviet times. Also in the first days after weaning the baby from the breast, cold cabbage leaves can be applied to the glands, changing them every hour.
Sometimes it makes sense to use herbal medicines or medicines.
Herbal preparations for the cessation of lactation
The intake of medicinal herbs refers to methods not only of traditional medicine. Many natural substances from medicinal plants, as studies show, have a very effective and persistent therapeutic effect. Herbal preparations are fairly sparing for the body, although it is still better to consult with a specialist before starting their use.
Herbal preparations that are used during the cessation of lactation have the following properties: diuretic, anti-inflammatory, sedative.
Get rid of excess fluid, which contributes to the cessation of tides, will help cowberry leaf, horsetail field, stigma corn, elephant tall, basil ordinary, bearberry ordinary.
Salvia officinalis, belladonna, mint will have an anti-inflammatory effect and will reduce the volume of milk.
It is possible to survive the stress reliably when using heather ordinary, marshweed grass, valerian root medicinal.
The following recipes of herbal infusions are recommended for use.
Infusion No. 1: 10 grams of chopped sage leaves pour 300 ml of boiling water. Leave to stand for about an hour, drain. Take half a cup three times a day.
Infusion No. 2: 10 grams of peppermint leaves pour 500 ml of boiling water. Leave to stand for about an hour, drain. Take half a cup three times a day.
Infusion No. 3: 10 g of cranberry leaf pour 300 ml of boiling water. Take half a cup three times a day.
Medication for lactation suppression
It may be necessary to inhibit mature lactation if it is necessary to wean the baby for some reason. These reasons can be both personal and medical. Medicamentous weaning from the breast is shown only in rare cases. Since breastfeeding is a natural process, then for its completion no medicine is needed for a woman. It is more useful for the mother and child - gradual excommunication, rather than one-time. Medicines have both a contraindication and side effects. In addition, do not expect that after taking the pill, albeit quite expensive, in one day, the allocation of milk will cease. Most likely everything will be quite difficult. Moreover, can not be applied to the breast from the moment of taking the drug of the child even once. And the experience of the child about the sharp excommunication severely worsens the condition of the mother.
The real field of application of lactation suppressants is late pregnancy, stillbirth, extremely severe purulent mastitis with a tendency to generalization, cases of severe pathology on the part of the mother( tuberculosis, HIV, oncopathology, heart failure) and the child( phenylketonuria, galactosemia).So, it is clear that a healthy mother of a healthy child does not need any medications, especially hormones to inhibit lactation.
The most aggressive method of suppressing lactation is the use of medicines that have a hormonal nature or influence the synthesis of hormones in the female body. These medications should be prescribed only by the attending physician in person, as they have a number of side effects and contraindications.
One of the longest-used drugs in this area is levodopa. The drug has dopaminergic activity. Its use to suppress lactation is considered obsolete today. Previously, it was prescribed 2 times a day for 0.5 g in capsules for 10 days. The medicine is very hard to bear. There may be nausea, loss of appetite, headache, sweating, dizziness, fainting, irregular heartbeat. Levodopa is contraindicated in hypertension, endocrine pathology, renal and hepatic insufficiency.
At the moment gynecologists, obstetricians and doctors of other specialties to suppress lactation choose female sex hormones( estrogens and gestagens), sometimes in combination with male sex hormones, as well as inhibitors of prolactin production.
Hormones for preventing lactation
Female hormones - estrogens are contraindicated in hyperplastic processes in the mammary gland, tumors of the genital organs, menstrual cycle disorders in the past, increased growth of facial and body hair, hypertension, diabetes, diseases of the veins, liver, kidneys. Most widely of the drugs in this group is used synestrol in the form of tablets or injections, ethinyl estradiol( Mikrofollin).Usually suppression of lactation with estrogen is carried out for 5-7 days. The side effects of the drugs are quite pronounced. A woman may experience nausea, vomiting, headache, swelling.
Androgen can be used testosterone propionate in the form of an oily solution for injection. Its use is possible only in conjunction with estrogens to enhance their effect.
In some cases, the doctor may recommend gestagens to suppress lactation. These hormones are produced in the second phase of the menstrual cycle and during pregnancy. Contraindications and side effects of gestagens are similar to estrogens. At the same time gestagens are much easier to carry. Most often used norethisterone( Norkolut).His reception is shown for 10 days: three days in a daily dose of 20 mg, then four days 15 mg and then two days in a daily dose of 10 mg. Sometimes it is acceptable to use in appropriate doses of other progestogens, including dydrogesterone( Dufaston).
Inhibitors of prolactin production
The most valid for suppressing lactation all over the world are recognized medications that affect the production of the hormone stimulating the formation of milk in a woman - prolactin. This hormone is synthesized in the brain in the pituitary gland. Its quantity is effectively influenced by bromocriptine( Parlodel) and cabergoline( Dostinex).
