Wednesday, January 12, 2011

Drying Up Milk Supply

By Danelle Frisbie © 2011
When a mother loses her baby, her aching breasts can monumentally compound her pain. Some mommas find healing in donating milk to another baby; others need their milk to dry up as quickly as possible to mend a broken heart. Still others find themselves in need of medical treatment that demands dry breasts. This article is dedicated to each of these mothers.

 
cabbage leaves

Peaceful parenting mothers are almost always concerned about increasing (or maintaining) milk supply in a culture that does little to support the normal breastfeeding relationship. However, in the past few months, at least three mamas in the peaceful parenting community have needed to dry up their milk supply as quickly as possible, despite their strong desire to nurse their babies for a normal duration of years. Two were sweet mothers who had their babies taken from them far too early in life (a little one week old son and a two year old daughter). The other woman is a young mom battling aggressive thyroid cancer who must undergo treatment that will "poison" her milk, and with a terribly heavy heart, she must wean her two year old son. In each of these cases, it was helpful for these mothers to have caring friends who could not only offer a listening ear, compassionate heart, and a lot of love during very tough times, but also some supplies to help with the engorgement and added pain that comes when your body longs to continue nursing a baby you can no longer feed.  

Quite honestly, I cannot even fathom the pain of losing a child or being forced to wean early. My desire for these three has been to just hold and cry with them. But after finding that there are not many good go-to places for moms in similar situations, I've decided it is necessary to have a list of ways to help in the drying up process. One mother said that her aching, leaking breasts were terrible constant reminders of the sudden loss of her little girl. She longed to hold and nurse her again, but desperately needed her milk to dry up quickly.

As humans, we generally continue to produce milk for about 45 days after the end of weaning. During natural weaning, many women experience milk secretion for several months or more after their little one has weaned completely. Weaning starts when a baby or child, for the first time, consumes something other than his/her mother's milk, or the human milk from another mother. This 'something other' could be in the form of artificial baby feeds (like formula), another animal's milk, baby 'mush' (homemade or store bought), or first foods self-tasted through baby-led weaning. Weaning concludes when a baby or child has consumed his/her mother's milk (or that of another human mother) for the very last time. Typically the natural weaning process takes place over the course of many years, as it is designed to do among humans. However, when it is sudden - due to the death of a child or illness beyond our control - it may have extremely uncomfortable consequences that can rapidly impact the health of a sudden/early weaning mother (via abscesses, clogged milk ducts, mastitis, etc.). As a result, it is important to have effective strategies for drying up milk.

These techniques and the way they are presented here are *not* for use by mothers wishing to forcibly wean an infant who is nursing on cue and under the age of 24 months. Rather, they are for moms who have lost a nursing baby (either at birth, in infancy, or later childhood) or for mothers who must dry up their milk for urgent health concerns that do not allow for the safe continuation of production.

Drying up milk does not necessarily equate to early weaning. In these later cases (especially if a baby is under the age of 24 months), there are mother-to-mother milk-share programs like Eats on Feets with moms willing to donate milk for free so that human babies continue to get the human milk they need in their first years of life, even if a mother must suddenly dry up her milk supply.

Drying Up Milk Strategies:

manual hand pump

1) Express milk in small amounts with a breast pump or manually

The most effective way to relieve engorgement and encourage fast milk reduction is to borrow or rent a breast pump if you do not already have one (or use manual expression if this works for you) and pump just enough to relieve the pressure. This tells the body that no more milk is needed, which quickly drops supply. Don't attempt to cold-turkey stop nursing/pumping/expressing altogether. Some milk needs to be pumped/expressed in order to avoid clogged ducts, engorgement, abscess and possible infection.

