Turns out there’s quite a few of us pregnant chicks on my private message board who struggled with breastfeeding the first time around who are panicking about feeding our second/third kids. A bunch of people are considering formula feeding from the start, (for the record, the majority are planning on trying again, and even some who formula fed from the beginning with the first child are excited to breastfeed the second), and this got me thinking about the drying-up process.
When I switched FC to hypoallergenic formula after exclusively pumping for about 5 weeks, I was overwhelmed and confused by the weaning advice I found online, and even more befuddled by the advice I got from my OB, who told me to just “go cold turkey”. I’d read on Kellymom that this course of action can cause mastitis and plugged ducts, and that it would be far better to slowly wean off the pump, decreasing my pumping sessions and times every few days. On the other hand, I hated pumping by this point, and resented my breasts and all things having to do with lactation (I’ve healed quite a bit since then, but at the time, with the open, festering wound of PPD still ever-present, I wanted to hurl my nursing bras, nipple shields, breast pads and the pump out the window and never look back. Of course, the pump was a rental, and an expensive one at that, so I’m glad I didn’t succumb to this impulse. I expect that this would have been a case of “you break it, you buy it”…)
Ultimately, I decided to go with the OB’s advice. I hunkered down for 2 days of utter hell, stuffed cabbage in my bra, popped some leftover post-oral-surgery Vicodin, and waited. It honestly did take a mere two days – I was still slightly leaky for about a week, but the bad part was over with pretty quickly.
But those two days were more painful than anything I experienced during labor; painful enough to scare me into nursing this time around just so I can avoid the inevitable “drying up” process that I’ll have to endure if I opt to formula feed from the start. Now, I’d built up a considerable supply by 5 weeks; it might be a less arduous process if one didn’t establish a supply in the first place. Knowing the pain of engorgment though, I worry about the new moms who either have to stop breastfeeding a few weeks in, like I did, or who are choosing not to breastfeed. It seems punitive that there isn’t better guidance or medical assistance for these women. And what about those who experience a stillbirth or infant death?
In some countries, medications are still available to assist with lactation cessation. Not in the US. The most common drugs used for this purpose were taken off the market years ago, due to some serious potential side effects. A newer drug, Cabergoline, is now being used in several other countries, but far as I can tell, there is no real call-to-action in the States for a new lactational suppressant. The latent conspiracy theorist in me struggles with the fact that when the old drying-up meds were taken off the market, it was the same time period that breastfeeding advocacy became part of the medical mainstream. I haven’t had the time to do the necessary research into the frequency of the side effects cited as evidence for the “danger” of these drugs; I wonder if statistically, the risk of side effects was any greater than, say, birth control pills or Viagra or weight loss drugs that are still readily available. The consensus in most of the articles (both scholarly and not) I’ve found is that the “natural” way is better; well, duh, but what if a woman wants some extra help? Doesn’t she have that right? Especially in cases where the lactation cessation is tied to a traumatic event?
A great piece from a 2003 issue of Pediatric Nursing (Moore, Debra Busta and Catlin, Anita; Lactation Suppression: Forgotten Aspect of Care for the Mother of a Dying Child. Pediatr Nurs. 2003;29(5) ), focusing on lactation suppression for women who’ve experienced the loss of a child, explains further:
Very little information exists in the literature on lactation suppression for those women who cannot or do not breast feed. In a comprehensive educational review of alternative nutrition with bottle feeding for newborns (PBM Products, 2001), no mention is made of lactation suppression. Spitz, Lee, and Peterson (1998), in a 100-year review of the literature, found nothing new or helpful to induce milk suppression or to treat the pain or discomfort of engorged breasts. Yet a mother who has established a full milk supply through breastfeeding or pumping will need counseling on strategies to diminish her milk production. Under the tragic circumstances of a baby’s death, the mother’s comfort must not be overlooked (Merewood & Philipp, 2001). Abrupt cessation of breastfeeding or pumping may lead to severe engorgement, extreme pain in the breasts, and possibly to mastitis.
Suppression of lactation prior to the 1990s was done with medications that influenced the brain’s directions to the breast regarding milk production, such as parlodel and bromocriptine. These were eventually found to have other brain-related side effects and taken off the market for milk cessation (Stehlin, 1990)…
What puzzles me is that I can’t find much information on this subject, anywhere. There’s plenty of advice for all types of lactation issues, but not getting your milk to dry up safely and with limited pain. Shouldn’t lactation cessation be considered part of post-partum care for those who are not breastfeeding? Especially as an oft-cited study on how breastfeeding reduces the risk of breast cancer mentions that a similar protective effect was conferred to those who took those lactation suppressants which are now considered “too dangerous”, suggesting that there might be something in the abrupt weaning process that is associated with increased cancer risk?
Anyway. I’m rambling. Point is, I’d like to offer some suggestions for those who are facing the “drying up” process with little support or guidance from the medical authorities or Internet Gods.
1. Cabbage is your friend. Seriously. It sounds bizarre, but this old-wives’s tale is a winner. Buy a head of cabbage (the yellow, not the red kind, unless you want to be bleaching stains out of your clothes for the next century), wash and separate the leaves, and throw them in the fridge. Once chilled, stuff leaves in a snug sports bra, covering the entire breast. Remove and replace with new leaves when the old ones are wilted and no longer cold. I did this whenever I was at home, and it helped so much that I wanted to donate to the Cabbage Association of America, if there even is such an organization.
2. Medical sites like MayoClinic.com suggest taking over-the-counter Ibuprofen to help with the pain. I’m not condoning this, but if you happen to have some leftover heavier painkillers in a drawer somewhere from a c-section or other past surgery…. well, all I’m saying is, there’s no reason to be a martyr.
3. A friend mentioned that Sudafed (the real kind that you need to ask the pharmacist to get for you, since kids these days are making it into meth or something. At least they’re paying attention in Chemistry class) can supposedly help. Not really sure about this one, but Kellymom mentions it as well, so it must have some popular literature backing it up.
4. Speaking of Kellymom, check out this article on herbs used to suppress lactation. It’s geared towards those in the weaning process or who have an oversupply issue, but it might be helpful.