Community Forum: General Discussion
Use this forum to discuss matters of interest to lactation professionals.
Suppressing lactation
Posted 11th Nov 09 By Anne Burton
I was wondering what was the current feeling was about Bromocriptine Mesylate to suppress lactation? I have a mum who has been prescribed it at just 3 weeks postpartum after she decided that she had poor supply and was going to wean her baby. My concern is that she suffered with hypertension in pregnancy and is still taking Labetalol 100mg twice daily. She was told to take Bromocriptine 2.5mg twice daily and "not to touch her breasts". I thought that while this drug decreased Prolactin and therefore reduced milk supply, there are too many risks and side effects for the new mum. I also thought it was contraindicated when taking any hypertensive drug. Anne
Re: Suppressing lactation
Posted 11th Nov 09 By Denise Fisher
That does sound like a very 'brave' decision on behalf of the prescriber, at the mother's potential expense.
There have been very serious side-effects identified with bromocriptine and many countries throughout the world have withdrawn 'lactation suppression' as a reason it may be used, and the manufacturers likewise no longer recommend its use for this reason. The mother in question appears to be in a high risk category too.
Prolactin-inhibiting drugs (dopamine receptor agonists) for lactation suppression, if there is any indication at all for their use (and that's debatable considering their side effects and that natural suppression is side-effect free and very effective), are really only useful when administered before the milk comes in (lactogenesis II).
At 3 weeks postpartum it will no longer be effective. If the mother does have low supply anyway she's not likely to suffer greatly from engorgement when milk removal ceases and lactation suppression should occur fairly quickly and without problems if managed naturally.
Definitely a reason for concern Anne. I suggest you gather some information together to give or post to the prescribing doctor. It's probably too late now to do anything for this mother but if not, perhaps a phone call to her doctor after you've supplied the information may be in order.
Fingers crossed that she will be OK.
Denise
There have been very serious side-effects identified with bromocriptine and many countries throughout the world have withdrawn 'lactation suppression' as a reason it may be used, and the manufacturers likewise no longer recommend its use for this reason. The mother in question appears to be in a high risk category too.
Prolactin-inhibiting drugs (dopamine receptor agonists) for lactation suppression, if there is any indication at all for their use (and that's debatable considering their side effects and that natural suppression is side-effect free and very effective), are really only useful when administered before the milk comes in (lactogenesis II).
At 3 weeks postpartum it will no longer be effective. If the mother does have low supply anyway she's not likely to suffer greatly from engorgement when milk removal ceases and lactation suppression should occur fairly quickly and without problems if managed naturally.
Definitely a reason for concern Anne. I suggest you gather some information together to give or post to the prescribing doctor. It's probably too late now to do anything for this mother but if not, perhaps a phone call to her doctor after you've supplied the information may be in order.
Fingers crossed that she will be OK.
Denise
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