Bromocriptine is a derivative of ergot alkaloids. Its effect is a sharp decrease in the secretion of prolactin by the pituitary gland due to interaction with the receptors of the central organs of the endocrine system. Bromocriptine is used to suppress normal lactation for two weeks, 1 tablet( 2.5 mg) 2 times a day. Treatment with the drug is often accompanied by nausea, vomiting, dizziness, fatigue. Sometimes there is a drop in blood pressure with a sharp change in the posture( orthostatic hypotension).Occasionally, orthostatic hypotension may occur. Contraindicated the use of bromocriptine in severe heart disease, severe hypertension, increased sensitivity to ergot alkaloids. It is necessary to regularly measure the pressure on the tonometer, especially during the first days of therapy. Do not take bromocriptine and other ergot preparations at the same time.
Special attention should be paid to the synthetic drug from the group of ergolines - cabergoline. This substance is sold under the trade name Dostinex( 0.5 mg tablets).Dostinex differs from other drugs to reduce lactation by extremely fast, strong and prolonged action. Already 3 hours after taking the pill, the level of prolactin in the blood drops, lactation begins to slow down. Even after a single application, some effect persists for 2-4 weeks. To suppress lactation, Dostinex is appointed by the doctor half a tablet every 12 hours for two days( 1 mg per course).To prevent lactation, the drug is taken at a dose of 1 mg immediately after birth.
Contraindication to prescription of the drug is hepatic or renal failure, late gestosis, increased sensitivity to ergot alkaloids, postpartum psychosis or in the past or other mental illnesses, gastrointestinal bleeding, gastritis, peptic ulcer, Raynaud's syndrome.
Sometimes a woman may not know about the presence of any of the listed diseases( for example, gastritis or peptic ulcer).This confirms the importance of examining the doctor before using the drug. Side effects of Dostinex are usually not too pronounced. Nevertheless, the drug can provoke the following conditions: dizziness, dyspepsia, abdominal pain, gastritis, constipation, breast tenderness, hot flushes to the face, pressure decrease, headache, nausea, general weakness, depression. When an overdose or excessive sensitivity to the drug is likely the development of a violation of consciousness, hallucinations, psychosis.
Before prescribing any medication, it is recommended to exclude pregnancy. Nursing mothers often do not have a menstrual cycle, but this does not mean that spontaneous ovulation is impossible and pregnancy will not occur. Sometimes a woman knows about a new pregnancy and it is with the aim of preserving her decision to( sometimes controversial) suppress lactation. In this case, the use of Dostinex is prohibited. Moreover, conception is contraindicated within 1 month after taking the pill. It is important to remember that breastfeeding should be discontinued immediately after applying the first dose of the medication. Dostinex affects the ability to drive and to all activities that require concentration. Remembering these side effects, do not take Dostinex at your discretion. Only some cases of suppression of lactation require such a serious intervention, and accordingly only in these cases, the risk will be justified.
In case of medical need to suppress lactation to date, doctors choose inhibitors of prolactin secretion( cabergoline, as it is more effective and easier to tolerate or bromprechtin).If there are contraindications or intolerance to these drugs, it is possible to use sex steroids. What exactly to prefer - the gynecologist solves, relying on the data of examination and ultrasound examination of the genitals. Less side effects of gestagens. Androgens are rarely used. Their function is that, with their use, the dose of estrogens will be less, which means fewer side effects.
Allocations from the breast can be 3 years after the last breastfeeding, as well as after any pregnancy, whatever it ends. Usually milk is secreted by drops when pressing on the nipple. Spontaneous leakage of milk should end after 3-6 months after weaning. If the allocation does not correspond to the given terms, then it is necessary to undergo an examination with the endocrinologist. Sometimes you may need treatment( Shien syndrome, prolactinoma, hypothyroidism).Reduce the allocation can be, reducing the promotion of areola( hard tight underwear, excessive exposure during sex, self-palpation of the nipple).It is necessary to reduce the consumption of products that promote lactation. First of all - beer.
In conclusion, I want to emphasize the importance for the mother and child of the moment of cessation of lactation. In order not to make mistakes, it is necessary to consult a doctor about the necessity and possibility to suppress the formation of milk, together to choose the most suitable method. The cessation of lactation is the natural phase of breastfeeding, which can and should in most cases pass without serious problems. Remember that the health of the mother, including the "female", as well as the health of the child, are jeopardized by unreasonable medical interventions to inhibit breastfeeding. Any impact should preferably be minimized and carried out only under the supervision of a specialist.
Doctor of the endocrinologist Tsvetkova IG