Rarely by choice, there are unfortunate times when lactation cessation becomes urgent. During such emotionally charged times, it is imperative that mom remain acutely aware of her own breast health while seeking to halt lactation. Abruptly altering any prior milk expression schedule can lead to breast engorgement, which left unchecked can develop into mastitis. Below is a plan of action to bring milk production to an end while guarding against engorgement.
- Affect the Supply. Mom should speak with her primary care doctor or OB/GYN about possible pharmaceutical options to negatively affect her milk supply. Hormonal birth control, bromocriptine, and the over-the-counter decongestant pseudoephedrine have all been shown to negatively affect milk production. There is also significant data that certain herbs, including peppermint and sage, may negatively affect milk supply (but should not be used during pregnancy).
- Release the Pressure. Until milk production begins to wane, keep breasts full. While empty breasts make more milk, full breasts signal the body to slow production. Unfortunately, full breasts also place mom at risk for engorgement. Mom should express just enough milk to relieve the pressure in the breasts, without emptying the breasts. Do not express milk on any sort of schedule but express milk only when the pain threshold or comfort level dictates. Hand expression is ideal during this time. As one hand expresses the milk, the other hand should be used to gently massage any lumps or bumps that may develop by moving in a downward motion towards the nipple.
- Address the Pain. Mom should discuss the options for pain relief with her primary care doctor or OB/GYN. For direct relief, try placing chilled cabbage leaves over the breasts and inside the bra. They may be used as frequently as needed and changed once wilted. Ice packs can also be used, but do not apply heat to the breasts; heat is counterproductive to lactation cessation.
- Breast Support. Wear a light-support sports bra. The extra support will accelerate cessation by constricting the breasts and assist with the pain by providing extra support for the fuller, heavier breasts. When abruptly ceasing lactation, do not wear underwire bras. The underwire can add unwanted pressure to areas of the full breast, exacerbating the risk of clogged ducts which can lead to mastitis.
- Stay Dry. Leaking milk is a normal part of lactation and will happen with greater frequency as lactation is brought to an abrupt end. Wear breast pads inside the bra and change frequently to guard against yeast infections.
In situations where lactation is unable to come to a natural end, self-monitoring is the key to breast health and it is recommended that lactation cessation be done only in conjunction with and under the care of a qualified lactation consultant. It should also be noted that abruptly ceasing lactation following pregnancy will not impact lactation during future pregnancies.