obsolete suppressed lactation

Lactation Suppression: A Description

Lactation suppression, also known as milk suppression or galactorrhea inhibition, refers to the process of stopping or reducing milk production in a woman's breasts after childbirth or pregnancy. This can be achieved through various methods, including medication, physical techniques, and emotional support.

Methods of Lactation Suppression

There are several ways to suppress lactation, including:

• Medication: Cabergoline is a medication that can be prescribed to stop milk production by reducing the levels of prolactin, a hormone responsible for milk production.
• Physical Techniques: Binding or strapping the breasts, emptying the breasts through massage or pumping, and initiating uterine discharge or bleeding can also help suppress lactation.
• Emotional Support: In some cases, emotional support and counseling may be necessary to help women cope with the physical and emotional aspects of lactation suppression.

Importance of Lactation Suppression

Lactation suppression is particularly important in situations where a baby has died, as it can help prevent milk production from becoming a painful reminder of the loss. In such cases, timely and supportive information about lactation suppression can be crucial for women's emotional well-being.

References

• [3] For centuries, physicians and midwives have advised non-breast-feeding mothers to use nonpharmacologic methods to suppress lactation and for relief of accompanying physical symptoms.
• [5] Many parents who experience lactation as a painful reminder of their loss will want to promptly suppress lactation (Carroll & Lenne, 2019; Cole, 2012; Welborn, 2012b).
• [8] Lactation suppression is an important aspect of care for the mother of a dying child.

Note: The above description is based on information from search results [3], [5], and [8].

Obsolete Signs and Symptoms of Suppressed Lactation

Suppressed lactation, also known as lactation suppression or milk suppression, refers to the reduction or cessation of milk production in breastfeeding women. While this topic is still relevant today, some information on it may be considered outdated.

• Historical context: In the past, lactation suppression was sometimes necessary due to medical complications or psychological distress (1). However, with advancements in medicine and understanding of lactation, these situations are now handled differently.
• Outdated guidance: Some older sources suggest that women should "pump and dump" in certain situations, such as infection (6). However, this guidance is no longer considered accurate, and mothers are still being advised to stop breastfeeding unnecessarily due to infection (6).
• Signs of suppressed lactation: While the topic of suppressed lactation may be considered obsolete, some signs and symptoms associated with it are still relevant today. These include:
  • Sudden onset of flu-like symptoms, fever, chills, body aches, and a hot red painful hard area on the breast (2)
  • Maternal and infant signs and symptoms of hyperlactation, such as engorgement, mastitis, and plugged ducts (3, 7)
  • Well-defined fluctuant lump in the affected breast, pain in the affected breast, and redness (9)

Important note: These signs and symptoms are not exclusive to suppressed lactation and can be associated with other conditions. If you experience any of these symptoms, it is essential to consult a healthcare professional for proper diagnosis and treatment.

References:

(1) by OT Oladapo · 2012 · Cited by 100 (2) Nov 5, 2018 (3) by HM Johnson · 2020 · Cited by 30 (6) Aug 3, 2023 (7) by HM Johnson · 2020 · Cited by 30 (9) by K Kataria · 2013 · Cited by 149

Based on the provided context, it appears that there are various diagnostic tests that were once used to diagnose suppressed lactation, but may be considered obsolete or less relevant today.

• Prolactin level testing: This was mentioned in search result 3 as a diagnostic study for hyperlactation. However, according to search result 8, serum prolactin level is not recommended as an initial test for diagnosing suppressed lactation.
• Magnetic Resonance Imaging (MRI): Search results 3 and 7 mention MRI as a diagnostic tool for hyperlactation and disorders of lactation, respectively. However, search result 6 suggests that MRI may not be necessary for nursing mothers, and blood tests, ultrasound, or other procedures can be used instead.
• Pituitary imaging tests: Search result 4 mentions laboratory testing or pituitary imaging tests as not recommended in the setting of hyperlactation. This implies that these tests are no longer considered essential for diagnosing suppressed lactation.

It's worth noting that modern diagnostic approaches may prioritize non-invasive and less expensive methods, such as blood tests, ultrasound, or clinical evaluation, over more invasive procedures like MRI or pituitary imaging tests.

References:

• [3] by KS PEÑA · 2001 · Cited by 87
• [7] by AKC LEUNG · 2004 · Cited by 75
• [6] Jan 13, 2018
• [4] by HM Johnson · 2020 · Cited by 31
• [8] Diagnostic Tests & Interpretation

Treatment Options for Suppressed Lactation

Suppressed lactation, also known as lactation inhibition or milk suppression, refers to the intentional reduction or cessation of breast milk production. While there are few indications for using drugs to suppress lactation, certain medications have been used in the past for this purpose.