Expressing a small amount (enough to relieve pressure and discomfort) will not prevent your milk from drying up.  Whereas adequate milk removal (completely emptying the breasts often, by a nursing baby or hospital grade breast pump) causes milk volume to stay the same or increase, "inadequate" milk removal with a shelf-bought pump or manual expression causes milk production to decrease.  When small amounts are removed from the breasts, but they are never fully emptied, the body is told that milk is no longer needed, and production ceases.

sage tea
2) Sage tea

Nursing mothers are advised not to drink sage tea - but for those who need to dry up supply, it can be very beneficial. It has been suggested that 2-6 cups of warm sage tea a day for 7 days is capable of dying up milk supply. There are several ways that sage can be consumed:

Tea:

Bring 1 quart of water to a boil and steep 8 teaspoons of dried or fresh sage leaves in the water for 45 minutes, covered. Then strain, add honey and drink.

Dried Herb:

Take 1/4 teaspoon of sage 3 times per day for 1-3 days. The sage can be mixed into vegetable juice (like V-8) or can be added to small food pieces and swallowed - a small bite of sandwich, peanut butter, cheese, etc. If you do not like the taste of sage, add a small amount of sage to the food item and swallow without chewing.

Tincture:

Take 30-60 drops of sage tincture, 3-6 times a day.


3) Jasmine

Research in the Australia New Zealand Journal of Obstetrics and Gynecology applying fresh, crushed jasmine flowers (Jasminum sambac) to the breasts over the course of several days will decrease milk flow. (1)


4) Cold compresses, frozen vegetable bags, or cabbage leaves (nothing hot!) to decrease swelling

Just as warmth increases milk flow, cold temperatures decrease swelling and discourage milk flow. Cabbage leaves work so well for this cause because they are already shaped perfectly to fit over the breasts and under a sports bra.

- Use cabbage leaves chilled or at room temperature, or a cold compress of your choice.
- Wash the leaves (or wrap ice or frozen veggie bags in thin cloth) and apply to breasts between the times you express/pump excess milk.
- Cabbage leaves are nice because they can also be left on the breasts until they wilt (no melting or hardness), and new leaves applied as needed. A comfortable (not tight!) sports bra or nursing bra can be worn over the leaves.

Additional information on using cabbage leaves (2, 3, 4, 5) and links included in reference section below.


5) Avoid hot showers or hot water on the breasts as this stimulates milk flow.


6) Ibuprofen - take as needed to reduce discomfort and inflammation. Be sure to take with a little food or milk, especially if you have a sensitive stomach.


7) No nipple stimulation - do not engage in any activity that stimulates the nipples other than the necessary time to pump/express excess milk and relieve breast pressure/fullness.


8) A good sports bra - use one that will hold the breasts securely but not tightly. You want your breasts, nipples, and lymph nodes to breath. Binding or tight fitting bras and clothing will only increase soreness and swelling and does not decrease milk supply as one old myth suggests.


9) Keep drinking water! Another myth is that decreasing water consumption will decrease supply. This is not true. In fact, reducing your water intake will only lead to dehydration, which in turn increases your risk for a breast infection. So keep drinking lots of water!


10) Hormone Contraception. Although I do not advise this or the use of artificial hormones (especially if you are dealing with an illness already), birth control pills, and especially those containing artificial estrogen, are well known for decreasing milk supply. (6, 7) Hormone contraceptives that regularly decrease milk supply include:

- Combination birth control (Alesse, Yasmin, Seasonale, Mircette, Loestrin, Lo/ovral, Demulen, Desogen, Nordette, Ortho Tri-Cyclen, Triphasil, Norinyl, Ortho-Novum, Ovral, etc.)

- Monthly injections (Lunelle)

- Birth control patches (Ortho Evra)

- Vaginal rings (NuvaRing).


