The body initiates lactation regardless of feeding choice, leading to discomfort, engorgement, and leakage when not breastfeeding. The focus must be on safely signaling the body to cease production while managing symptoms to prevent complications. This overview provides practical steps to suppress milk supply and minimize the physical symptoms associated with drying up breast milk.
Why Milk Production Continues
Milk production is a hormonal process triggered by childbirth. During pregnancy, high levels of progesterone and estrogen suppress prolactin. The delivery of the placenta causes these inhibiting hormones to drop rapidly, allowing prolactin levels to surge and initiating copious milk production, commonly known as the milk “coming in.”
This sudden increase in prolactin causes the breasts to become full, heavy, and uncomfortable, often peaking between 48 and 72 hours postpartum. The body normally downregulates production when milk is not consistently removed. Without nursing or pumping stimulation, the supply will eventually stop naturally, but the initial phase involves significant engorgement and leakage. The goal is to manage this hormonal transition to minimize discomfort and hasten the cessation of supply.
Immediate Non-Medical Suppression Methods
Non-pharmacological techniques focus on reducing stimulation and suppressing engorgement symptoms to signal the body to stop production. A firm, supportive bra or binder should be worn day and night to provide consistent pressure, which inhibits milk synthesis and reduces stimulating movement. The garment should be snug but not so tight as to cause pain or skin breakdown.
Applying cold therapy is effective for reducing swelling and numbing pain. Ice packs or frozen vegetable bags, wrapped in a thin towel, can be applied to the breasts for short periods to limit inflammation. Some people find relief by placing chilled, fresh cabbage leaves inside their supportive bra, replacing them when they wilt, as this is thought to draw out fluid and reduce swelling.
Avoid any form of nipple or breast stimulation, as this releases oxytocin and encourages continued prolactin release. When showering, avoid directing warm water onto the chest, as warmth can trigger milk flow and increase engorgement. If the breasts become painfully full, hand-expressing a tiny amount of milk to relieve pressure is acceptable, but excessive removal encourages continued supply.
Pharmacological and Medical Interventions
For managing the pain and inflammation associated with engorgement, over-the-counter pain relievers are the first line of defense. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, reduce both pain and swelling, making the suppression process more tolerable. These medications should be taken as directed to manage discomfort, especially during the peak engorgement period in the first week postpartum.
If non-medical methods are insufficient or lactation must be stopped rapidly, a healthcare provider may discuss prescription options. Dopamine agonists, such as cabergoline, inhibit prolactin release from the pituitary gland, directly suppressing milk production. Cabergoline is often the most effective option, sometimes requiring only one or two doses for successful suppression.
Older medications, such as bromocriptine, and hormone-based treatments like high-dose estrogen, are no longer routinely recommended due to concerns about side effects, including an increased risk of thromboembolism. Any decision to use prescription medication must involve a thorough consultation with a medical professional to weigh the benefits against potential risks.
Identifying and Managing Health Complications
While drying up milk is generally safe, it carries a risk of complications like blocked milk ducts and mastitis, requiring careful monitoring. A blocked duct presents as a painful, localized hard lump or tender spot in the breast tissue, often accompanied by warmth. If a blocked duct is not resolved, it can progress to mastitis, an inflammation that may involve infection.
Mastitis symptoms appear rapidly and are typically systemic, presenting with flu-like symptoms, including a high fever of 101.3°F or greater, chills, and body aches. The breast may show increased redness, swelling, and heat, sometimes in a wedge-shaped pattern. If blocked duct symptoms do not resolve within 24 hours of self-care, or if signs of systemic illness like a persistent high fever develop, urgent medical attention is necessary.