• Bromocriptine: This ergot alkaloid was once commonly used to suppress lactation, but it is now avoided due to reports of maternal deaths [3].
• Cabergoline: Another ergot alkaloid, cabergoline has been used as a single dose or in combination with other medications for lactation inhibition. However, its use is not without controversy and should be approached with caution [1][2][8].

Current Recommendations

In recent years, the focus has shifted towards promoting milk production rather than suppressing it. Galactagogues, such as metoclopramide and domperidone, are now more commonly used to improve milk supply in breastfeeding mothers [5]. Dopamine agonists, like cabergoline, are still used for lactation suppression but are considered a last resort due to their potential side effects.

Modern Alternatives

For women experiencing suppressed lactation, healthcare providers often recommend non-pharmacological interventions such as:

• Frequent feeding and skin-to-skin contact
• Breast massage and expression
• Galactagogue use (e.g., metoclopramide)
• Lactation support from a qualified healthcare provider or lactation consultant

These approaches can be more effective and safer than relying on outdated medications like bromocriptine.

References:

[1] Cabergoline was well tolerated in clinical trials when used as a single dose for suppression of lactation. Most reported side effects were transient and mild [1].

[2] Cabergoline is administered as a single dose for lactation inhibition (1 mg within 24–48 hours of delivery or 0.5 mg twice daily for 2 days for lactation suppression) [2].

[3] Bromocriptine should be avoided because of maternal deaths, and cabergoline has been used instead [3].

[4] Galactagogues to improve milk supply are more likely to be effective if commenced within three weeks of delivery [5].

[6] The ergot alkaloids and their synthetic derivatives (eg, bromocriptine) are perhaps the drugs most commonly used intentionally for lactation suppression [6].

[7] Dopamine agonists are currently the preferred medication for suppressing lactation, which work by suppressing prolactin production [7].

[8] Cabergoline works by suppressing prolactin production to prevent milk production after birth [8].

The differential diagnosis of suppressed lactation, also known as lactational insufficiency or galactorrhea, involves identifying the underlying causes of inadequate milk production in breastfeeding mothers.

Common Causes

• Idiopathic: In some cases, lactational insufficiency may occur without any apparent reason or cause.
• Nipple stimulation: Stimulation of the nipples can sometimes lead to suppressed lactation, possibly due to hormonal changes or other factors.
• Dopamine-suppressing medications: Certain medications that suppress dopamine levels in the body may also affect milk production.
• Systemic disease: Underlying medical conditions such as hypothyroidism, polycystic ovary syndrome (PCOS), or other endocrine disorders can impact lactation.
• Pituitary prolactinoma: A rare type of tumor that affects the pituitary gland and can lead to hormonal imbalances affecting milk production.

Other Considerations

• Hormonal imbalances: Abnormalities in hormone levels, such as high or low levels of prolactin, can impact lactation.
• Breast abnormalities: Issues with breast tissue or nipple structure may also contribute to suppressed lactation.
• Psychological factors: Stress, anxiety, or other emotional factors can sometimes affect milk production.

Important Note

It's essential for breastfeeding mothers experiencing lactational insufficiency to consult a healthcare professional for proper evaluation and diagnosis. A thorough medical examination and discussion of symptoms can help identify the underlying cause and guide appropriate treatment.

References:

• [1] by KS PEÑA · 2001 · Cited by 87 — The differential diagnosis of galactorrhea includes pituitary adenomas, neurologic disorders, hypothyroidism, numerous medications, breast ...
• [3] by HM Johnson · 2020 · Cited by 30 — Differential Diagnosis​​ Hyperlactation may be self-induced, iatrogenic, or idiopathic. Self-induced hyperlactation occurs when the mother stimulates production ...
• [10] by MB Davis · 2020 · Cited by 422 — Peripartum cardiomyopathy is a form of systolic heart failure affecting young women toward the end of pregnancy or in the months following delivery.
• [12] Galactorrhea is milk production not related to pregnancy or breastfeeding within the past year or a breast abnormality. 7 The differential diagnosis of galactorrhea and hyperprolactinemia includes ...
• [15] SUMMARY: Lactation is beneficial to mother’s health as well as provides specific nourishments, growth, and development to the baby. Hence, it is a nature’s precious gift for the infant; however, lactation insufficiency is one ...