11) Pseudoephedrine (brand name: Sudafed, a decongestant), or phenylephrine, also decrease milk supply, especially when taken regularly (120 mg/day). In fact, Sudafed is especially potent in reducing milk supply in late stage breastfeeding mothers (i.e. those who have already nursed a baby 24 months or more). Pseudoephedrine has been shown to decrease milk supply by 24%, and while similar studies have not yet been done on phenylephrine, its similar compounds suggest relatively equal impact. This is another avenue of decreasing milk production that is not 'natural' and I do not recommend it as a first course, but I include it in this list in an effort to be thorough. (7, 8)

spearmint

12) Various Herbs. Other than Sage and Jasmine mentioned earlier, the following herbs are also known to decrease milk production:

- Peppermint (Mentha piperita)
- Spearmint
- Parsley (Petroselinum crispum)
- Chickweed
- Black Walnut
- Stinging Nettles (not Nettle which has been shown to increase milk supply)
- Yarrow
- Herb Robert (Geranium robertianum)
- Lemon Balm
- Oregano
- Periwinkle Herb (Vinca minor)
- Sorrel (Rumex acetosa)
- Thyme

Sage, peppermint, spearmint, lemon balm, oregano, and cabbage leaves can all be hot or cold pressed into a pressed oil to make massage oils for milk suppression. To be effective, they do not need to be massaged into the breasts, necessarily, but can be used all over.

Peppermint oil has been used traditionally for decreasing milk supply. While peppermint tea is a very weak form of peppermint and it would take very large amounts (quarts a day) to decrease milk supply, some women have reported that consuming a lot of strong peppermint candies (like the Altoids® Curiously Strong Peppermints) has decreased their supply.


It is important to note that no matter a mother's reason for needing to dry up her milk - whether it is due to the loss of a baby, severe illness that needs treatment, or necessary early weaning for reasons beyond her control - her sadness and potential depression may be compounded by the change in hormones that occur when weaning takes place.

Prolactin is one hormone that stimulates milk production and also brings a mother a natural feeling of well-being, calmness and relaxation. Oxytocin is a powerful 'love hormone' that is released while nursing a child. When weaning happens, we find a drop in both prolactin and oxytocin levels. This means that sudden (often unwanted) weaning can take a real toll on a mother's hormones and emotions. The faster the weaning process occurs, the more abrupt the shift in hormone levels will be, and the more likely a mom will experience these adverse effects.

Mothers who are forced to wean before they are ready (or for reasons beyond their control) and those with a history of depression are also more likely to experience depression after weaning. (9, 10, 11, 12, 13) Hormones are very powerful factors in women's (and men's) lives. We have yet to understand all the rolls they play in our bodies and brains, or their intricate influence on human health, behavior, and emotion. Yet, in the cases of early weaning and drying up milk, some of the same strategies that are used for reducing post-partum depression may also help with early weaning depression and sadness. See Combat Postpartum Depression without Medications for some related suggestions. (14)


A poem in honor of peaceful parenting weaning mommas: Wean Me Gently


References:

1) Shrivastav P, George K, Balasubramaniam N, Jasper MP, Thomas M, Kanagasabhapathy AS. Suppression of puerperal lactation using jasmine flowers (Jasminum sambac). Australia New Zealand Journal of Obstetrics and Gynaecology. 1988 Feb;28(1):68-71.

2) Yount, Paula: Cabbage? Why Use It and How Does It Work? Instructions for Use 

3) Newman, Jack: Cabbage Leaves for Engorgement

4) Davis, Marie: Engorgement: The Cabbage Cure

5) Smith, Sandra: Cabbage Leaves for Prevention and Treatment of Breast Engorgement 

6) Guthmann RA, Bang J, Nashelsky J. Combined oral contraceptives for mothers who are breastfeeding. American Family Physician. 2005 Oct 1;72(7):1303-4.

7) Hale, Thomas (2008). Medications and Mothers' Milk: A Manual of Lactational Pharmacology. (Hale's site also located here with information)

8) Aljazaf K, et. al. Pseudoephedrine: effects on milk production in women and estimation of infant exposure via breastmilk. British Journal of Clinical Pharmacology. 2003 Jul;56(1):18-24.

9) Susman VL, Katz JL. Weaning and depression: another postpartum complication. American Journal of Psychiatry. 1988 Apr;145(4):498-501.

10) Berkeley Parents Network: Depression and Weaning
 
11) Highton, Brylin. Weaning as a Natural Process. Leaven. December 2000-January 2001; 36(6):112-114.

12) Trad PV. The emergence of psychopathology in a previously adaptive mother-infant dyad. American Journal of Psychotherapy. 1990 Jan;44(1):95-106.

13) Bering, Jesse (2009) Breasts in Mourning: How Bottle-Feeding Mimics Child Loss in Mothers' Brains.

14) KellyMom: Combat Postpartum Depression without Medications 


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29 comments:

  1. My heart goes out to those mamas. My sister had a still birth a week before Christmas, and after years of being an advocate for boobs, hadn't the foggiest of how to decrease milk supply. In addition to the pain of the loss, there is the added physical pain of engorged and bound breasts.

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  2. Sadly this information is needed very often, but not easily available to those who need it. When my son was stillborn at 41 weeks, my milk coming it just added insult to injury. The only advice I was given by the nurse at the hospital was to wear a sports bra and bind myself tightly with a gauze. My sister in-law new about the cabbage and brought some to the hospital. I can just remember sobbing as my husband wrapped my chest in gauze, A constant reminder I had no baby in my arms to nurse. SO, thank you for giving more options to those who need it.

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  3. I'm glad to read that it would take a LOT of peppermint tea to mess with milk supply. I loooooove peppermint tea, but I've been avoiding my nightly cup because I'm afraid of messing with my supply! Maybe I'll drink one cup every other day :)

    Or, better yet, I could just get one of those yummy nursing mothers teas and indulge to my heart's content!

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  4. Thanks for this post, I know it will help Mama's in need.

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  5. I'm confused about the difference between nettle and stinging nettle. Stinging nettles ARE nettle so what would a generic "nettle" be?

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  6. thank you so much! you are such a beautiful person and are always here for me when i need you. thanks for taking time for this. it was very helpful.

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  7. With all 3 of my children, I ended up with illnesses that caused me to not be able to continue to breastfeed. They were all temporary things (severe infections, once in my kidneys, both other times in my uterus) so I hoped to "pump and dump" while I healed and continue after the medications were out of my system. This unfortunately did not work. No matter how hard I tried, my milk dried up. So while the situation was a bit different, I understand all to well how heartbreaking it is to be forced to stop nursing too soon.

    Thank you for the excellent information.

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  8. So thankful to have found your information. I am being forced to abruptly stop do to health issues and it breaks my heart. My daughter is 10 months and I never thought I would have to stop this soon or this quickly. This is day 2 for me and my emotions are rolling, but it is comforting to find some good advice.

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  9. Thank you for this. One week ago I lost my baby girl. She was eight weeks old and was born with a severe heart defect. I pumped from birth with the hope of one day feeding her my milk. Now the more than 800 ounces will go to help other babies whose momma's can't give them humanmilk.

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    Replies
    1. ❤ so much love to you. I cannot imagine the pain you're enduring right now, but just wanted to thank you on behalf of all those babies whose lives you will impact, and let you know a stranger out there is thinking of you. (((hug))) ❤

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    2. Oh, momma. I just read this and it's not even one month later yet, but love and light to you.

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    3. Love and thoughts are with you, my daughter was also born with a heart defect and went through a procedure at one week old. I'm deeply sorry for your loss.

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  10. Thank you for sharing this information. My second child was stillborn and when my milk came in a couple of days later, it simply reminded me that I had no baby to feed. Looking back, I wish I could have pumped and given my milk to babies that needed it but at the time, I just wanted my milk to dry up as soon as possible.

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  11. A friend of mine told me that there are also very valuable homeopatic "drugs" that could be taken in this case. I am sure that almost any other alternative medicine like accupunture etc. would offer a solution in their tradition. Just to show two more possibilities.

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  12. Thank you for this information. I just lost my 7mo son and although I initially desired to express milk for donation, my daily tasks are already so many that I must encourage my breasts to dry up.

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  13. Thank you so much for this. Im at a complete loss since being told i would have to stop breastfeeding since Im pumping blood from the left since and 3 rounds of tests show nothing and i was told i needed to dry up so they can start the next round of tests to seeing they can find the tumor they believe is hiding in there.

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  14. Does anyone know how long it may take to dry up milk when using sage tea (No More Milk Tea)? I experienced a stillbirth 1 week ago and now my breasts are so full and painful. Also, will expressing just a little help the drying up process? Advise would be great! Oh by the way i read this article when it came out in Jan. thinking to my self I hope I never need that and here I am seeking advise on just this...Thank you for this info!

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  15. Thank you! After 4 1/2 months or trying desperately to make breastfeeding work I have to stop. My daughter has food allergies and even after eliminating dairy, soy, wheat, eggs, nuts, and sea food it was just not enough. I EBF my son for 12 months and I'm so sad to have to stop breastfeeding now, so early, when she's so young. It breaks my heart.

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  16. I have just lost my baby - I don't want my milk to dry up, I had to express as he was ill and had to be fed by NG tube - expressing full time was a battle - I can't give up my supply its what is holding us together, thats what it feels like. What about us - the mums who can't face losing their milk as well as their baby?

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    1. heartbreaking. i lost my baby in December, and think you are so brave for wanting to still experience milk production. there are many families seeking donations that would be so thankful for your courage.

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    2. I am so sorry for the loss of your sweet little baby boy. If you want to keep pumping, I don't see any reason not to as long as it brings you a little bit of comfort. Donating to mamas in need would be a wonderful way to honor your son's memory.

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    3. I'm so sorry! There is no hurry. You can keep your milk supply for as long as you wish to. Although you feel you have lost him he will always be with you in your heart and your body will always be changed by the journey you shared with him when you were pregnant. I wish I could take your pain away. Maybe its too soon to think about it but one day you could consider donating some of your precious milk? All my love xxxx

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    4. I am so, so sorry. <3

      Another mom I read about here felt the same way and kept pumping and gave her milk to other babies who needed it: http://www.drmomma.org/2011/09/from-despair-to-donation-mother-loses.html

      It's not the same, and nothing can make the pain less, but maybe it would help in some way? All my love.

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  17. I'm so sorry, I know there is nothing I can do or say to make you feel better, but I'm sending you my love and I will pray for you....

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  18. Oh my God,I'm so sorry for your loss!You're so brave considering of doing this...Your in my thoughts...

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  19. I have also just lost my baby girl on 3rd May, aged 21 days. It was very sudden and unexpexted she seemed perfectly healthy. my situation is a bit different as I aalready have a 2.5 year old little boy who is still breastfeeding. I don't want to wean him as he still feeds a lot and I don't think he is ready (I think he was dry nursing a bit in pregnancy as well so think it would be very tough to get him to stop anyway). But I am also plagued by thoughts and reminders that this is my little newborn's milk and although too soon I do think I want to conceive again and am panicking as have just turned 35 and worried about fertility dropping. It took 19 months for my periods to return last time. And then what if I don't have another baby this will be the end of my nursing relationship and I don't want to end it if so. I am in UK and I think bf rates are lower here than US so it is proving impossible to find anyone who has been in similar situation or even get any professional advice.

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  20. melatonin used as a sleep aid supplement will help dry up milk pretty quickly! I found out accidently by taking while nursing.

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  21. Thank you so much for this article. I just lost my second baby in a year at 16 weeks. Having the milk come in is pure torture - it makes you fall in love with a baby that you cannot hold. This time, I am hoping to avoid some of that stress by proactively taking sage and lemon balm tea. Maybe I can spare myself this one thing. Anything would help.

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  22. Im so sad for all of the mothers who have lost babies.



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